The ulna nerve runs around the inner aspect of the elbow, down along the forearm and through the wrist to provide feeling over the little and ring fingers and control the small muscles of the hand.
The ulna nerve can be entrapped, most commonly around the elbow but also at the wrist. Nerve entrapment at the elbow is known as “cubital tunnel syndrome”. This can lead to tingling and numbness in the little and ring fingers and even weakness of the small muscles of the hand. People may describe dropping objects or a loss of grip strength.
Mild or intermittent symptoms can be treated without surgery. Often patients describe worse symptoms at night as people sleep with their elbows bent, which increases the pressure on the nerve. Patients often describe waking in the night and having to shake their arm “awake”. Advice is given to sleep with straighter elbows. A towel around the elbow can be a simple homemade solution but in some cases a night splint can be made.
Patients who have persistent symptoms, or any evidence of muscle weakness, should undergo nerve conduction testing (electrical tests of the nerves in arm) to confirm the site of entrapment and the severity of the problem.
Surgery then may be required to take the pressure off the nerve and prevent further deterioration of symptoms and give the nerve the best chance of recovery. Surgery depends on symptoms and whether or not the nerve is tending to slip out of its groove. The surgery either simply releases the nerve at the elbow or transposes (moves) the nerve in front of the elbow. This will be discussed with you at your consultation.