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The ulnar nerve is one of the three main nerves in the arm and can become entrapped at several places along the course.
Ulnar neuritis, also known as ulnar neuropathy or cubital tunnel syndrome, is a condition characterized by compression or irritation of the ulnar nerve, and the most common site of entrapment is at the elbow. This condition is the second most common entrapment neuropathy of the upper extremity after carpal tunnel syndrome [Mondelli et al 2005; Caliandro et al 2012; Elhassan & Steinmann, 2007; Cambon-Binder, 2021; Carter et al, 2016].
Ulnar nerve inflammation,
also known as ulnar neuropathy, typically presents with a range of
symptoms that reflect the nerve's sensory and motor functions. Common symptoms include numbness and tingling in the hand and fingers, and patient can have the sensation that the little finger and ring
fingers are falling asleep.
The primary symptoms include:
Sensory disturbances: Patients often experience numbness, tingling, or dysesthesias in the fourth and fifth digits (ring and little fingers). This can extend to the ulnar side of the hand and forearm [Elhassan & Steinmann, 2007; Carter et al, 2016; Yalcin et al, 2015].
Motor deficits: There may be weakness in the intrinsic muscles of the hand, particularly those innervated by the ulnar nerve, such as the abductor digiti minimi and the first dorsal interossei muscles. This can lead to a reduced grip strength and difficulty with fine motor tasks [Elhassan & Steinmann, 2007; Yalcin et al, 2015; Huang et al, 2004].
Pain: Pain is commonly reported along the ulnar aspect of the forearm and elbow, often exacerbated by elbow flexion or pressure on the cubital tunnel [Carter et al, 2016; Clark, 1979].
Muscle atrophy: In chronic cases, there may be visible atrophy of the hypothenar eminence and the interosseous muscles of the hand [Huang et al, 2004; Clark, 1979].
The outcomes and success rates of various treatment options for ulnar neuritis vary depending on the severity of the condition and the specific treatment modality used. In most cases, symptoms of ulnar neuritis can be managed without surgery.
Activity modification and splinting: Rigid night splinting combined with activity modification has shown high success rates, with 88% of patients avoiding surgery and significant improvements in symptoms and functional scores [Shah et al, 2013]. Patients should avoid activities that exacerbate symptoms, including:
Avoiding activities that require you to bend the arm for prolonged periods of time.
Avoid leaning on the elbow.
Keeping the elbow straight when you are sleeping. This can be done with a brace that keeps the elbow straight.
Injections:
Non-surgical treatments are effective for mild to moderate cases and can help avoid surgery, but in severe cases or when non-surgical treatments fail surgical treatments have a high success rates