What is Ulnar Neuropathy?

Ulnar neuropathy is dysfunction of the ulnar nerve, the nerve responsible for providing sensation to the outside of the lower arm and the exterior portion of the hand. People with this neurological condition experience numbness, pain, and tingling in areas supplied by the ulnar nerve. The onset is often slow, and the sensations can increase in intensity over time. Treatment options vary, depending on why the neuropathy developed in the first place.

This condition is also sometimes called “handlebar palsy.” It happens when the ulnar nerve is damaged and can no longer send signals appropriately. Most commonly, this is the result of compression in the elbow, as the nerve passes through the elbow on its way down the arm. The nerve can also become inflamed, mixing signals sent along its length in response to strain, infection, or systemic inflammation. Direct trauma to the nerve such as entrapment in a crush injury or a sharp blow can also cause nerve damage.

People with ulnar neuropathy can feel numbness, tingling, and burning. Weakness is usually common, and sometimes people lose sensation altogether. A neurological exam will show changes in sensation in this area. Medical imaging studies can be used to look for inflammation, as well as impingement in the elbow joint. This evaluation will provide a neurologist with important diagnostic information to use in treatment.

Rest is often recommended for ulnar neuropathy, to give the nerve a chance to recover from inflammation and irritation. Medications may be prescribed and ice or heat can be used to address pain and swelling. Some patients benefit from splinting to support the arm while the nerve heals. Gentle physical therapy can also help people regain sensation in their arms. Changing sleep position can also sometimes help, as many people curl their arms up during sleep, and this can make inflammation of the ulnar nerve even worse.

If these conservative options for treating ulnar neuropathy do not work, surgery is available. Surgery is usually recommended when the nerve is being pinched and the pressure can be relieved to make the patient feel more comfortable. If there is no clear physiological cause for the problem, surgery may not be beneficial, as it is possible that the surgery will not address the issue. After ulnar neuropathy surgery, people will need to go on a physical therapy regimen to rebuild strength in the arm before they can engage in normal activities. Potential complications of surgery can include infections and nerve damage.