What does the ulnar nerve do and where does it come from?
The ulnar nerve originates from the lower part of the neck, passes under the shoulder, runs down the inside portion of the arm, and into the 4th and 5th fingers of the hand. The nerve sits very close to the surface around the elbow and can be palpated near the ‘funny bone’, a small bony groove on the inside of your elbow. It can be a very sensitive area to touch and can even send sharp pain or pins and needles down the arm if you unintentionally bump the elbow.
The ulnar nerve is responsible for controlling muscles around the wrist, little fingers, and even contributes to movement of the thumb. The ulnar nerve also allows us to interpret touch and sensation in the same areas.
What causes nerve pain or damage?
Neuropathy is a term used to describe damage or injury to a nerve within the body. The injury could be the result of a traumatic incident, infection, underlying medical diagnoses, e.g diabetes, compression, or an inflammatory response. Traumatic injuries usually result in more serious damage and may be medically or surgically managed. Physiotherapists tend to see nerve injuries that are the result of entrapment causing compression or inflammation.
The term ‘peripheral neuropathy’ indicates that the damage or injury to the nerve is occurring outside of our brain and spinal cord. In other words, the injury is located somewhere along the nerve pathway, most commonly seen in the arms and legs.
Entrapment of the ulnar nerve is when the nerve gets compressed or ‘pinched’ from surrounding structures such as muscle, tendon or bone. It can occur anywhere along the nerve pathway but most commonly at the location of the elbow. This injury is also known as cubital tunnel syndrome. Less common sites for entrapment are under the collarbone or the lower portion of the neck.
What does it present like?
People usually present with a gradual onset of symptoms in the wrist and little fingers. They may report a change in physical activity, e.g an increase in sports involving the upper limb, increased use of the hand and wrist, or have a history of neck pain.
Common symptoms include:
Pins and needles
A burning or sharp sensation
Loss of control or dexterity in the fingers and wrist
Increased sensitivity to touch
Muscle atrophy (severe cases)
Symptoms are usually aggravated by activities causing excessive strain or stretch on the neural tissue. Nerves often respond poorly to aggressive stretching and symptoms can worsen if movements are not modified or avoided for short periods of time.
Am I at risk?
The exact cause of compression or injury is usually unknown but there are some factors that may put individuals more at risk of developing an ulnar nerve injury. Prolonged periods of pressure at the elbow, history of fracture or dislocation, sports or activities involving repetitive flexion of the elbow, increased stress or pressure at the risk, swelling or fluid around the joint, and age related degenerative changes are some of the factors that may be linked to ulnar nerve injuries.
Do I need to be worried about long term damage?
In most cases, no. Like all injuries however, nerve injuries can range from minor to severe. The majority of injuries are caused by minor irritation that may resolve in a number of days or weeks. Other injuries can be more severe and may require weeks to months to improve with management. If your nerve injury is on the more serious side, it is likely you will be referred to a specialist for review and possibly more invasive management.
What can physiotherapy do to help manage my nerve injury?
Physiotherapy plays an important role in managing minor to moderate neuropathies that will respond well to conservative treatment. Interventions may include short term modification of activities or sport, short term use of anti-inflammatory or pain medication, nerve specific mobility exercises, manual therapy techniques and general exercise prescription.
Bracing or splinting may be appropriate in some cases, this will be determined upon assessment. Be assured, your physiotherapist will guide you through the perfect balance of offloading and mobilising to ensure a full recovery.
We recommend that you seek advice as early as possible if you are experiencing symptoms of pain, change in sensation, or loss of muscular control at the wrist or elbow. Early treatment often leads to quicker recovery and less severity in symptom progression.
Come and see us at Melbourne Sports Physiotherapy if you think you are someone who needs help in managing your nerve pain or injury!
How can we help you?
At Melbourne Sports Physiotherapy our goal is to get you moving pain free as soon as possible.
But, we also want you to actually move better and live a healthier, more active and fulfilling life!
If your sports, fitness training or work has been wearing your body down, book in with one of our expert massage therapists so we can help you reduce your pain or stiffness.
If you are showing some signs of this condition or simply want help prevent this from happening in the future then book in with one of our highly experienced Remedial Massage Therapists today!