Ulnar Nerve Entrapment – Tunnel of Guyon Chandler AZ
Ulnar nerve entrapment is characterized by numbness, tingling, weakness, or a lack of coordination in the little and ring fingers. People often feel like these two fingers are not working as they should.
This feeling tends to worsen with repetitive activities and movements that require coordination like playing the piano, knitting, typing, or working with their hands. The amount of pain or tingling tied to this condition varies person-to-person. In some people, it can be quite intense, while others feel a slight tingling sensation similar to when they bump their “funny bone.” The ulnar nerve runs down the arm and behind the elbow as it travels to the hand. Striking your elbow on a hard surface triggers the same reaction of pain, numbness, and tingling in the fourth and fifth digits because it is compressing the ulnar nerve and the pain receptors travel to the two fingers.
Some people mistakenly misdiagnose ulnar nerve entrapments as carpal tunnel or thoracic outlet syndrome because these conditions also have pain, numbness, weakness, or lack of coordination. However, carpal tunnel syndrome affects the thumb and next two fingers. Meanwhile, thoracic outlet syndrome will affect the entire hand and all the fingers. The ulnar nerve specifically controls the ring and little finger, which is why any compression in the ulnar nerve only results in problems only in these fingers.
Tunnel of Guyon syndrome is the entrapment of the ulnar nerve around the wrist and palm of the hand. The tunnel of Guyon runs between the two wrist bones and ligaments. This condition is common when a person leans on their elbow or hand on a hard surface for prolonged periods of time. It also occurs with jobs that utilize power tools or heavy machinery. Use of tools and equipment with vibration, pushing,or pulling increases the likelihood of injury near the ulnar nerve. Prolonged compression damages the muscles, tendons, and ligaments, producing swelling and edema; this compresses the nerve and causes the symptoms mentioned. Near the wrist, the ulnar nerve travels in a very distinct path between two bones. Irritation of the muscles and tendons creates mild swelling and edema. The repetitive nature of some work or recreational activities injures and aggravates the tissue, resulting in injury.
Treatment for any nerve entrapment works to reduce pain, inflammation, and irritation that is compressing the nerve. At the wrist, we utilize several modalities including heat, ice, electric therapy, cold laser, or ultrasound to decrease inflammation and increase blood flow to accelerate healing. Graston technique, active release technique (ART), and massage therapy address the wrist flexor muscles that may contribute to ulnar nerve entrapments. The muscles surround the ulnar nerve, and muscle spasms contribute to the “nerve squishing.” Muscle treatment therapies decrease spasms and increase flexibility while accelerating overall recovery times. Treating the forearm muscles also reduces the likelihood of reoccurrence.
Home treatment involves wrist and hand braces to decrease stress and strain on the hand and ulnar nerve. Braces restrict hand movements, allowing the area to rest and recover. The braces also limit direct compression on the ulnar nerve to further allow the area to heal. Overall cubital tunnel and Tunnel of Guyon nerve entrapments at the wrist can be treated with conservative therapy treatments. In severe cases injections or surgical interventions may be required but this is less likely with early and proper conservative treatment.