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Ulnar Tunnel Syndrome of the wrist

Extensive Care

What is ulnar tunnel syndrome?

Ulnar tunnel syndrome occurs when the ulnar nerve is compressed at the wrist.

The ulnar nerve is one of the three main nerves that provide feeling and function to the hand. It travels from your neck down into your hand, and can be constricted in several places along the way.

While bones and muscles protect many nerves in the human body, the ulnar nerve is not so well protected and is therefore at more risk of injury.

What are the symptoms of ulnar tunnel syndrome?

Symptoms develop gradually. Weakness  particularly on the little finger side of the hand are usual signs of ulnar tunnel syndrome. The degree of weakness and numbness depends on the location of the pressure point especially when you wake up. Pain may or may not be present.

As the syndrome progresses, it may become more difficult to open jars, hold objects, or coordinate the fingers during such tasks as typing or playing a musical instrument.

Causes of ulnar tunnel syndrome of the wrist

The most common cause of ulnar tunnel syndrome is a soft tissue tumor, usually a benign (noncancerous) cyst called a ganglion which originates from the wrist joint.

Other frequent causes are arthritis and repetitive trauma or chronic pressure applied to the area of the hand.

Chronic pressure can occur in the hand of a weightlifter and a bicyclist against the handlebars.

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Evaluation and diagnosis

Your doctor will begin by taking your medical history and performing a physical exam. They’ll examine your elbow, wrist, and hand. Your doctor may also do a simple test to see if you feel tingling after tapping on your ulnar nerve and dryness or spots where the muscle is weak.

Your hand and wrist specialist may order the following tests:

These imaging tests can help your doctor diagnose ulnar tunnel syndrome and rule out the possibility of another medical problem causing your symptoms.

Personalized treatment of ulnar tunnel syndrome

Kienbocks disease

Since many ulnar tunnel syndrome cases are caused by ganglions or cysts, surgery is necessary to remove them and treat the condition. However, other causes of ulnar tunnel syndrome may be treated with nonsurgical options.

Nonsurgical options are safer, faster, and easier, but they may not be as effective.

Nonsurgical options

The nonsurgical options for treating ulnar tunnel syndrome involve identifying what’s causing the pressure or trauma in your hand or wrist. You may need to switch to ergonomic and padded tools or other objects. You may also need to change jobs, eliminate vibrating tools, and hold your wrists in a different way.

Massage, occupational, and physical  therapies may help relieve symptoms.

Over-the-counter (OTC) and prescription pain relievers or anti-inflammatory drugs may also help. Your doctor may recommend corticosteroid injections for temporary relief.

You may also benefit from wearing a splint or wrist brace.

Get back to your best

Surgical treatment

Surgery is necessary to remove the ganglion or cyst that’s causing the pressure on your wrist. Scars and other growths may also need to be removed if they cause ulnar tunnel syndrome.

Another option is to use surgery to relieve the pressure in the wrist by cutting a ligament.

After the surgery, you should feel relief. The tingling, pain, and numbness should disappear. However, it may take several months for your ulnar nerve to heal completely.

You’ll need to do rehabilitation therapy and specific exercises during the recovery process. Your physical therapists will advice you more about the rehab exercises that are right for you.

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