14/06/2023
ULNAR NEUROPATHY
BACKGROUND:
Ulnar neuropathy is a medical condition in which the ulnar nerve is compressed as it travels across the elbow or the wrist. It is considered to be the second most common site of nerve entrapment in the upper extremity, the first being the wrist (carpal tunnel syndrome). There is a higher occurrence in men.
CAUSES:
Ulnar neuropathy is caused by increased pressure on the ulnar nerve as it travels across the elbow or the wrist less frequently. Compression of a peripheral nerve induces marked changes in the nerve fiber structure causing impairment and damage to the nerve. Ulnar neuropathy can be associated with many medical conditions that cause pressure on the ulnar nerve, such as arthritis, pre-diabetes (impaired glucose tolerance), diabetes, thyroid dysfunction, trauma or excessive use of the arms. Few studies also suggest that ulnar neuropathy is provoked by repetitive flexion of the elbow in industrial occupation causing damage to the ulnar nerve.
SIGNS & SYMPTOMS:
Numbness and tingling sensations in the fingers in the ulnar nerve distribution are the hallmark neuropathic and compressive symptoms of ulnar nerve entrapment. Most often, the abnormal sensations are diverse and are confined to the fourth and fifth fingers, but should not include the palm of the hand.
The numbness may be more noticeable at night, possibly related to awkward sleep position causing prolonged flexion of the elbow. If left untreated, it may progress to involve the motor fibers leading to difficulty using the fingers and weakness of hand grip as patients report trouble with opening jars, brushing the teeth, turning doorknobs, etc. Occasionally, few patient also complain of elbow pain that may radiate to the shoulder.