Nerve irritation in the elbow / Ulnaris neuritis / Cubital tunnel syndrome
Description of ulnaris neuritis

Ulnaris neuritis is a form of irritation of the ulnaris nerve (nerve along the elbow) and the ulnaris nerve is, like median nerve (nerve in the arm), susceptible to compressions several places along its course in the arm. At the wrist, the nerve extends to the hand through a small flat tunnel (Guyon’s canal), between the carpal bones (bones of the hand) namely the pisiform and hamate bones. The “floor” of this channel consists of a thin layer of ligament and muscle, and the” roof “consists of the palmaris longus tendon and muscle.
The condition often results from a trauma that may be of acute nature or repeated trauma, such as working with air hammers. Bike riders are often affected by the disorder, as they almost constantly receive shocks from the bike through the wrist. Finally, poorly healed fractures in the palm of the hand can also be the cause.

Symptoms of ulnaris neuritis
  • Burning sensation around the fourth and fifth finger.
  • May impair fine motor skills (dexterity) of fingers.
  • Pain in the wider part of the hand.
  • Often intense nocturnal pain that awakens the patient.
  • Weakness of the hand that dissipates when used.
  • Impairment of adduction and abduction (inward and outward movement) of the fingers (muscles interossei).
  • Possible atrophy of the thenar muscles.
  • Pinch grip weakened.
Examination for ulnaris neuritis
  • Analysis / Inspection / Palpation / ROM test of power and active and passive motion
  • Palpation of Guyon’s Channel.
  • Sensitivity test (feeling). (two points, two tracks and pointed / dumb).
  • Pinch test.
  • Phalens test.
  • Flexor carpi ulnaris test and palpation.
  • Adduction and abduction test of the fingers.
  • Flex test of art. Metacarpophalangeal (metacarpophalangeal joint) for hand’s own muscles.
Treatment for ulnaris neuritis
  • Rest.
  • Cryotherapy for acute pain (ice massage for 9 min.).
  • Anti-inflammatory meds, which should be prescribed by your own doctor.
  • Wrist tape with padding.
  • Ultrasound (continuous / pulsating), 3 Mhz, 0.5-1.5 W cm2.
  • Kinesiology tape.
  • K-Laser.
  • Avoid using flexor carpi ulnaris muscle (i.e. bending in the wrist).
  • Possible surgery to release the nerve (gives very good results).