Ask Dr. Geier – Ulnar Nerve Compression

I want to apologize to all of you who have submitted questions through the Contact section of this blog over the last month or so. We recently switched our email to Google Apps, and it has been great. Unfortunately, none of the Contact forms transferred to the new system. We were still getting emails to our accounts, so we didn’t realize that the forms were not coming to us. And for that, I sincerely apologize.

I have spent the last 10 days or so responding to all of you, but it has created an even bigger backlog of questions for the Ask Dr. Geier column and for The Dr. David Geier Show than already existed. I will try to answer more of them to try to catch up. But it does mean a lot to me that you all keep sending me great questions about sports injuries and give me wonderful feedback.

As always, please keep in mind my disclaimer that I cannot and will not discuss specific medical information by email, online, and on my show.

David

Steven Kubler in Stewart Manor, New York asks:

I have what I believe to be an ulnar nerve problem. I have tingling in the pinky and along the outside of the hand. However, I also have weakness in my hand particularly when doing twisting motions such as turning a doorknob or a key in a lock. I have noticed that the muscle in this hand between the thumb and index finger has atrophied compared with the other hand. Is there anything I can do about this without surgery, and if I do get surgery, will I be able to rehabilitate the muscle and get my strength back in this hand?

I’ll preface my answer by saying that I don’t do much hand surgery. I do occasionally treat ulnar nerve compression at the elbow. And the ulnar nerve can be irritated or compressed at both the elbow and along the wrist and hand. So while I think a hand surgeon might be better to address intrinsic muscle atrophy of the hand, I can discuss ulnar nerve compression at the elbow.

Typically early ulnar neuritis presents with soreness or discomfort and numbness and tingling along the fourth and fifth finger on the palm side of the hand. If compressed at the elbow, there can be forearm soreness as well. Treatment of early ulnar nerve issues includes anti-inflammatory medications or an elbow splint. If needed, surgery to decompress the nerve and possible transpose it in front of the medial epicondyle at the elbow can relieve these symptoms.

If the nerve compression continues, there can be chronic changes to the muscles that the nerve innervates. Essentially atrophy of the intrinsic muscles of the hand can result. Whether or not that is reversible by only decompressing the nerve is harder to know.

Read more about ulnar neuritis (ulnar nerve compression at the elbow) in the Sports Injury Locator.

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