You might have suffered a temporary injury to the ulnar nerve at some point. You hit your elbow on a hard object, and you get a sharp pain and tingling sensation that runs down from your elbow into your hand and fingers. You just hit your “funny bone” – or more correctly, your ulnar nerve. In my latest Ask Dr. Geier column, I discuss a difficult problem with the ulnar nerve, ulnar nerve subluxation.

Tayla Walsh in Irvine, California writes:

Afternoon Dr. Geier,

I just read your article on Ulnar Compression and was wondering if I could get any advice.

I’m an international student and don’t have access to my usual doctors. I’m currently a sophomore in college and playing Water Polo. I saw an orthopedic doctor today who told me that I have subluxation of my Ulnar Nerve. I get pain when I swim (I can hear/feel it pop in and out when swimming) and sometimes with my throwing action. I’m a sophomore and have two years left and I intend to continue playing at a high level when college is over.

My question is could this cause me more issues in the future, or get worse?
Is there a good way to treat or prevent this?

Signs and symptoms

Ulnar nerve subluxation is a condition where the ulnar nerve slides back and forth from its normal position behind the medial epicondyle (the bony prominence on the inside of the elbow) to in front of it. Snapping of the nerve with motion of the arm is uncomfortable along the inside of the elbow and forearm. It often causes numbness and tingling that radiates into the fourth and fifth fingers, much like compression of the nerve does in cubital tunnel syndrome.

Location of ulnar nerve subluxation

Treatment options for ulnar nerve subluxation

For compression of the nerve, nonoperative treatments can often relieve symptoms early in the course of the problem. Avoiding prolonged flexion of the elbow, a brace that keeps the elbow straight and more can be tried. Orthopedic surgeons will often perform nerve conduction velocity studies to determine the extent of compression and any long-term nerve changes. Surgical treatment to relieve pressure on the nerve at the elbow is often indicated for a patient failing to improve or with more advanced nerve compression and symptoms.

Also read:
Lateral Epicondylitis (“Tennis Elbow”)
Medial Epicondylitis (“golfer’s elbow”)

Surgery for ulnar nerve subluxation

Subluxation of the nerve causes many of the same symptoms as ulnar neuritis or cubital tunnel syndrome with the added discomfort from snapping of the nerve. Nonoperative treatments can be attempted, but the nerve subluxation often persists. An orthopedic surgeon can operate to move the nerve and stabilize it in front of the medial epicondyle. That surgery often relieves numbness, tingling and weakness, although it can take a long time for the nerve to recover and the symptoms to resolve.

Also read:
Ask Dr. Geier – Ulnar Nerve Compression
Ask Dr. Geier – Distal Biceps Rupture

A patient with long-standing compression or subluxation of the ulnar nerve in theory could develop chronic symptoms. Persistent numbness, hand muscle weakness and atrophy of the muscles of the palm can develop. Surgery to relieve pressure on the nerve at that point might fail to obtain complete relief of symptoms.

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