What is ulnar nerve compression, or ulnar neuritis? What treatment options can decrease the pain, numbness, tingling and weakness?

Steven 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?

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.

Location of ulnar nerve compression
The ulnar nerve (orange arrow) travels behind the bony process on the inside of the elbow (the medial epicondyle).

Signs and symptoms of ulnar nerve compression

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 ulnar neuritis

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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