Condition: Ulnar neuropathy at the elbow occurs when the nerve that crosses at the elbow, the ulnar nerve, is compressed, causing pain, numbness, and weakness in the arm.
Background: Ulnar nerve dysfunction may be caused by repetitive movements, trauma, leaning on hard surfaces, or abnormal elbow structure.
Risk Factors: Ulnar neuropathy at the elbow occurs more frequently in manual laborers and wheelchair users. Patients with diabetes and rheumatoid arthritis often have this condition. Sleeping with the elbows bent and leaning on hard surfaces while driving or working at a desk are risk factors for developing this condition.
History and Symptoms: Patients typically report sensation changes in the small finger and lower half of the ring finger, weakness and loss of coordination of the hand, and localized pain at the inner elbow that radiates to the hand.
Physical Exam: A physical exam will be performed to assess the sensation and movement in the entire involved limb. The exam will focus on specific effects of ulnar nerve dysfunction, including positions of the hand and fingers, the effects of bending the elbow on the sensations, fine motor skills, and grip strength.
Diagnostic Process: Laboratory studies may be used to evaluate patients for risk factors, such as the presence of diabetes or rheumatoid arthritis. While imaging is not always used, ultrasound may be used to examine the site of nerve compression, and MRI may be used to exclude other causes of elbow pain. Measurement of the electrical activity in the muscles and nerves of the affected arm can also be helpful.
Rehab Management: Conservative treatment for mild neuropathy includes patient education, activity modifications, and night splinting or elbow padding. Occupational therapy can ensure optimal positioning during work and help to address any losses of function. Moderate or severe neuropathy may require surgery if less invasive treatment fails.
Other Resources for Patients and Families: Patient education is critical for lifestyle modifications and successful rehabilitation.