Ulnar Neuropathy of the Elbow

Abstract

Ulnar nerve entrapment is the second most common compressive neuropathy in the upper extremity because of its anatomy and superficial location. Major aetiological factors in the development of ulnar neuropathy of the elbow are compression, inherent anatomical structures, or lesions within the cubital tunnel. Extrinsic nerve compression may be elicited by acute or recurrent trauma. Nerve mobility may be impeded by congenital deformities. Ulnar nerve dysfunction has been associated with metabolic conditions, certain occupations and athletes involved in repetitive overhead activities. Ulnar nerve injuries may result in both motor and sensory abnormalities. Common symptoms include point tenderness, digital numbness and hand weakness. Evaluation of suspected neuropathy includes physical inspection for muscle atrophy, bony or muscle hypertrophy, deformities, digital clawing and a radiographic examination. Clinical techniques include the elbow flexion test, strength testing of hand intrinsics, flexor carpi ulnaris and digitorum profundus, and Tinel's sign. Sensory testing and McGowan's grading system may confirm the diagnosis and prognosis. Treatment options range from conservative (i.e. rest, splinting, nonsteroidal anti-inflammatory drugs, ice and abstinence) to radical surgical intervention (i.e. decompression, medical epicondylectomy and anterior transposition). In the throwing sport athlete, nerve involvement typically occurs along with other medical elbow problems.

Neurodynamic Mobilization in the Conservative Treatment of Cubital Tunnel Syndrome: Long-Term Follow-Up of 7 Cases

“…3,6,14 There are 4 stages to nonoperative rehabilitation of ulnar neuropathy at the elbow: (1) reduction of overload, pain, and inflammation; (2) promotion of total arm strength and normal joint arthrokinematics; (3) interval return to full activity; and (4) maintenance. 3 The mean duration of the complaints before treatment was 5 weeks.…”

Chiropractic management of a patient with ulnar nerve compression symptoms: a case report

“…Cubital tunnel syndrome is a condition brought on by an increase in the pressure exerted upon the ulnar nerve at the cubital tunnel and is the most common entrapment condition involving the ulnar nerve. 27,28 It is second only to carpal tunnel syndrome in compressive neuropathologies of the upper extremities. 27,28 Repetitive overhead activities, such as throwing, are a primary cause of this condition.…”

“…27,28 It is second only to carpal tunnel syndrome in compressive neuropathologies of the upper extremities. 27,28 Repetitive overhead activities, such as throwing, are a primary cause of this condition. The ulnar nerve is the terminal branch of the medial cord of the brachial plexus and contains fibers from the C8 and T1 spinal nerve roots.…”

“…The unusual anatomy of the cubital tunnel and the increase in intraneural pressure associated with elbow flexion are believed to be key issues in the pathogenesis of cubital tunnel syndrome. 28 The classic clinical symptomatology of those with cubital tunnel syndrome is having paresthesias over the small and ring fingers. 1,30 Typically, these sensory deficits are seen first in the disease, followed by motor dysfunction as the compression of the nerve becomes chronic in nature.…”

Sport–related peripheral nerve injuries: part 1

“…Nerve mobility in the tunnel is, therefore, essential to accommodate for the various potential forces occurring during elbow movements [12].…”