Ulnar Tunnel Syndrome - Lancashire Teaching Hospitals

What are the risks of surgery?
The risk of surgery is very small but includes
bleeding, infection, stiffness, nerve injury and
increased sensitivity of the skin. The surgeon
will discuss these with you.
How successful is the surgery?
This depends on how severe the nerve is
compressed. For mild compression, excellent
results are achieved in close to 100% of patients.
For severe compression, excellent results are
achieved in less than 50% and the recurrence
rate (chance of the symptoms recurring) is close
to 70%.
Ulnar nerve
Produced by The Orthopaedic Hand and Upper Limb Service
Do I have to have an operation?
No. If your symptoms are mild then your surgeon
may not recommend surgery. Your surgeon will
discuss this with you.
Sources of further patient information:
www.lancsteachinghospitals.nhs.uk
www.nhsdirect.nhs.uk
www.patient.co.uk
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Ulnar Tunnel Syndrome
Produced by
The Orthopaedic Hand and Upper Limb Service
Illustrations by
M Briggs Medical Illustration Royal Preston Hospital
Production date Review Date -
What is ulnar tunnel syndrome?
Most people are familiar with carpal tunnel
syndrome, which can cause numbness and
tingling in the hand. A similar condition, called
ulnar tunnel syndrome, can cause numbness
and tingling that is confined to your little finger
and the outside of your ring finger. The ulnar
nerve is one of three major nerves that provide
feeling and movement to the hand. It runs down
the inside of your forearm to the heel of your
hand. Then it branches out across the palm and
into the little and ring fingers. Excessive pressure
on this nerve can result in a loss of feeling and/
or muscle weakness in the hand.
What are the symptoms of ulnar tunnel
syndrome?
You may or may not have pain in your hand,
but you will probably experience weakness and
increasing numbness, particularly on the little
finger side of the hand. You may experience
sensory (feeling) or motor (power) changes or
both, depending on the location of the pressure
point. Symptoms develop gradually and can lead
to difficulties in opening jars, holding objects, or
coordinating your fingers while typing or playing
a musical instrument.
How is ulnar tunnel syndrome
diagnosed?
Your surgeon will ask you questions about your
symptoms and examine your hand. Your surgeon
may arrange a nerve conduction study to see
if the nerve is working properly. A computed
tomography scan or a magnetic resonance image
(MRI) may be useful in identifying whether a cyst
or other growth is putting pressure on the nerve.
X-rays can show if you have fractured (broken)
a bone that is now pressing on the nerve. The
ulnar nerve also passes through a narrow tunnel
at the elbow. Pressure at that point can cause
similar symptoms in your hand, so your surgeon
will examine that area as well.
What are nerve conduction studies?
A nerve conduction study is a test to measure
the ability of a nerve to transmit messages
(electrical impulses) to and from the brain. If a
nerve is compressed it will not be able to transmit
the impulse normally. As well as the ulnar nerve,
other nerves are tested at the same time to be
certain that the abnormality is in the ulnar nerve
and that your symptoms are not the result of
some other cause.
Treatment
Treatment depends on what’s causing the
pressure on the nerve. If pressure results
from the way you rest your wrist when typing,
a change in position or the addition of some
padding may help. Your doctor may prescribe
anti-inflammatory medications such as aspirin
or ibuprofen to help alleviate your symptoms,
and may recommend that you wear a wrist
splint for a time. However, most cases of ulnar
tunnel syndrome are caused by a growth in
the wrist and must be treated with surgery
to remove the growth. An experienced hand
surgeon can remove cysts, scar tissue, or other
causes of compression on a day case surgery
basis. Once the pressure point is removed,
you will notice an improvement in sensation
with a decrease in the numbness and tingling.
However, it will take several months for the nerve
to regrow and heal completely. Your surgeon
will make recommendations for postoperative
rehabilitation and exercises.
What happens after surgery?
You will have a bandage around your wrist when
you leave hospital. This will be removed at you
first follow-up visit, normally between 10 and 14
days later. It is important that you try to use your
arm and hand for light activities even whilst the
bandage is on.