Question

Ulnar Tunnel Syndrome

Dr.Umesh Shetty · Accepted Answer

The Ulnar nerve is the longest unprotected nerve in the human body (meaning it is not protected by any bones or muscles), and is also one of the predominant nerves that enables efficient sensation and function to the hand. The Ulnar nerve begins at the neck and travels all the way down the inside of the forearm to the palm of the hand. However, at this point, the Ulnar nerve branches out within the palm and into the ring and little fingers.

Ulnar Tunnel Syndrome of the wrist is a condition characterized by an entrapment of the Ulnar nerve as it passes through the Guyon's canal within the wrist. Women are more likely to develop this condition than men because of incessant household works and also sitting at the table and working on the laptops and desktops on an everyday basis.

The most common cause of Ulnar Tunnel Syndrome is a ganglion cyst, which is a non-cancerous fluid-filled lump that usually originates from the wrist joint.

The treatment of Ulnar Tunnel Syndrome of the wrist includes both non-surgical and surgical methods. Usually, people who are diagnosed with this syndrome at the first stage can be cured with simple physiotherapy at home.

Ulnar Tunnel Syndrome of the wrist may occur in individuals of all ages, races, ethnic groups and gender but majorly as per the reports, women are more likely to develop this condition than men. From the past studies, it is seen that the individuals who participate in sports that involve repetitive stress on the wrist, such as gymnastics , table tennis, lawn tennis , badminton are the common and frequent victims of the syndrome.

Also, certain occupations that require repetitive overuse of the wrist, such as carpentry or painting are also sufferers of this syndrome.

The common signs and symptoms of Ulnar Tunnel Syndrome are as follows;-

Tingling sensation within the little finger(pinky) and ring finger.
The patient might feel pain within the wrist.
The person might also face difficulty while gripping objects.
Loss of Ulnar nerve function.
Techniques which help in the diagnosis of Ulnar Tunnel Syndrome are as follows :-

Physical Examination:- A thorough physical examination is important in determining if an individual has Ulnar Tunnel Syndrome of the wrist. During the process, a physician will examine the hand to look for any common signs of the syndrome such as a diminishing or loss of muscle tissue, muscle weakness or dry skin within the spaces between the fingers.
X-rays:- This process uses radiation to produce images of the wrist.
Computerized Tomography of the wrist joint:- A CT SCAN takes a series of X-ray images from several different angles. These images are then intermingled to create cross-sectional images of bones and soft tissues with the body.
Magnetic resonance imaging:- An MRI is a more scrutinized scan that uses strong magnetic fields to produce clearer and transparent images of the bones and soft tissue that surrounds the wrist.
Electromyography(EMG):- An EMG shows the electrical activity of the muscle during rest and contraction of the muscle.
Nerve conduction velocity (NCV):- Nerve conduction velocity shows the speed at which electrical signals move through a nerve.
Treatment for Ulnar tunnel syndrome:

The treatment measures for Ulnar Tunnel Syndrome of the wrist include both non-surgical and surgical methods:-

Surgical Method:

Surgical excision - Surgical excision involves the removal of the ganglion cyst, scar tissue, or it may help mitigate any other factor that causes compression of the ulnar nerve.
Endoscopic Ulnar- Endoscopic ulnar tunnel release is a minimally invasive surgical procedure that allows a physician to examine the carpal tunnel within the wrist using an orthopedic device called an endoscope.
Non-surgical method:

Applying ice or a damp heated towel to the wrist can help reduce pain and swelling.
Any activity that aggravates the wrist condition should be avoided.
Complete immobilization of the wrist with a cast may be required to restrict movement.
Non-steroidal anti-inflammatory oral medications, such as indomethacin and naproxen, may be used to treat Ulnar Tunnel Syndrome.
Corticosteroid injections help in temporary relieving symptoms, such as pain, and in improving the range of motion.
It is important to begin some light exercises after the symptoms have decreased. Physical therapy may help restore strength, as well as flexibility in the muscles.

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