Ulnar And Radial Neuropathy

What is ulnar and radial neuropathy?

Cubital tunnel syndrome

The ulnar nerve runs along the inside of your elbow and is the nerve that produces a shock down the arm when you bump your ‘funny bone’. The ulnar nerve travels through the cubital tunnel inside the elbow and then on to the hand. This tunnel is surrounded by soft tissue and bone which can narrow and squash the nerve. When you hit your ‘funny bone’, you are actually hitting the ulnar nerve on the inside of the elbow.

This is a condition affecting the ulnar nerve as it passes behind the medial epicondyle (at the tip of the elbow and otherwise known as the funny bone) on the inside of the elbow joint. The nerve is most commonly susceptible to irritation or compression here but can be affected at any point along its track in the arm.

Radial tunnel syndrome

Radial tunnel syndrome is an entrapment of the radial nerve. This condition is thought to be a compression injury to the radial nerve near the elbow. The condition is often confused with tennis elbow.

The radial nerve travels through an open space surrounded by muscle and bone (called the radial tunnel), along the outer side of the elbow and then to the hand.

Why does ulnar and radial neuropathy occur?

Cubital tunnel syndrome occurs when the tunnel is compressed. Constant pressure on the nerve is the main cause when the ulnar nerve shifts out of its groove behind the elbow or stretches abnormally. It is often caused by flexing the elbow for long periods of time. The ulnar nerve can also be damaged from a blow to the cubital tunnel.

Radial tunnel syndrome occurs when muscles of the forearm compress the radial tunnel, pinching the radial nerve at one or more points. This is typically caused by repetitive motion, such as pushing or pulling, twisting, gripping with the hand or bending the wrist. It can also be caused by an injury to the elbow.

Ulnar and radial neuropathy symptoms?

Cubital tunnel syndrome may cause numbness, weakness or pain in the hand and pain on the inner side of the elbow. The hand may feel as if it is falling asleep, or pain can radiate from the elbow into the hand. This pain and numbness is restricted to the skin that is fed by the ulna nerve, the ring and little fingers of the hand.

Radial tunnel syndrome causes pain along the outer side of the arm, about two inches below the elbow. The pain worsens when the arm is used. Weakness of the wrist and the hand can also occur.

How is ulnar and radial neuropathy diagnosed?

Your consultant will take a thorough medical history and a physical examination, specifically testing the ulnar or radial nerve. You may be referred for nerve conduction studies to assess the nerve function.

How is ulnar and radial neuropathy treated?

Non-surgical

Treatment options may include rest, immobilisation in a splint, cushioning of the nerve with an elbow pad and anti-inflammatory medications. The pain will settle with some activity modification, including reducing the amount of time you do activities that require a lot of bending in the elbow, and taking frequent breaks.

If your symptoms are mainly at night, a lightweight plastic extension splint may be worn to limit movement while you sleep and ease irritation. The nerve can be protected from external pressure with a soft cushioning pad worn around the elbow.

Surgical

In severe cases of pain, numbness or weakness, surgery may be needed to relieve pressure on the nerve. The surgery is a 20 minute day case procedure under general anaesthetic but can be performed under local anaesthetic while you are awake if preferred. A tourniquet is used, which prevents blood from obscuring the surgeons view.