Ulnar Tunnel Syndrome

What is Ulnar Tunnel Syndrome?

The ulnar nerve is one of three nerves that provide motor and sensory function to the arm. The ulnar nerve originates at the brachial plexus running down the length of the arm (near the ulna bone) thru the wrist and into the little finger. It provides sensation to the little finger and half of the ring finger. It also provides motor function of some of the larger muscles in the forearm responsible for grip along with some of the smaller muscles in the hand. As the largest nerve in the body not protected by muscle or bone, the ulnar nerve is prone to injury. Ulnar Tunnel Syndrome happens when the ulnar nerve becomes compressed as it passes thru Guyon’s canal where the wrist meets the palm of the hand. This is not to be confused with Cubital Tunnel Syndrome which occurs with ulnar nerve compression at the elbow.

What causes Ulnar Tunnel Syndrome?

The most common cause of Ulnar Tunnel Syndrome is the presence of a ganglion cyst. This benign (noncancerous) cyst is a soft tissue tumor that originates in the wrist. Repetitive use injuries or overuse can result from using vibrating tools such as a jackhammer and can cause swelling of the tissues around the nerve. Additionally, activities that provide constant palmar pressure such as weightlifting and cycling can cause Ulnar Tunnel Syndrome.

What are the symptoms of Ulnar Tunnel Syndrome?

Symptoms tend to develop gradually over time. Numbness or tingling may be present in the ring and little finger and may be worst in the morning. Increasing weakness may be dependent on the location of compression. With time, grasp and hand dexterity may diminish. Some people also experience pain to the wrist and one or both the ring and little finger.

How is Ulnar Tunnel Syndrome diagnosed?

In addition to a comprehensive medical history, review of symptoms and activity, the physician will perform a physical examination of the affected hand and wrist to determine the site of compression. The doctor may tap their fingers over the ulnar nerve to observe if tingling is caused. This is called Tinel’s test. The practitioner will also be looking for muscle atrophy (wasting), weakness in the hand or fingers and to determine if the cause of symptoms is in the elbow or wrist. X-rays of the wrist can rule-out bone involvement. MRI (magnetic resonance imaging) or CT (computed tomography) scan can rule-out tissue growths that may be exerting pressure on the nerve. Electromyography and nerve conduction studies may also be helpful for a definitive diagnosis.

How is Ulnar Tunnel Syndrome treated?


Determining the causative factors leads to the simplest treatment. If the compression is caused by repetitive use or prolonged palmar pressure, the activity in question should be avoided, reduced to a minimum or modified so as not to cause compression. Splinting with a wrist brace may be helpful. Additionally, anti-inflammatory medications such as ibuprofen may help to mitigate symptoms.


If all non-surgical interventions fail to alleviate symptoms, outpatient surgery may be performed to release pressure or remove any cysts or scar tissue causing the compression. The ligament the covers Guyon’s canal may be cut to release pressure. As the wrist heals the gap created grows together leaving more room for the ulnar nerve. Post-operatively the symptoms of numbness and tingling should decrease. The nerve will heal completely over the next several months during which time the surgeon will prescribe rehabilitation exercises and physical therapy.

How can Dr. Knight help you with Ulnar Tunnel syndrome?

Ulnar tunnel syndrome can cause debilitating pain, and it is important that this pain be alleviated so that you can go about your daily routine. Dr. Knight is well-trained in the release of these types of injuries, so in his care you will be treated and, hopefully, freed of your affliction in as short a time as possible.

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