ORTHOPEDICS/HAND & WRIST
Pain, burning, and coldness in the thumb, two adjacent fingers, and a part of the palm are frequently occurring with most people who are probably familiar with carpal tunnel disorder where an impingement of the wrist (the carpal tunnel) appears.
A comparable disorder may take place on the other side of the wrist where impingement of the ulnar nerve causes a radiating pain or coldness in the pinky finger, the ring finger, and the edge of the hand.
This is known by ulnar neuropathy, which can be caused by two different situations known as cubital tunnel disorder and ulnar tunnel disorder.
Hand and Wrist Nerves
To know why these disorders happen necessitates a fundamental understanding of hand anatomy.
The hand embraces an intricated network of nerves of three principal kinds: the radial, median, and ulnar nerves.
Each of these kinds of nerves has a different utility in the hand:
The radial nerve is liable to the sensation of the hand back, in addition to the fingers’ straightening.
The median nerve provide this sensation to the thumb and the first two fingers, in addition to providing flexion to these three fingers.
The ulnar nerve is liable to the sensation of the pinky finger and a part of the ring finger, in addition to flexing those fingers and allowing those fingers moving separately.
The clinical term “ulnar neuropathy” just signify that something is wrong with the ulnar nerve.
When this occurs, it is frequently due to pressing on the nerve.
The jostle and the wrist are the two most common places for ulnar nerve compression.
Cubital Tunnel Disorder
The ulnar nerve (i.e., the “funny bone” nerve) originates from the spine and travel to the arm.
Cubital tunnel disorder happens precisely when this ulnar nerve is compressed at the jostle.
Whenever the ulnar nerve is compressed at this level, pain appears in the fingers and it is aggravated by repeated flexion of the jostle.
Cubital tunnel disorder can cause a radiating pain in the forearm as well, in addition to weakness in the muscles of the hand.
Note that in serious cases, muscle atrophy and hand tearing may occur.
Ulnar Tunnel Disorder
At a different position than a carpal tunnel disorder, a compression of the nerve at the wrist may cause an Ulnar tunnel disorder, precisely, at a narrow space called the Guyon’s Canal.
Repetitive vibrating movements, such as hammering, can also cause a persistent pressure on the wrist known by Ulnar tunnel disorder, such as occurs when cyclists lean on their handlebars for long periods.
Diagnosis and Therapy
A physical inspection is frequently needed to confirm a diagnosis of an ulnar neuropathy.
If the indications are serious, the specialist may recommend an nerve conduction analysis called electromyogram.
Therapy for cubital tunnel or ulnar tunnel disorder are similar.
The first aim to avoid any inflammation that might compress the nerve. This therapy requires relaxation and supportive bandaging, in addition to pain reliever.
With cubital tunnel disorder, supportive bandaging helps maintaining the elbow flexion at 45 degrees.
If this physical therapy fails, a medical operation may be recommended to decompress the nerve at the jostle level.
Similar to the above therapy is applied to restrain the wrist from flexing.
In both therapy, if surgery is performed, a physical therapy would follow to regain strength and flexion of the elbow or wrist.
Note that complete recovery may take up to 12 weeks.
A final word
When doubting a nerve damage with pain at the wrist or hand levels, do not hesitate to call a specialist.
Situations such as cubital tunnel disorder and ulnar tunnel disorder require specific examinations and therapy.