When the ulnar nerve is compressed at the elbow it is called cubital tunnel syndrome, and when compressed at the Guyon's canal at the wrist it is called ulnar tunnel syndrome. Numbness in the little finger and part of the ring finger, together with reduced hand dexterity, may occur.
Ulnar nerve compression at the elbow and the wrist
The ulnar nerve passes along the inner side of the elbow on its way to the hand. Compression at the elbow is called cubital tunnel syndrome, while compression occurring in the Guyon's canal at the wrist is called ulnar tunnel syndrome. Although it is the same nerve, the site of compression and the surgical approach differ.
What symptoms occur?
- Numbness in the little finger and the side of the ring finger nearest the little finger.
- Increasing tingling when the elbow is held bent for long periods or when leaning on the elbow.
- Weakening grip, difficulty with fine finger movements, and, in advanced cases, muscle wasting.
How is the site of compression determined?
The examination is not limited to the numb fingers alone; the elbow, wrist, and hand muscles are examined together. Nerve conduction studies and EMG can help assess the location of the compression and nerve function. If an injury or bone problem is suspected, imaging may be requested.
Treatment options
Reducing direct pressure on the elbow and avoiding prolonged bending can be helpful in early-stage symptoms arising from the elbow. Splints and other supports are chosen based on examination findings. For compression at the wrist, the activity or structure causing the pressure is separately assessed.
Surgery may be considered for persistent numbness, loss of strength, or symptoms that continue despite non-surgical treatment. The extent of the procedure depends on the site of compression. The aim is to relieve pressure on the nerve; it should not be assumed that advanced muscle loss will fully recover.
Difference from carpal tunnel
In carpal tunnel syndrome, it is mainly the thumb side that is affected. Although the distribution of symptoms is a useful guide, it does not provide a diagnosis on its own. When you come for examination, you can bring any previous test results and notes on the movements that increase your symptoms.
Frequently Asked Questions
No. In early or mild cases, non-surgical options can be used; the degree of involvement and response to treatment are important in the decision for surgery.
The correct name for compression at the elbow is cubital tunnel syndrome. Ulnar tunnel refers to the Guyon's canal at the wrist.
Sources and information
This content is for general information only; it does not replace personal diagnosis, treatment advice or a medical consultation. The applicability of recommendations in these sources depends on your individual situation and local practice.