Ulnar Nerve Entrapment Treatment

Ulnar nerve entrapment occurs when the ulnar nerve in the arm becomes compressed or irritated. The ulnar nerve is one of the three main nerves in your arm. It travels from your neck down into your hand, and can be constricted in several places along the way. Depending upon where it occurs, this pressure on the nerve can cause numbness or pain in your elbow, hand, wrist, or fingers.

Sometimes the ulnar nerve gets compressed at the wrist, beneath the collarbone, or as it comes out of the spinal cord in the neck. The most common place where the nerve gets compressed is behind the elbow.

When the nerve compression occurs at the elbow, it is called “cubital tunnel syndrome.”

At the elbow, the ulnar nerve travels through a tunnel of tissue (the cubital tunnel) that runs under a bump of bone at the inside of your elbow. This bony bump is called the medial epicondyle. The spot where the nerve runs under the medial epicondyle is commonly referred to as the “funny bone.” At the funny bone the nerve is close to your skin, and bumping it causes a shock-like feeling.

Beyond the elbow, the ulnar nerve travels under muscles on the inside of your forearm and into your hand on the side of the palm with the little finger. As the nerve enters the hand, it travels through another tunnel (Guyon’s canal).

The ulnar nerve gives feeling to the little finger and half of the ring finger. It also controls most of the little muscles in the hand that help with fine movements, and some of the bigger muscles in the forearm that help you make a strong grip.

Ulnar Nerve Entrapment FAQ

What Causes Ulnar Nerve Entrapment?

In many cases, the exact cause of cubital tunnel syndrome (ulnar nerve entrapment) is unknown. The nerve is especially vulnerable at the elbow due to the **narrow space** it passes through with minimal soft tissue protection.

Common Causes of Compression:

**Repeated elbow bending**—such as while using a phone, typing, or sleeping with bent elbows.
**Nerve instability**—in some cases, the nerve slides out of position, leading to irritation.
**Prolonged pressure**—leaning on the elbow for extended periods can compress the nerve.
**Fluid buildup**—swelling in the elbow can increase pressure on the nerve.
**Direct trauma**—a direct hit to the elbow (hitting the "funny bone") can cause temporary nerve pain and numbness.

What Are The Symptoms of Ulnar Nerve Entrapment?

Ulnar nerve compression primarily affects the hand, but it may also cause elbow pain.

Common Symptoms:

Numbness and tingling in the **ring finger and little finger**, especially when the elbow is bent.
Pain or aching on the **inside of the elbow**.
Weak grip strength and difficulty with **finger coordination** (e.g., typing, playing an instrument).
Muscle wasting in the hand (in severe, long-term cases), which **may be irreversible**.

Symptoms are often **worse at night** or when **holding the elbow in a bent position** (e.g., while driving, talking on the phone, or sleeping).

What Are The Treatment Options for Ulnar Nerve Entrapment?

Many cases can be managed with **nonsurgical treatments** that relieve inflammation and reduce pressure on the nerve.

Nonsurgical Treatment

**Avoid pressure on the elbow** (e.g., don't rest elbows on hard surfaces).
**Use a speakerphone or headphones** to reduce strain from holding a phone.
**Avoid resting the elbow on the car door while driving.**
**Nonsteroidal anti-inflammatory drugs (NSAIDs)** for temporary pain relief.
**Use a night splint or towel wrap** to keep the arm straight while sleeping.
**Wrist splinting** (for wrist-based entrapment) to keep the wrist in a neutral position.

Bracing or Splinting

A **brace or splint** may be used to **immobilize the arm** for a few weeks to prevent additional nerve irritation. Wearing a **splint at night** helps prevent excessive elbow bending during sleep.

Hand Therapy

Physical and **occupational therapy** may be recommended to strengthen and stretch the hand, arm, and elbow. Certified hand therapists develop **individualized exercise programs** to help patients regain function and reduce symptoms.

Surgical Treatment

Surgery may be recommended if symptoms are severe, persistent, or worsening despite nonsurgical treatments.

Common surgical options include:

**Ulnar nerve decompression**—relieves pressure by enlarging the cubital tunnel.
**Ulnar nerve transposition**—relocates the nerve to prevent irritation from elbow bending.
**Medial epicondylectomy**—removes part of the bone to reduce compression.

Surgery is typically performed as an **outpatient procedure**, followed by **physical therapy** for optimal recovery.