The Funny Bone (aka The Ulnar Nerve) Is No Laughing Matter

funny boneWhat’s so funny about the funny bone? Actually, nothing. This is what you quickly conclude if you accidentally hit just the right spot on your elbow. Suddenly, a shocking, tingling pain shoots right down your elbow, into your hand.

It isn’t even a bone you’ve hit. It’s actually a nerve. Specifically, the ulnar nerve. This nerve, one of the three main nerves in the arm, runs from the neck area and extends to the hand. The ulnar nerve innervates muscles of the forearm, hand and two fingers (the ring and pinky fingers). It is believed to have been named the “funny bone,” because the nerve corresponds to the humerus bone (which sounds like humorous, as in funny). It is also speculated that the term comes from the “funny” feeling of hitting it.

How can a gentle tap cause such a severe reaction? At its most vulnerable spot, the ulnar nerve passes through a channel called the cubital tunnel. It is there that protection is limited to only a thin coating of skin and minimal fat.

Typically, when you hit the ulnar nerve, you give it 30 seconds, shake your arm around and that fleetingly pain goes away. But, what happens when it’s more than a temporary feeling? Prolonged pain, numbness or tingling can be caused by an injury or overuse. In rare incidents, maybe a tumor. It is the result of nerve irritation, inflammation or ulnar nerve entrapment.

What is ulnar nerve entrapment?

Ulnar nerve entrapment ensues when the nerve is compressed or pinched. Although it can occur in the forearm or hand, the most common site of ulnar nerve entrapment is at or near the elbow, especially in the region of the cubital tunnel. When compression of the ulnar nerve at the elbow occurs, it is called cubital tunnel syndrome. The cubital tunnel is the second most common location of nerve entrapment in the body (the first most common is in the carpal tunnel, located in the wrist).

Some factors put people at greater risk for developing ulnar nerve entrapment. These include:

  • Arthritis or bone spurs of the elbow
  • A prior elbow fracture or dislocation
  • Repetitive or prolonged stress caused by activities requiring a bent or flexed elbow

Symptoms of ulnar nerve entrapment include:

  • Pain (or burning sensation) in the elbow, palm or ring/pinkie finger
  • Weakness (especially in the pinky finger and in gripping with the hand) or tenderness in the hand
  • Tingling, numbness, decreased sensation in the palm or ring/pinkie finger
  • Sensitivity to cold
  • Tenderness in the elbow joint
  • Claw-like appearance of the hand and wrist

How do you treat ulnar nerve entrapment?

There are a variety of nonsurgical treatments that can alleviate the pain and potential damage caused by ulnar nerve entrapment. These include:

  • Nonsteroidal anti-inflammatories, such as ibuprofen, aspirin and other over-the-counter pain relievers
  • Occupational or physical therapy
  • A splint or elbow brace for cubital tunnel syndrome

For cases in which these methods have not improved the condition, surgery may be recommended. Additional factors indicating surgery include:

  • Severe compression of the ulnar nerve
  • Muscle weakness
  • Damage that has resulted from nerve compression

Ulnar nerve decompression surgery has been shown to be effective in a majority of patients. In addition to providing pain relief, this surgery can prevent further damage or deterioration, which is necessary to avoid further hand weakness and impaired function. Among its benefits are also simplicity and safety. 

At Neurosurgical Associates of New Jersey, we are experts in performing ulnar nerve decompression. We can evaluate your individual ulnar nerve condition and review the various available treatments and recommendations. Contact us today for more information.

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