Ulnar Nerve Palsy (Dysfunction)

Written by Rachel Nall | Published on July 20, 2012
Medically Reviewed by George Krucik, MD

Ulnar Nerve Palsy

Your ulnar nerve runs from your shoulder to your little finger. If you experience damage to the ulnar nerve that causes sensation loss, this is known as ulnar nerve palsy. The condition can affect your ability to make fine movements and can cause your hand to appear claw-like. Surgery can correct ulnar nerve palsy, if needed.

What Are the Symptoms of Ulnar Nerve Palsy?

Ulnar nerve palsy can be a progressive condition that results in sensation loss in your fingers.

Symptoms associated with ulnar nerve palsy include:

  • loss of sensation, especially in your ring and little fingers
  • loss of coordination in your fingers
  • pain
  • tingling or burning in your hand
  • hand weakness
  • weakness that worsens with physical activity
  • loss of grip strength

Lack of strength in your hand can affect your activities of daily living, such as gripping and holding items.

Over time, the lack of control and sensation in your hand can lead to a claw-like deformity. This typically occurs only in severe cases.

What Causes Ulnar Nerve Palsy?

The cause of ulnar nerve palsy is not always known. However, damage to the ulnar nerve can occur due to:

  • illness that damages your nerve
  • injury to the nerve
  • excess pressure on the nerve
  • nerve pressure due to swelling
  • elbow fracture or dislocation

Damage to the ulnar nerve is like cutting a telephone cord. The messages from your brain cannot transmit to your little finger.

What Are the Effects of Ulnar Nerve Palsy?

In some instances, the ulnar nerve damage can be so extensive that it causes permanent deformity. Even after surgery, you can still experience sensation loss and movement. Post-surgery, a full recovery and return to wrist and hand function can take months.

How Is Ulnar Nerve Palsy Diagnosed?

Your physician will start a physical examination by asking when and how your symptoms began. Pinpointing any times when you could have injured your hand is important to help your physician determine potential causes.

Your physician will test how well you can move your fingers and the current condition of your hand.

In addition to a physical examination, testing can include:

  • blood tests
  • imaging tests
  • nerve conduction tests
  • X-rays

These tests can help determine swelling and nerve function in the ulnar nerve.

How Is Ulnar Nerve Palsy Prevented?

Seeking medical treatment as soon as you experience ulnar nerve issues is vital to preventing more serious complications.

If you experience tingling, numbness, or pain in your fourth and fifth fingers, call your physician. You may also wish to consult an occupational therapist to determine if your daily work habits are placing excess pressure on your ulnar nerve.

To prevent further injury, you might be advised to wear a cast, splint, or other physical therapy tool.

How Is Ulnar Nerve Palsy Treated?

Nerve tissues are traditionally slower or harder to heal than other tissues. However, some ulnar nerve palsy symptoms may get better on their own without any additional treatments.

Your physician may recommend other treatments, including:

  • over-the-counter pain relievers
  • medications to reduce nerve spasms, such as gabapentin, phenytoin, carbamazepine, or tricyclic antidepressants
  • corticosteroids to reduce inflammation
  • a splint to support the hand and reduce painful symptoms
  • physical therapy to increase muscle strength and function
  • occupational therapy to minimize further injury

If the nerve damage is extensive or extremely painful, your physician may recommend surgery. One surgical correction involves tendon transfer to repair damaged tendons that pull on muscles. This can help to restore function and allow you to once again perform activities of daily living.

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