What Is Ulnar Nerve Entrapment?
Ulnar nerve entrapment occurs when the ulnar (funny-bone) nerve is compressed along its route from the neck to the hand. Common sites of entrapment include the elbow and the wrist, where space is limited and the nerve can become irritated, leading to pain, tingling or weakness.
Key Entrapment Sites
• Cubital Tunnel (Elbow)
– Located behind the “funny bone” at the medial epicondyle
– Compression here causes numbness in the little finger and half the ring finger, elbow pain and hand weakness
– Learn more on our Cubital Tunnel page (/hand/cubital-tunnel)
- Arcade of Struthers (Upper Arm)
– A fibrous band in the mid-upper arm from which the nerve can be compressed
– Symptoms mirror cubital tunnel but may include aching in the inner arm - Guyon’s Canal (Wrist)
– A narrow tunnel at the base of the palm formed by ligaments and carpal bones
– Causes handlebar palsy in cyclists and “hypothenar hammer” injuries in manual workers
– Results in weakness of pinch and grip, plus tingling in the little and ring fingers - Flexor Carpi Ulnaris Aponeurosis (Forearm)
– The tendon arch of the wrist-flexor muscle can pinch the nerve during pronation/supination
– May present as diffuse forearm ache with ulnar-distribution tingling
Why Does It Happen?
• Repetitive bending of the elbow or pressure on the inner arm (e.g. resting on hard surfaces)
• Cycling or weight-bearing activities that press the palm against handlebars or tools
• Previous elbow or wrist injuries, arthritis or bone spurs narrowing tunnels
• Anatomical variants such as extra muscles or tight fibrous bands
Recognising the Symptoms
• Tingling or numbness in the little finger and ulnar half of the ring finger
• Weakness or clumsiness when gripping, pinching or typing
• Ache or sharp pain at the elbow or base of the palm
• In advanced cases, muscle wasting between the fingers (“interosseous atrophy”) or a claw-like posture
Diagnosis
Your specialist will:
• Review your history and activities that worsen symptoms
• Perform tests such as Tinel’s tap over the elbow or wrist and the elbow flexion test
• Assess hand strength, sensation and muscle bulk
• Order nerve conduction studies (EMG/NCS) and imaging only if needed to confirm the site and severity of compression
Treatment and Management
Non-Surgical Care (First Line)
• Activity Modification: Avoid prolonged elbow bending and direct pressure on the inner arm
• Splints and Braces: Night-time elbow extension splints or padded wrist guards to reduce nerve stretch
• Pain Relief: Paracetamol or NSAIDs for discomfort
• Nerve Gliding Exercises: Gentle guided movements to help the nerve slide freely through tunnels
• Hand Therapy: Strengthening and dexterity exercises under professional guidance
Surgical Options
Considered if non-operative measures fail after 3–6 months, or if there is significant muscle weakness or atrophy. Procedures include:
• Cubital Tunnel Release: Cutting the ligament over the elbow tunnel to enlarge space
• Ulnar Nerve Transposition: Moving the nerve to a new position in front of the elbow to prevent stretch
• Guyon’s Canal Decompression: Releasing tight structures at the wrist to relieve pressure
Preventing Recurrence
• Use ergonomic tools and avoid leaning on your elbows or resting on hard surfaces
• Take regular breaks when typing, cycling or performing repetitive tasks
• Perform home stretches and nerve glides as taught by your therapist
• Maintain good overall health—manage diabetes, arthritis and excess weight
Clinical Pearls / Key Points
• Ulnar nerve entrapment often mimics carpal tunnel but affects the little finger side of the hand
• Early symptoms—intermittent tingling—respond best to activity changes and splinting
• Persistent weakness or muscle wasting warrants prompt specialist review
• Surgical outcomes are excellent when nerve compression is released before permanent damage
Patient FAQs
How do I know if my nerve will recover?
Most people improve significantly with early non-surgical care. Full recovery can take 3–12 months, depending on severity.
Is surgery painful, and how long is recovery?
Surgery is performed under anaesthetic; pain is managed with medication. Recovery typically involves a few weeks in a splint, with gradual return to activities over 2–3 months.
Can I prevent this if I cycle or type a lot?
Yes—using padded gloves, adjusting handlebar position, typing with soft wrist rests and taking breaks all help reduce risk.
Call to Action
If you have pain, book an appointment to be reviewed by Prof Imam or another member of our specialist team at The Arm Clinic. Early specialist care helps prevent long-term issues. Visit www.TheArmDoc.co.uk or book your consultation today. Phone: 020 3384 5588 | Email: Info@TheArmDoc.co.uk
Disclaimer
This information is for general educational purposes and should not be used as a substitute for professional medical advice. Consult a healthcare professional for individual guidance on your condition and treatment options.
This page was last clinically updated in May 2025