Hand and Wrist

The hand and wrist are made up of many different bones, muscles and ligaments that enable a wide range of movements to perform many functional capabilities.

Your wrist is made up of eight small bones known as the carpal bones. These bones support and give your wrist flexibility, and connect your hand to the two long bones in your forearm known as the radius and the ulna.

The eight carpal bones can be grouped into 2 groups: the upper and lower area of the wrist

  • Upper area (closer to the wrist): Pisiform, Triquetrum, Scaphoid and Lunate
  • Lower area (closer to the hand): Trapezium, Trapezoid, Capitate and Hamate

 

Each finger consists of a metacarpal bone and 3 phalanges, while each thumb consists of one metacarpal bone and two phalanges.

Ulnar Nerve Impingement

WHAT IS ULNAR NERVE IMPINGEMENT?

Ulnar nerve impingement (also known as ulnar nerve entrapment) is a condition that occurs when the ulnar nerve becomes compressed, swollen or irritated at the wrist. The ulnar nerve is a nerve that crosses the elbow, and starts in the side of your neck and ends in your fingers.

WHAT ARE THE SYMPTOMS OF ULNAR NERVE IMPINGEMENT?

Numbness and tingling in the hand and fingers (ring and little finger) is a common symptom.

Other symptoms include:

  • Numbness and tingling in the hand and fingers (ring and little finger) at night
  • Hand pain
  • Weak grip and clumsiness due to muscle wasting in the affected arm and hand

WHAT ARE THE CAUSES AND RISK FACTORS OF ULNAR NERVE IMPINGEMENT?

Some causes of ulnar nerve impingement are:

  • Formation of a cyst in the wrist joint known as a ganglion which might compress the ulnar nerve
  • Repeated pressure on your hand due to repetitive actions such as using a jackhammer or riding a bicycle where constant pressure is applied on your wrists and hands

WHAT IS THE DIAGNOSIS OF ULNAR NERVE IMPINGEMENT?

A history of the injury and a physical examination of the hand will be conducted by the Doctor. He will do some physical tests, such as checking on the muscle strength in your hands and fingers, and tapping the ulnar nerve at the hand and elbow.

Imaging tests will be taken, such as an x-ray for other causes of ulnar nerve compression (bone spurs, arthritis). A nerve conduction test will also be taken to locate the point of nerve compression and an electromyogram (EMG) to measure your nerve and muscle function.

WHAT ARE THE TREATMENT OPTIONS FOR ULNAR NERVE IMPINGEMENT?

Treatment for ulnar nerve impingement consists of both nonsurgical and surgical options. The first line of treatment is always nonsurgical treatment.

These methods include:

  • Resting the wrist
  • Medication such as nonsteroidal anti-inflammatory drugs (NSAIDs) (ibuprofen) to reduce swelling and inflammation of the nerve
  • Nerve gliding exercises
  • Wrist pad to be worn during the day to protect the wrist
  • A wrist splint to be worn during the night to keep your wrist in place and to let it heal

 

Should nonsurgical treatments fail to alleviate your symptoms or if your condition is caused by a cyst in the wrist, surgery may be recommended to remove it.

 

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