Ulnar Groove Syndrome

Autor: RAFAŁ CZEPUŁKOWSKI
Consultation JOANNA WAŁECKA
Date added 10.12.2024
Date of last revision 11.12.2024

Table of contents:

In ulnar groove syndrome, the ulnar nerve becomes chronically irritated in the groove of the nerve at the level of the medial epicondyle of the humerus. Irritation of the ulnar nerve in the ulnar groove is the second most common compression syndrome of the upper limb.

Table of contents:

Causes of Ulnar Groove Syndrome

  • Chronic overuse or pressure;
  • Direct trauma;
  • Elbow osteoarthritis;
  • Rheumatoid arthritis;
  • Displacement of the ulnar nerve due to a shallow groove or absence of the aponeurosis;
  • Tumors in the ulnar nerve canal, such as ganglia, lipomas, and others.

Symptoms of Ulnar Groove Syndrome

  • Pain in the medial area of the elbow joint, aggravated by movement;
  • Tingling and numbness in the fourth and fifth fingers, radiating from the elbow along the inner side of the forearm;
  • Sensory disturbances in the medial epicondyle region;
  • Sensory disturbances in the pads of the fourth and fifth fingers;
  • Mechanical symptoms such as "snapping," which may indicate nerve subluxation;
  • In advanced cases, weakness and atrophy of the intrinsic muscles of the hand.

Diagnosis of Ulnar Groove Syndrome

  • Medical History
  • Initial clinical diagnosis involves provocation tests.
  • Imaging
  • X-rays may reveal irregularities in bone structure causing local compression.
  • MRI and ultrasound may identify soft tissue pathologies compressing the nerve and nerve fiber swelling.
  • Spinal Examination
  • Evaluation of the cervical spine is essential during diagnosis because the ulnar nerve originates from the brachial plexus.

Treatment of Ulnar Groove Syndrome

Conservative Treatment
Initial therapy involves rest and avoiding prolonged elbow flexion, especially during sleep. Anti-inflammatory medications are recommended. However, conservative treatment may often be ineffective.

Surgical Treatment
If nerve subluxation, structural changes in the nerve, sensory or motor weakness, or rapidly progressing symptoms are detected, surgical intervention is advised. Surgery involves decompressing the ulnar nerve. After a short postoperative immobilization, the patient begins exercises and physical therapy (e.g., galvanization, electrostimulation, whirlpool massage).

Exercises for Ulnar Groove Syndrome

Exercises aim to mobilize the ulnar nerve to improve its gliding motion, reducing pain. Exercises should be pain-free and performed slowly. Regularity is crucial for alleviating upper limb discomfort, but excessive repetitions may fatigue nerve structures, worsening symptoms.

Overhead Arm Circles
Standing position, perform arm circles overhead with the palm facing upward. Duration depends on the patient’s condition and symptoms, 30–60 seconds per repetition, repeated 3–5 times.

Hand-to-Cheek Movement
Similar to a dart-throwing motion. Standing position, head rotated toward the exercising arm, arm flexed at 90° in the shoulder joint. Bend the elbow and bring the palm (facing upward) to the cheek.
Perform 3 sets of 8–10 repetitions.

"Putting on Glasses" Exercise
Resembles the motion of putting on glasses. Perform 2–3 sets of 8–10 repetitions. Nerve Mobilization

Exercise (Three Levels)

  • Level I: Dorsal and palmar flexion of the hand with the arm abducted at the shoulder joint.
  • Level II: Add side elevation of the arm up to the ear.
  • Level III: Similar to Level II, but end by covering the ear with the palm.

If symptoms intensify during exercises, rest and reduce the intensity of nerve mobilization.

Prognosis

Conservative treatment generally yields satisfactory results. The success of surgical treatment depends on the condition of the nerve and the time elapsed since the onset of symptoms.

Prevention of Ulnar Groove Syndrome

Prevention primarily involves proper positioning of the upper limbs during work, particularly for individuals working at computers, such as IT professionals. Those who frequently lean on their elbows should also take precautions. Sleeping with the arm bent under the head can exacerbate symptoms significantly.

Related Articles:
Discover other potential elbow injuries and conditions.

References:

Autor
RAFAŁ CZEPUŁKOWSKI
RAFAŁ CZEPUŁKOWSKI

Specjalista do spraw content marketingu, dziennikarz sportowy i medyczny. Redaktor naczelny magazynu „Poradnik Zdrowie i Sport”, członek Dziennikarskiego Klubu Promocji Zdrowia, współtwórca wielu artykułów medycznych z zakresu ortopedii i urazowości w sporcie.

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Konsultacja merytoryczna
JOANNA WAŁECKA
JOANNA WAŁECKA

Lekarz w klinice Rehasport, specjalizuje się w ortopedii i traumatologii narządu ruchu z ukierunkowaniem na leczenie zachowawcze oraz operacyjne schorzeń barku, łokcia oraz nadgarstka. Pracuje nad rozwojem wykorzystania biologii w leczeniu schorzeń ortopedycznych.

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