Nerve compression in the wrist or hand can cause persistent numbness, tingling, and weakness that affect grip strength and fine motor control. One of the most common forms of nerve compression in the upper extremity involves the ulnar nerve, which runs from the neck down to the hand.
When this nerve becomes compressed—most often near the elbow (cubital tunnel) or at the wrist (Guyon’s canal)—it disrupts communication between the brain, muscles, and skin. This results in sensations of numbness, tingling, or weakness, particularly in the ring and little fingers.
At Dr. Burke Orthopedics, we provide accurate diagnosis and advanced treatment for ulnar nerve compression, helping patients throughout Pearland, Houston, Friendswood, and Southeast Texas restore function and relieve nerve pain.
The ulnar nerve is one of three main nerves that provide movement and sensation to the hand (along with the median and radial nerves). It travels through several narrow tunnels along its path—from the upper arm to the wrist—and supplies feeling to the ring and little fingers, as well as control to small muscles in the hand that help with grip and coordination.
Compression occurs when the nerve becomes trapped or irritated as it passes through tight anatomical spaces. The two most common sites of entrapment are:
- Cubital Tunnel (Elbow): Causes Cubital Tunnel Syndrome
- Guyon’s Canal (Wrist): Causes Ulnar Tunnel Syndrome
Both conditions can produce similar symptoms in the hand and wrist, but the exact pattern and severity depend on where the nerve is compressed.
Ulnar nerve compression can develop gradually from repetitive motion or result from acute injury. Several factors can increase susceptibility to nerve irritation.
Common causes include:
- Repetitive bending or leaning on the elbow: Increases pressure on the cubital tunnel.
- Prolonged elbow flexion: Common during phone use or sleeping with bent arms.
- Direct trauma or injury: A blow to the inner elbow (“funny bone”) can bruise or inflame the nerve.
- Cysts or bone spurs: Can narrow the space through which the nerve travels.
- Fractures or arthritis: Prior injuries to the elbow or wrist may alter joint anatomy and compress the nerve.
- Prolonged pressure on the wrist: Seen in cyclists or workers who use vibrating tools.
People with diabetes or thyroid conditions may also have an increased risk due to nerve sensitivity or decreased healing response.
Symptoms depend on where along its course the ulnar nerve is compressed but typically affect the ring and little fingers more than others.
Common symptoms include:
- Numbness or tingling in the ring and little fingers
- Pain or burning on the inside of the forearm or wrist
- Weak grip strength or clumsiness when handling objects
- Difficulty spreading fingers apart or coordinating small hand movements
- Hand fatigue, especially after prolonged activity
- Muscle wasting in severe or chronic cases (especially in the small hand muscles)
Symptoms often worsen when the elbow or wrist remains bent for extended periods, such as during phone calls or while sleeping.
At Dr. Burke Orthopedics, diagnosis begins with a detailed examination to identify the exact site of nerve compression and its severity.
Dr. Robert L. Burke, board-certified orthopedic surgeon, performs a comprehensive evaluation that may include:
- Medical history: Discussion of symptoms, occupational activities, and previous injuries.
- Physical examination: Tests for tenderness, muscle weakness, and changes in sensation.
- Tinel’s sign: Lightly tapping over the nerve to reproduce tingling sensations in the fingers.
- Elbow flexion test: Holding the elbow in a bent position to provoke symptoms of cubital tunnel syndrome.
- Nerve conduction studies: Measure electrical activity along the nerve to detect slowed signals or blockages.
- Electromyography (EMG): Assesses muscle response and identifies long-term nerve irritation or damage.
- Imaging (MRI or ultrasound): Used to visualize structural causes like cysts, bone spurs, or joint inflammation.
This precise diagnostic process ensures that Dr. Burke identifies not only the location but also the underlying cause of nerve compression, allowing for effective and targeted treatment.
Treatment focuses on relieving pressure on the nerve, reducing inflammation, and restoring normal function. The appropriate approach depends on how severe the compression is and whether permanent nerve damage has occurred.
Non-Surgical Treatments
- Activity modification: Avoid prolonged elbow flexion, leaning on hard surfaces, or resting elbows on desks.
- Bracing or splinting: Keeps the elbow or wrist in a neutral position during sleep to prevent nerve pinching.
- Anti-inflammatory medication: Reduces swelling around the nerve.
- Ergonomic adjustments: Using padded supports or ergonomic tools can relieve ongoing strain.
- Gentle stretching, nerve gliding exercises, and posture correction techniques improve mobility and circulation.
Surgical Treatments
If non-surgical care fails or nerve testing shows significant compression, surgery may be recommended.
- Ulnar Nerve Release Surgery: The compressed portion of the nerve is released to create more space and restore normal nerve function.
- Nerve Transposition: The nerve is repositioned to a more protected location to prevent recurrent irritation.
- Removal of structural causes: Cysts, scar tissue, or bone spurs may be removed if they are pressing on the nerve.
These procedures are typically performed on an outpatient basis, and most patients notice gradual improvement as the nerve heals.
Recovery time depends on the type of compression and treatment chosen.
- Non-surgical recovery: Most patients improve within several weeks of splinting and physical therapy.
- Surgical recovery: Light movement begins soon after surgery, with full recovery typically achieved in 8–12 weeks.
Rehabilitation may include:
- Nerve gliding exercises to restore flexibility
- Gentle strengthening of hand and forearm muscles
- Avoiding pressure on the healing site
- Ergonomic adjustments for daily tasks or workstations
With proper care, most patients regain strength, coordination, and sensation without lasting effects.
When treated early, ulnar nerve compression responds well to both conservative and surgical care. However, untreated or chronic compression can result in permanent nerve damage or hand deformity.
Preventive tips include:
- Avoid resting elbows or wrists on hard surfaces for extended periods
- Keep the wrist and elbow in a neutral position during work or sleep
- Stretch regularly to maintain flexibility
- Address repetitive strain injuries early
- Maintain good posture and ergonomic habits at workstations
Ongoing physical therapy and periodic orthopedic evaluation can help protect nerve function and prevent recurrence.
You should schedule an evaluation if you experience:
- Persistent numbness or tingling in the ring and little fingers
- Weakness in grip or difficulty manipulating small objects
- Pain that radiates from the elbow to the hand
- Visible muscle wasting or hand deformity
- Symptoms that worsen at night or with activity
Prompt diagnosis prevents irreversible nerve injury and supports faster recovery.
Take the First Step Toward Relief
If hand or wrist numbness is affecting your strength, coordination, or daily comfort, it may be more than simple overuse — it could be a sign of nerve compression. Early diagnosis and treatment can prevent long-term damage and restore natural hand function.
At Dr. Burke Orthopedics, we specialize in diagnosing and treating nerve-related hand and wrist conditions with precision, compassion, and experience.
We proudly serve patients throughout Pearland, Houston, Friendswood, and Southeast Texas.
Call (713) 436-3488 or Request an Appointment Online to schedule a consultation with Dr. Robert L. Burke, board-certified orthopedic surgeon specializing in hand and nerve disorders.
