There are three main nerves in your arm: the median, radial, and ulnar. Most people know their ulnar nerve as the “funny bone” when you hit your elbow and feel a sudden zinger.

Like all nerves in the body, the ulnar nerve is susceptible to irritation. When nerves are irritated, this refers to the nerve being compressed or trapped. This can happen to the ulnar nerve pretty easily: like when you hit your elbow unexpectedly, or “pinch” it when your elbow is bent for too long, or when your hand is resting on a tabletop right on the “bony” corner of your wrist. In all of these instances, the nerve can send tingling, numbness, and pain into your hand. Some of our patients describe this as “the feeling when your foot falls asleep.”

Patients often ask us, “If it is so easy to irritate this nerve, how do I keep from doing that?” One easy way is to remember: “LBO”- LEANING, BENDING, OPENING (up).

• LEANING: When your ulnar nerve is irritated in your elbow, your hand may start to tingle or go numb. Immediately, notice how you are sitting: are you sitting “propped’ up on your elbow? If so, LEAN away. Taking the pressure off of the elbow can sometimes give your elbow a moment to relax.
• BENDING: Sleeping in a tight, cozy position can sometimes cause your nerve to become irritated because your elbow has been BENT too long. When your elbow is bent to its max, your nerve is running into a roadblock: your elbow! To prevent this, try to avoid pulling your arm tightly into yourself (as best you can).
• OPENING (up): Your elbow is the main spot of irritation for this nerve; however, your hand can also be the culprit. The bony corner in your hand, where your hand meets your wrist, is a common spot of irritation when you rest on the corner too long. “Opening up” your hand by sitting palm up for a brief moment could help.

If your symptoms persist, it may be time to be evaluated by a physician. OrthoSouth has several hand surgeons who specialize in these kinds of diagnoses. Although surgery is never our first choice, sometimes, it is necessary. There are 2 common surgeries for ulnar nerve entrapment of the elbow:

• A release with decompression: In this procedure, the area around the ulnar nerve in the elbow is expanded. This decreases the pressure on the ulnar nerve at rest and with movement. This surgery has a short recovery time and some patients are back to work within a few days. Hand therapy following this surgery can be helpful but may not be required. Regardless, most patients return to normal activities without pain or numbness soon after.
• Decompression with transposition: This procedure involves moving the ulnar nerve a few millimeters and decompressing the “tunnel” the nerve sits in. This also allows better movement and stabilizes the nerve at the same time. Recovery time following this includes rest and time in therapy to ensure the health of the arm and nerve. Most patients are back to normal activities without pain following the procedure.

This article is provided courtesy of Tyler Cannon, MD, and Evelyn Daniel, ORT/L, CHT.