How Can Physiotherapy Remedy Ulnar Nerve Transposition

Image Source: https://www.jaaos.org/content/9/2/99/F11.expansion   

The ulnar nerve is a single nerve that arises from a group of nerves called the brachial plexus. It runs down the inner aspect of the arm, behind a bony prominence on the inner side of the elbow called the medial epicondyle. And, it runs all the down to the hand, supplying sensation to the muscles of the forearm and hand along the way.

The procedure performed to move the ulnar nerve from behind the medial epicondyle to a suitable position where it is not irritated or pinched by this bony prominence is known as Ulnar Nerve Transposition. Transposition means ‘to change in position’.

Why Does Anybody Need Ulnar Nerve Transposition?

Patients whose ulnar nerve is compressed against the medial epicondyle require Ulnar Nerve Transposition. Compression can occur due to excessive pressure on the area where the ulnar nerve is located, such as from leaning the elbow on a desk for many hours, fracturing of the medial epicondyle, or even resting the elbow on the car window when driving long distances. Additionally, certain conditions like rheumatoid arthritis and cubital tunnel syndrome can also cause entrapment of the ulnar nerve.

Due to compression of the ulnar nerve, the function of the nerve is compromised. Patients may have pain at the site of the medial epicondyle or may even have weakness of the muscles that are supplied by the ulnar nerve.

Normally, people also experience tingling and pain extending down their arms to the Ring and Little finger. These painful, tingling sensation is brief but bothersome. Some people feel these or similar sensations continuously.

Physical therapy can help correcting the condition, but sometimes surgery is required to move or transposition the Ulnar nerve.

Tips For Ulnar Nerve Pain:

If you have constant pain or tingling sensation extending from your elbow to your Little and Ring fingers, follow these simple tips to ease your pain –

• Placing ice directly on the Ulnar nerve at the elbow can cause Ulnar palsy. Hence, use a thin barrier between the ice and your skin
• Nerve stretching exercises can restore normal nerve movement (gliding) and reduce symptoms most of the time
• The symptoms of ulnar nerve pain may resemble the feeling you get when you hit your ‘funny bone’
• Seek for a Physical Therapist as soon as you face these symptoms, and allow him to educate you with the proper do’s and don’ts

Ulnar Nerve Treatment:

In case, the Ulnar nerve gets irritated, damaged, or entrapped, then Physical therapy is essentially required to address the symptoms. If physiotherapy fails to bring relief, then surgical procedure may be required.

Surgery is usually performed as an out-patient procedure. The nerve is carefully moved or transposed from the back or the posterior aspect of the medial epicondyle to the front or anterior aspect of the medial epicondyle through incision.

Physical therapy can begin immediately. During the first couple of weeks, physiotherapy focuses on reducing pain and swelling by maintaining motion and in the shoulder, wrist and hand. For the first couple of weeks, the surgeon may restrict the elbow movement. Once the doctor says it okay, the patient can move his elbow through the full range of motion and a strengthening program can be started to regain full function of the involved arm.
​
Physiotherapy is a major aspect of the rehabilitation process. Our professional physiotherapist will design a rehabilitation program utilizing the doctor’s protocols that will regain the motion and function of the involved elbow. Feel free to contact our physiotherapists who have abundant experience and knowledge to treat ulnar nerve entrapment.