Why Does My Left Hand Go Numb And Tingle – The ulnar nerve is one of the three main nerves in the arm. It runs from the neck to the hand and can be contracted in several places along the way, such as under the collarbone or in the wrist. The most common place for nerve entrapment is behind the inside of the elbow. Compression of the ulnar nerve in the elbow is called cubital tunnel syndrome.
Loss of sensation and tingling in the hands and fingers are common symptoms of cubital tunnel syndrome. In most cases, symptoms can be managed with non-surgical treatments, such as changes in activity and braces. If non-surgical methods do not improve your symptoms, or if nerve compression is causing muscle weakness or damage to your hand, your doctor may recommend surgery.
Why Does My Left Hand Go Numb And Tingle
This illustration of the bones of the shoulder, arm and hand shows the course of the ulnar nerve.
Tingling In One Hand
Reproduced from Mundanthanam GJ, Anderson RB, Day C: Ulnar nerve palsy. Orthopedic Knowledge Online 2009. Accessed August 2011.
In the elbow, the ulnar nerve travels through a tunnel of tissue (the cubital tunnel) that runs under a ball of bone on the inside of the elbow. This bony bulge is called the medial epicondyle. The place where the nerve runs under the medial epicondyle is often called the “funny bone”. In the funny bone, the nerve is close to your skin, and hitting it causes a tingling sensation.
Beyond the elbow, the ulnar nerve travels under the muscles on the inside of the forearm and reaches the hand on the side of the palm and little finger. As the nerve enters the hand, it travels through another tunnel (Guyyon’s canal).
The ulnar nerve supplies sensation to the little finger and half of the ring finger. It also controls most of the small muscles in the hand that help with fine movements and some of the larger muscles in the forearm that help you make a strong grip.
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The ulnar nerve provides sensation (sensation) to the little finger and half of the ring finger, both in the palm and the back of the hand.
In many cases of cubital tunnel syndrome, the exact cause is unknown. The ulnar nerve is especially vulnerable to compression at the elbow because it must pass through a narrow space with a lot of soft tissue to protect it.
Cubital tunnel syndrome can cause dull pain on the inside of your elbow. Most symptoms, however, occur in your hands.
(Left) The picture shows the appearance of the normal muscle between the thumb and index finger when the fingers are pinched. (Right) In this picture, muscle wasting was due to long-term ulnar nerve entrapment.
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There are many things you can do at home to help relieve your symptoms. If your symptoms interfere with normal activities or last longer than a few weeks, make an appointment to see your doctor.
Wrapping a towel loosely around your arm with duct tape can help you remember not to bend your elbows during the night.
Your doctor will discuss your medical history and general health. They may also ask about your job, activities, and what medications you are taking.
After discussing your symptoms and medical history, your doctor will examine your arm and hand to determine which nerve is pinched and where it is pinched. Some of the physical exams your doctor may perform include:
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To perform the Tinel test for nerve damage, your doctor will gently tap on the inside of your elbow joint, directly over the ulnar nerve.
X-rays. X-rays provide detailed images of dense structures, such as bones. Most causes of ulnar nerve compression cannot be seen on an X-ray. However, your doctor may take X-rays of your elbow or wrist to look for bone spurs, arthritis, or other places where the bone could be compressing the nerve.
Nerve conduction studies. These tests can determine how well the nerve is working and help identify where it is being pinched.
Nerves are like electrical cables that travel through the body carrying messages between the brain and muscles. When a nerve is not working properly, it takes longer to conduct.
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During a nerve conduction test, a nerve is stimulated at a single location and the time it takes for a response is measured. Several locations on the nerve will be tested; The area where the response is most likely to be delayed is where the nerve is pinched.
Nerve conduction studies can also determine if compression also causes muscle damage. During the test, small needles are inserted into some of the muscles controlled by the ulnar nerve. Muscle damage is a sign of more severe nerve compression.
Unless nerve compression has caused significant muscle wasting, your doctor will likely recommend nonsurgical treatment first.
Nonsteroidal anti-inflammatory drugs (NSAIDs). If your symptoms are just starting, your doctor may recommend an anti-inflammatory medication, such as ibuprofen or naproxen, to help reduce swelling around the nerve.
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Although steroids such as cortisone are very effective anti-inflammatory medications, steroid injections are generally not used to treat cubital tunnel syndrome because there is a risk of nerve damage.
Bras or braces. Your doctor may prescribe a padded brace or night brace to keep your elbow in a straight position.
Nervous sliding exercises. Some doctors feel that exercises to help the ulnar nerve slide through the cubital tunnel at the elbow and Guyon’s canal at the wrist can improve symptoms. These exercises can also help prevent arm and wrist stiffness.
Examples of sliding nerve exercises. With your arms in front of you and your elbows straight, bend your wrists and fingers toward your body, then extend them away from you and bend your elbows.
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There are some surgical procedures that relieve pressure on the ulnar nerve in the elbow. Your orthopedic surgeon will talk to you about the best options for you.
These procedures are usually performed on an outpatient basis, but some patients do better with an overnight stay in the hospital.
Release of the cubital tunnel. In this operation, the roof of the cubital tunnel ligament is cut and divided. This increases the size of the tunnel and reduces pressure on the nerve.
This illustration shows the course of the ulnar nerve through the cubital tunnel. Also shown are structures that can compress the nerve – such as the medial epicondyle and the ulnar collateral ligament.
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After the procedure, the ligament begins to heal and new tissue grows over the split. New growth heals the ligament and allows more room for the ulnar nerve to slide.
Cubital tunnel releases tend to work best when the nerve compression is mild to moderate and the nerve does not slip behind the bony crest of the medial epicondyle when the elbow is bent.
In this surgical photo, an cubital tunnel release was performed to decompress or relieve pressure on the ulnar nerve. The arrow shows the portion of the nerve that has shortened over time due to compression.
Anterior transposition of the ulnar nerve. In many cases, the nerve moves from its place behind the medial epicondyle to a new location in front of it. Moving the nerve to the front of the medial epicondyle prevents it from catching on the bony crest and stretching when you bend your elbow. This procedure is called anterior transposition of the ulnar nerve.
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The nerve can move under the skin and fat but over the muscle (subcutaneous transposition); in the muscle (intermuscular transposition); or under the muscle (muscular transposition).
For anterior transposition of the ulnar nerve, an incision is made either on the inside of the elbow (pictured) or on the back of the elbow.
Medial epicondylectomy. Another option to free the nerve is to remove part of the medial epicondyle. Like transposition of the ulnar nerve, this technique also prevents the nerve from becoming trapped in the bony crest and stretching when the elbow is bent.
Depending on the type of surgery you have, you may need to wear a brace for a few weeks after surgery. A muscular transposition usually requires a longer time (3 to 6 weeks) in a brace.
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Your surgeon may recommend physical therapy exercises to help you regain strength and movement in your arm. They will also talk to you about when it will be safe for you to return to all your normal activities.
The results of surgery are generally good. Each surgical method has a similar success rate for routine cases of nerve entrapment. If the nerve is very compressed or there is muscle wasting, the nerve may not be able to return to normal and some symptoms may remain even after surgery. Nerves heal slowly and it may take a long time to know how the nerve will look after surgery.
AAOS does not endorse any treatment, procedure, product or physician mentioned herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopedic advice or assistance should consult their orthopedic surgeon,
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