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Ulnar Neuropathy

Ulnar neuropathy affects the ulnar nerve, which runs from the shoulder down to the hand and controls the fingers’ sensation and movement. If you think of it like an electrical wire, the axons are the wires on the inside that transmit the signals. The myelin is the thick insulation that protects the axons and allows for faster transmission of information along the nerve.

The severity of nerve injury is often classified based on the damage to the myelin and axons. When this nerve is compressed or damaged, it can result in symptoms such as numbness, tingling, weakness, and pain in the affected arm and hand.

Ulnar neuropathy can significantly affect daily activities and quality of life. Prompt diagnosis and treatment are critical to prevent further damage and improve outcomes.

What Is Ulnar Neuropathy?

Simply put, ulnar neuropathy refers to the compression or damage to the ulnar nerve in the arm. It affects up to 6% of the population, based on reports.

The ulnar nerve is one of three main nerves in the arm that run from the shoulder to the hand and is responsible for providing sensation to the small and ring fingers and for controlling the movement of specific hand muscles. When the ulnar nerve is damaged or compressed, it can lead to a range of symptoms, including pain, numbness, weakness, and tingling in the affected hand.

Symptoms Of Ulnar Neuropathy

The symptoms of ulnar neuropathy can vary depending on the extent and location of the nerve damage or compression.

Common symptoms include pain or aching in the arm, hand, or fingers, numbness or tingling in the small and ring fingers, weakness in the hand and fingers, and difficulty with delicate motor tasks, such as writing or typing. In severe cases, the weakness and loss of sensation in the affected hand can interfere with daily activities and affect the quality of life.

Arm Pain at Night

Arm pain at night can be miserable.  The pain can interrupt your sleep and erode your quality of life. Irritability becomes increasingly more common.  What are the causes?  When should I worry about it?  What are the treatment options for arm pain at night? The neck is composed of 7 boney building blocks numbered 1- 7. Sandwiched between the bones is a disc that functions as an important shock absorber. The cervical discs are susceptible to injury due to trauma, degeneration, repetitive motion, and surgery. Common disc injuries include disc bulges, and herniations. The injured disc can compress or irritate one or more nerves resulting in arm pain at night. It can…

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Left Arm Numbness

Treatment depends upon the underlying cause of the arm numbness. Left-arm numbness is a warning sign that requires attention. As noted above unexplained numbness requires immediate attention. At the Centeno-Schultz Clinic, we are experts in the treatment of left-arm numbness due to cervical nerve irritation, cervical stenosis, thoracic outlet syndrome, and peripheral nerve injuries. When appropriate first-line treatment should involve conservative care including physical therapy and stretching. Steroid injections should be avoided as they are toxic to orthopedic tissue and can accelerate damage. Surgery for Cervical Stenosis and Thoracic…

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Common Causes Of Ulnar Neuropathy

Ulnar neuropathy can be caused by various factors, including direct trauma to the nerve, overuse, or long-term compression at the elbow. Compression of the ulnar nerve is called cubital tunnel syndrome, and it is one of the most common causes of ulnar neuropathy.

It can be caused by bending the elbow repeatedly, such as when working on a computer or playing a musical instrument, or by leaning on the elbow for extended periods.

In addition to cubital tunnel syndrome, there are several other conditions that can contribute to ulnar neuropathy. These include arthritis in the elbow, tumors in the arm, or injury to the nerve tissue itself. 

Certain medical conditions, such as diabetes, can also increase the risk of developing diffuse peripheral neuropathy, as can age-related changes in the nerve and surrounding tissues.

Diagnosis and Examination

Diagnosis of ulnar neuropathy should involve a thorough medical history and comprehensive physical examination. Tests such as nerve conduction studies, electromyography, or imaging such as diagnostic ultrasound or MRI can help provide additional information.

These tests can help to identify the extent and location of the nerve damage and to assist in determining the underlying cause, which is ultimately the most critical aspect.

Common Treatments Of Ulnar Neuropathy

Treatment for ulnar neuropathy depends on the underlying cause of the nerve damage and the severity of the symptoms.

In some cases, simple measures such as rest and physical therapy may be enough to relieve symptoms. If the cause of the nerve damage is cubital tunnel syndrome, the patient may be advised to avoid bending the elbow and to use a splint to help protect the nerve. Physical therapy is often prescribed, utilizing nerve glides to mobilize the nerve.

Two standard surgical procedures for ulnar neuropathy include cubital tunnel release and ulnar nerve transposition. These surgeries involve cutting through any tissue that may be compressing the nerve and potentially removing the medial epicondyle, the bony part of the inside of the elbow.

In addition, often, the nerve itself is moved from the back of the elbow to the front of the elbow to help relieve pressure.

Cubital Tunnel Syndrome Surgery

Cubital Tunnel Syndrome, a compressive neuropathy of the ulnar nerve at the elbow, is the second most common compressive neuropathy in upper extremities (1st = carpal tunnel syndrome). The Ulnar nerve is a continuation of nerve roots from your middle and lower neck (cervical spine) that get combined in the upper arm and then travel down the inside of your arm. It enters the cubital tunnel on the inside of your elbow and then travels to your hand. How successful is cubital tunnel syndrome surgery? In recent years, physicians have been favoring surgery. In a study by Osei et al., 41.3% of patients diagnosed…

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Nerve Hydrodissection

Nerve Hydrodissection is a medical procedure that aims to free up scar tissue or adhesions on a given peripheral nerve. The procedure utilizes ultrasound guidance to visualize both the needle and the targeted nerve. Medication is then injected through the needle to free up the scar tissue. Nerve Hydrodissection is a minimally invasive treatment option for many peripheral nerves that are compressed or entrapped by scar tissue.Pain is an uncomfortable and at times painful sensation. It varies significantly from patient to patient. There are many different types of pain which include inflammatory, nociceptive, and neuropathic. Neuropathic pain is pain that arises from nerve compression or injury.

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Platelet-Rich Plasma (PRP) Injections

PRP is short for platelet-rich plasma, and it is autologous blood with concentrations of platelets above baseline values. The potential benefit of platelet-rich plasma has received considerable interest due to the appeal of a simple, safe, and minimally invasive method of applying growth factors. PRP treatments are a form of regenerative medicine that utilizes the blood healing factors to help the body repair itself by means of injecting PRP into the damaged tissue. In regenerative orthopedics, it is typically used for the treatment of muscle strains, tears, ligament and tendon tears, minor arthritis, and joint instability. There have been more than 30 randomized controlled trials of PRP…

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Prolotherapy Injections

It has been successful in the treatment of many disorders including neck, shoulder, knee, and ankle pain. Dr. Centeno recently published an article in The Journal of Prolotherapy in which he discusses the use of x-ray guidance with prolotherapy. This ensures that the injection is in the correct place to maximize clinical results. Dr. Centeno discusses the use of prolotherapy for the treatment of neck, knee, sacroiliac joint, ankle, ischial tuberosity, and shoulder pain. At the Centeno-Schultz Clinic x-ray guided prolotherapy is just one of the therapies utilized in the successful treatment of pain. Regenerative injection therapy (RIT) or prolotherapy…

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The Regenexx Difference – Your Body Healing Itself!

Here at Centeno-Schultz Clinic, we utilize image-guided injections of Platelet Lysate to hydro-dissect or create space around nerves that may be compromised by surrounding tissue.

This not only improves space for the nerve but the growth factors in platelets are concentrated in our in-house laboratory and allow for enhancement of the healing process. Nerve growth factor, brain-derived growth factor, ciliary neurotrophic factor, and glial-derived neurotrophic factor are just a few of those that help provide nerve healing and regeneration.

Following treatment, patients need to take steps to protect the ulnar nerve and prevent further damage. This may include avoiding activities that put pressure on the nerve, such as leaning on the elbow for extended periods and doing exercises to help strengthen the muscles in the hand and arm.

Experience The Best Treatment At Centeno-Schultz Clinic

In conclusion, ulnar neuropathy is a type of nerve damage that affects the ulnar nerve in the arm, causing a range of symptoms, including pain, numbness, weakness, and tingling. 

The condition can be caused by various factors, including direct trauma, repetitive stress, or long-term compression, and can be diagnosed through a combination of medical history, physical examination, and tests such as nerve conduction studies. Treatment options for ulnar neuropathy may include rest, physical therapy, surgery, and steps to protect the nerve and prevent further damage.

Christopher J. Centeno, MD

Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…

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John Schultz, MD

John R. Schultz M.D. is a national expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate for orthopedic injuries. He is board certified in Anesthesiology and Pain Medicine and underwent fellowship training in both. Dr. Schultz has extensive experience with same day as well as culture expanded bone marrow concentrate and sees patients at the CSC Broomfield, Colorado Clinic, as well the Regenexx Clinic in Grand Cayman. Dr. Schultz emphasis is on the evaluation and treatment of thoracic and cervical disc, facet, nerve, and ligament injuries including the non-surgical treatment of Craniocervical instability (CCI). Dr. Schultz trained at George Washington School of…

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John Pitts, M.D.

Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.

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Jason Markle, D.O.

Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.

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Brandon T. Money, D.O., M.S.

Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…

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An TW, Evanoff BA, Boyer MI, Osei DA. The Prevalence of Cubital Tunnel Syndrome: A Cross-Sectional Study in a U.S. Metropolitan Cohort. J Bone Joint Surg Am. 2017 Mar 1;99(5):408-416. doi: 10.2106/JBJS.15.01162. PMID: 28244912; PMCID: PMC5324036.

Bhandari PS. Management of peripheral nerve injury. J Clin Orthop Trauma. 2019 Sep-Oct;10(5):862-866. doi: 10.1016/j.jcot.2019.08.003. Epub 2019 Aug 13. PMID: 31528058; PMCID: PMC6739245.

Centeno C, Markle J, Dodson E, Stemper I, Hyzy M, Williams C, Freeman M. The use of lumbar epidural injection of platelet lysate for treatment of radicular pain. J Exp Orthop. 2017 Nov 25;4(1):38. doi: 10.1186/s40634-017-0113-5. PMID: 29177632; PMCID: PMC5701904.

Malahias MA, Johnson EO, Babis GC, Nikolaou VS. Single injection of platelet-rich plasma as a novel treatment of carpal tunnel syndrome. Neural Regen Res. 2015;10(11):1856–1859. doi: 10.4103/1673-5374.165322. 

Wade RG, Griffiths TT, Flather R, Burr NE, Teo M, Bourke G. Safety and Outcomes of Different Surgical Techniques for Cubital Tunnel Decompression: A Systematic Review and Network Meta-analysis. JAMA Netw Open. 2020;3(11):e2024352. doi:10.1001/jamanetworkopen.2020.24352

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