From the Guidelines
Orthopedic surgeons, neurologists, and hand specialists, particularly those with expertise in hand surgery, are the primary doctors for treating ulnar neuropathy. When evaluating ulnar nerve entrapment, T2-weighted MR neurography is considered the reference standard for imaging, as it can provide detailed information on nerve signal intensity and enlargement 1.
In terms of treatment, conservative approaches are often considered first, including:
- Anti-inflammatory medications, such as ibuprofen 400-800mg three times daily
- Nerve gliding exercises
- Splinting at night
- Activity modification to avoid elbow flexion and pressure on the nerve Physical therapy may also be recommended to strengthen surrounding muscles and improve nerve mobility.
If conservative treatments fail after 6-12 weeks, surgical options may be considered, including decompression, transposition, or medial epicondylectomy, with the goal of relieving pressure on the nerve and preventing further damage 1. Prompt treatment is crucial, as prolonged compression can lead to permanent nerve damage, resulting in persistent numbness, weakness, and muscle wasting in the hand and fingers.
The use of diffusion-tensor imaging and diffusion-tensor tractography can provide additional quantitative information and increase diagnostic confidence in evaluating ulnar nerve entrapment 1. However, the primary consideration in treating ulnar neuropathy remains a multidisciplinary approach, involving orthopedic surgeons, neurologists, and hand specialists working together to provide the best possible outcomes for patients.
From the Research
Ulnar Neuropathy Treatment
Ulnar neuropathy can be treated by various healthcare professionals, including:
- Orthopedic surgeons, who may perform surgical procedures such as decompression or transposition of the ulnar nerve 2, 3
- Chiropractors, who may use manipulative therapy, myofascial therapy, and elastic therapeutic taping to manage symptoms 4
- Physical therapists, who may provide exercises and education on workstation ergonomics to help reduce symptoms 5, 4
- Primary care physicians, who may provide conservative treatment such as information on avoiding prolonged movements or positions, night splinting, and nerve gliding exercises 2
Treatment Options
Treatment options for ulnar neuropathy may include:
- Surgical treatment, such as simple decompression or decompression with transposition of the ulnar nerve 2, 3
- Conservative treatment, such as information on avoiding prolonged movements or positions, night splinting, and nerve gliding exercises 2
- Chiropractic care, including manipulative therapy, myofascial therapy, and elastic therapeutic taping 4
- Physical therapy, including exercises and education on workstation ergonomics 5, 4
Specialized Care
In some cases, ulnar neuropathy may require specialized care from:
- Neurologists, who may evaluate and manage underlying neurological conditions contributing to ulnar neuropathy
- Occupational therapists, who may provide education and training on workplace ergonomics and adaptive equipment to reduce symptoms 4