Carpal Tunnel and Ulnar Nerve Entrapment Los Angeles
Pinched nerves can cause pain and other neurological symptoms. A nerve can get pinched at any point in its path. Most often, people think about pinched nerves in the spine. However, nerves can also be pinched in the arms or legs. The most common type of pinched nerve is in the wrist and elbow.
In the wrist, the median nerve can get pinched and is called carpal tunnel syndrome. Symptoms can include numbness, tingling, and pain in the thumb, index and middle fingers as well as thumb and finger weakness. Symptoms tend to get worse at night, with the hand “falling asleep” at night.
In the elbow, the ulnar nerve can get pinched (called cubital tunnel syndrome). Symptoms can include numbness, tingling, and pain in the pinky and ring fingers. Weakness is usually noted in the pinky, with atrophy (or wasting) around the pinky as well as in the space between the index finger and thumb. Symptoms tend to get worse at night, with the hand “falling asleep” at night.
Initial management includes using a wrist brace both at night and during the day. Sometimes, targeted injections can be used as well.
If symptoms progress or if there is clear weakness or atrophy, surgery should be considered. The goal of surgery is to increase the space through which the nerve is traveling and reduce the “pinching.” For carpal tunnel syndrome, surgery involves making a small incision on the wrist ad opening the covering of the median nerve (the flexor retinaculum). The surgery is brief and can be extremely helpful. There is a risk of injuring the nerve, causing thumb weakness, but this is rare. For ulnar nerve entrapment, an incision is made on the elbow, where the nerve is decompressed in the region of the “funny bone.” If the nerve moves around a lot, we will sometimes move the nerve to a new, more stable position.