Wrist Pain: possible ulnar nerve entrapment


Q: I have on and off wrist pain on my left wrist on the pinky side.I have had it for as long as i can remember. It is a sharp pain and hurts the most when i bend my wrist towards the pinky side, especially when holding or pulling something. I am right handed so it is not my dominant hand that hurts. I get the pain once every month to two months and usually lasts a couple days. It gets to the point where i can't move it at times and struggle to hold items. I used to play alot of tennis as a kid, i know coach twice a week, though very rarely play. I did break my wrist as a child.


A:   According to your description, this may be most likely an inflammation of the Ulnar nerve at the level of the wrist that is producing the pain, associated or not with a tendinitis , you may experience mild transient numbness in the ring and small fingers , also early fatigue or weakness may be present if you do a work that requires repetitive hand movements. The ulnar nerve is also very superficial at the level of the elbow so if you rest on the elbows at work, this may increase the numbness and pain  throughout the day. The suggested conservative treatment consist of: avoid the wrist movements that produce pain or discomfort, avoid resting on elbows at work, using elbows to lift the body from bed, and resting elbows on car windows while driving, using an anterior elbow extension splinting (if necessary), and correction of ergonomics at work should correct the transient numbness. Anti-inflammatory medications also are useful to relieve nerve irritation. Oral vitamin B-6 supplements may be helpful for mild symptoms. This treatment should be done out for 6-12 weeks, depending on the response. Surgical intervention is indicated if symptoms get worse despite adequate conservative treatment.

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