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The Not So Funny Bone – Ulnar Nerve Entrapment

What happens when we hit our ‘funny bone’? What causes that immense pain to shoot down from our elbow to our hand? Well, when we hit our ‘funny bone’, we’re not actually hitting a bone. We are in fact, directly hitting a nerve. The ulnar nerve to be specific. The ulnar nerve is one of three main nerves that run from our neck to our hand. Specifically, the ulnar nerve runs down the inside of our forearm and all the way into our ring and pinkie fingers. You may be wondering why you don’t you get similar symptoms when you knock other parts of your arm. It’s because the ulnar nerve travels through a space in our elbow called the cubital fossa. The nerve is most vulnerable in this space because there is only a thin layer of skin and fat to protect the nerve, so even the smallest knock or tap can produce pain. Generally, when we knock our ‘funny bone’, we feel severe pain shoot down into our fingers which is often accompanied by tingling. After a short time, the pain dissipates, and you can move on with your day. But sometimes these symptoms can become more constant and can occur without a knock to the funny bone. When this happens, we term it Ulnar Nerve Entrapment.

Ulnar Nerve Entrapment is the most common problem associated with the ulnar nerve and occurs when the nerve becomes compressed. Ulnar Nerve Entrapment can occur either in the elbow or in the wrist. Compression at elbow level is termed Cubital Tunnel Syndrome, while compression in the wrist is referred to as Guyon’s Canal Syndrome. Cubital Tunnel Syndrome is one of the most common peripheral neuropathies that occur in the arm, second to Carpal Tunnel Syndrome (which affects the median nerve in our upper limb). Guyon’s Canal Syndrome, on the other hand, is quite rare.

So what causes Ulnar Nerve Entrapment? Activities that continually stretch the ulnar nerve at the elbow joint, such as sustained bent elbow positions, or activities that put a lot of direct pressure through your elbow, can increase the risk of Cubital Tunnel Syndrome. Activities that put direct pressure through your wrists, such as leaning on handlebars, can increase the risk of Guyon’s Canal Syndrome. Populations that commonly complain of Ulnar Nerve Entrapment include baseball, tennis and golf players, cyclists, weightlifters and those who use a keyboard frequently.

Ulnar Nerve Entrapment can result in pain, tingling and numbness through the forearm, hand and ring and pinky fingers, as well as tenderness in the elbow region. In severe cases, compression on the ulnar nerve can lead to weakness in the hand and muscle mass loss.

Non-surgical management has been shown to effectively treat Ulnar Nerve Entrapment. Physiotherapy can provide appropriate activity modifications and positional advice, manual therapy for symptom relief and prescribe an individualised exercises to increase strength and mobility of the muscles, joints, and nerves. Splinting the elbow at night may also be indicated for some patients.

If you have persistent pain or other issues in your elbow, forearm or hand that are affecting your daily routine, book an appointment with one of our physiotherapists to get you back on track.


John Hopkins Medicine, Ulnar Nerve Entrapment,


Alle Foster

Alle completed a Bachelor of Physiotherapy at the University of South Australia and relocated to Sydney from Adelaide in 2023. Alle has a keen interest in Women’s Health, including pregnancy and postnatal care and pelvic floor dysfunction and has completed further study in this area. Alle has also completed post-graduate studies in osteoarthritic care through the GLAD (Good Living with Osteoarthritis) Program and enjoys applying this knowledge to patients suffering from osteoarthritic knee and hip pain. Alle adopts a biopsychosocial approach to her management and ensures no stone is left unturned in the management of her patients. She uses a combination of manual therapy including massage and dry needling for short term symptom relief and exercise to facilitate long term results. Alle has completed further training in clinical reformer Pilates and applies these principles when treating her patients, in both an individual and class setting.

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