The dorsal ulnar cutaneous nerve is a branch of the ulnar nerve, extending from the neck down to the hand. It relays sensations from a specific area on the back of your hand and fingers to your brain.
Understanding the Dorsal Ulnar Cutaneous Nerve
The dorsal ulnar cutaneous nerve branches off the ulnar nerve in the forearm, about 5 centimeters above the wrist joint. It travels towards the wrist, often passing underneath the flexor carpi ulnaris muscle, then pierces through tissues to reach the back of the hand on the pinky finger side.
At the back of the hand, the dorsal ulnar cutaneous nerve divides into smaller branches. These provide sensory innervation to the skin over the medial (pinky finger) side of the back of the hand, the dorsal surface of the little finger, and the medial half of the ring finger. This nerve is purely sensory, relaying information about touch, pressure, temperature, and pain, but not controlling muscle movement.
What Can Go Wrong
Due to its superficial location, the dorsal ulnar cutaneous nerve is susceptible to injury or compression. External pressure is a common cause, often from tight wrist items like watches or bracelets, or repetitive resting of the wrist on hard surfaces, or certain sleeping positions.
Direct trauma to the forearm or wrist, such as blows, lacerations, or fractures, can also damage this nerve. These events can disrupt the nerve’s ability to transmit sensory signals.
Less frequently, other factors within the wrist can impinge on the nerve. These include ganglion cysts or inflammation in surrounding tissues, which can irritate or damage the nerve.
Identifying Problems
When the dorsal ulnar cutaneous nerve is affected, individuals experience distinct sensory changes in the areas it supplies. Common symptoms include numbness, tingling, or a “pins and needles” sensation on the back of the hand, particularly on the pinky finger side, extending to the dorsal surfaces of the little finger and the medial half of the ring finger. Some may also report a burning sensation or pain in these regions.
A healthcare professional diagnoses issues with this nerve through a physical examination, assessing sensation and performing tests to pinpoint the nerve. To confirm the diagnosis or identify the cause of compression, nerve conduction studies may be performed to measure electrical signal speed. Imaging techniques like ultrasound or MRI can also visualize the nerve and surrounding structures, helping identify cysts, inflammation, or other anatomical issues.
Steps Towards Recovery
Initial recovery steps for dorsal ulnar cutaneous nerve issues involve conservative measures. Rest is recommended, along with avoiding activities or pressures that aggravate symptoms, such as removing tight wrist accessories or adjusting sleeping positions.
Splinting or bracing the wrist can help maintain a neutral position and reduce pressure on the nerve. Over-the-counter NSAIDs can manage discomfort and reduce inflammation. If conservative approaches are insufficient, physical or occupational therapy may be suggested to improve nerve gliding and reduce compression.
If inflammation is significant and conservative methods fail, a healthcare provider might consider corticosteroid injections near the nerve to reduce localized inflammation and relieve symptoms. Surgical intervention is rarely needed, but may be considered in severe, persistent cases where a compressive lesion, like a cyst or scar tissue, can be surgically released. Consulting a healthcare professional is important for a personalized treatment plan.