The ulnar nerve is one of three main nerves in the arm, running from the neck down to the hand. Its path takes it along the inner arm and around the elbow through a narrow passageway called the cubital tunnel. When this nerve becomes compressed or irritated, it results in Cubital Tunnel Syndrome. The goal of “releasing” the ulnar nerve is to relieve this pressure through self-care, medical treatments, or surgery.
Identifying Ulnar Nerve Symptoms
The primary symptoms of ulnar nerve compression involve specific sensations in the hand. Individuals often experience numbness and tingling, described as “pins and needles,” affecting the pinky finger and the medial half of the ring finger. These sensations tend to worsen when the elbow is held in a bent position for a long period.
The compression can also lead to muscle weakness or a sense of clumsiness in the affected hand, making fine motor tasks difficult, such as buttoning a shirt or gripping objects. Some individuals may also feel an aching pain localized to the inner side of the elbow, which is the point of compression. Symptoms often become more noticeable at night, particularly if the person sleeps with their elbows tightly flexed.
At-Home Nerve Glides and Stretches
The initial approach focuses on modifying daily activities and performing specific movements designed to encourage the nerve to slide smoothly. These self-administered exercises, known as nerve glides, help reduce irritation and improve the nerve’s mobility within the cubital tunnel. Perform these movements gently, as over-stretching a compromised nerve can worsen symptoms.
One common exercise involves creating an “OK” sign by touching the tips of the thumb and index finger. With the elbow bent and the palm facing the body, rotate the hand inward until the “OK” sign is brought toward the ear. The motion is repeated slowly to promote a gliding effect on the nerve.
Another technique is the “neck tilt” stretch, which combines arm and neck movement to apply gentle tension. Extend the arm out to the side, palm facing up, while tilting the head away from the outstretched hand. This combined motion is held briefly and then released, creating a subtle stretch along the nerve’s path. These exercises should be performed in sets several times a day, only to the point of a gentle pull, not pain.
Ergonomic adjustments are also a powerful self-care step, mainly by avoiding positions that increase tension on the nerve. This includes consciously avoiding leaning on the elbow, especially on hard surfaces like a desk or chair armrest. During sleep, a simple wrap or towel can be used to keep the elbow from bending fully, preventing the prolonged flexed posture that aggravates symptoms overnight.
Doctor-Recommended Non-Surgical Treatments
If at-home measures do not provide adequate relief, a healthcare provider can recommend professional non-surgical interventions. One common recommendation is the use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to manage pain and reduce inflammation surrounding the nerve. While these medications offer symptomatic relief, they do not resolve the physical compression.
Formal physical therapy (PT) is often prescribed, moving beyond basic glides to a customized program. A hand or occupational therapist can teach advanced nerve gliding and strengthening exercises tailored to individual needs. They may also use therapeutic modalities like ultrasound or electrical stimulation to reduce localized swelling and pain.
Professionally fitted splints or braces are another common treatment, particularly for nighttime use. These devices maintain the elbow in a near-straight position, preventing the nerve from being stretched and compressed during sleep. In some cases, a physician may consider a corticosteroid injection near the site of compression to reduce severe inflammation. This injection aims to decrease swelling within the tunnel.
Recognizing When Surgery is Needed
While conservative management is successful for most people, severe or progressing cases of ulnar nerve compression require surgical evaluation. Failure of symptoms to improve after several weeks or months of consistent non-surgical treatment suggests the compression may be too severe for conservative methods.
Specific physical signs, often called “red flags,” indicate a need for prompt specialist consultation. The most serious is muscle wasting, or atrophy, in the small muscles of the hand, which manifests as visible thinning. Progressive or severe weakness in grip strength or fine motor control also signals that the nerve is experiencing significant damage. Surgery, which typically involves decompressing or moving the ulnar nerve, is reserved for these instances to prevent irreversible loss of muscle function and sensation.