Olympian long-distance cyclists are at risk for this condition, as are professional baseball pitchers, but you could be too. Do you notice numbness, tingling or pain radiating into your arm and hand on the side of the little finger? “Handlebar Palsy” or Ulnar Neuropathy can be caused by the repeated jarring of the wrists and hands when cycling. The result is an inflammation of the ulnar nerve, a major nerve in your arm that runs down your hand. Inflammation of the ulnar nerve can occur in several areas as it travels from your neck to your hand. Resting your elbows on hard surfaces for a long period may cause a slight inflammation, but intense physical activity such as long-distance biking or repeatedly pitching a baseball are more likely to cause the serious cases of this condition.
Watch for numbness, tingling or pain in the forearm or hand on the side of the little finger. Pain and numbness in the elbow may also be present, with decreased hand grip and the inability to pinch together the thumb and the little finger. The ulnar nerve often becomes trapped in the elbow, as the space it has to travel through in this area is limited. This is called “Cubital Tunnel Syndrome.”
Although ice, rest and anti-inflammatory medications may help initially, if the pain and tingling persist, seek the advice of a specialist trained to evaluate and rehabilitate the hands and upper body. This doctor will review your symptoms and ask about your lifestyle and activities. He or she will examine your neck, shoulder, arm and wrist. The doctor may order tests such as a nerve conduction study (NCS) or an electromyogram (EMG). EMG is a procedure where electrodes are placed into the muscles and on the skin to measure the health of muscles and the nerves that control them, to help identify the area of nerve damage and determine the severity of the condition.
The exact cause of the condition must be determined, and behavioral changes must be made to reduce the pressure on the nerve. Wrist splints may be prescribed to reduce discomfort. If the cause is from bicycling, it may help to wear padded gloves and to change your hand position on the handlebars frequently. Oral anti-inflammatory medications and B vitamins may also be prescribed. Typically these minimally invasive measures will alleviate the condition, but if not, surgery may be required. The vast majority of patients respond favorably to some type of surgery to correct this condition.
If the nerve is trapped in the elbow, Cubital Tunnel Release surgery can be effective. This is typically done on an outpatient basis, and individuals can go home the same day. The area known as the cubital tunnel is cut to allow more room for the nerve to pass through. As healing occurs, new tissue is formed and fills in this area. The recovery period for this type of surgery includes wearing a splint for a few weeks and physical rehabilitation therapy to return full range of motion and strength to the arm and hand.
Repetitious motions or constant jarring of the arm cause the inflammation of the ulnar nerve. Try to reduce activities that repeatedly stress this area, and take frequent breaks with arm stretching when you can. If you are a bicyclist, wear padded gloves and move your hand position on the handlebars frequently.
If you are experiencing pain, stiffness or tingling in your hands, arms or shoulder, contact Dr. Rehman for a comprehensive evaluation and treatment plan. Her team of hand therapists will help you return to your activity with full use of your arm or hand. Call 586-532-0803 for more information.
To Learn More:
