Ulnar Nerve Entrapment

[Scott L]

Over the past year, I've begun to experience some numbness and tingling in the 3rd and 4th fingers of my left hand as well as the outside of the forearm. I especially notice this when playing guitar and mandolin. I'm an RN, so I am aware that the ulnar nerve is responsible for innervating those fingers. I've researched this is bit and believe the condition is likely ulnar nerve entrapment. The ulnar nerve passes close to the surface of the outside of the elbow, and is the nerve that is affected when we refer to hitting the "funny bone". I've not been to the doctor about this yet, but I am trying to research possible treatment options. From what I've read, this condition can lead to muscle atrophy, hand weakness, and loss of finger coordination. I've played guitar for about 35 years and more recently have developed a strong love for the mandolin. Although I'm not a professional musician, playing music is one of the most important things in my life. I'm very concerned about losing my ability to play. My grip is still strong and I can still play, but I can see this is something I need to address before it gets worse.

I'm reaching out to my fellow musicians to see if anyone of you have suffered from this condition and found effective treatment.

Scott

[Tobin]

I get that tingly sensation and my pinky/ring fingers go numb on a regular basis. Oddly enough, it never happens when playing an instrument. Usually it's when I'm reading a book or using a smart phone. It's got to be one particular position of my elbow that's doing it.

Anyway, one of my employees is going through treatment for ulnar nerve entrapment. They gave him some steroid pills that are supposed to provide relief, and he had to special-order some elbow braces. They are telling him that it could go as far as surgery to relocate the nerve to the inside of his elbow (???). That sounds pretty radical to me, but apparently it's a common procedure that fixes the problem.

I had wrist surgery about 11 years ago when I shattered my wrist and they had to install a plate. It involved relocating nerve bundles in my wrist, and it's never been right since. So I'm not a big fan of them moving things around where they shouldn't be.

[T.D.Nydn]

You have to start lifting weights and slowly build up your forearm muscles.its really the only long term solution.its what has saved me in the past ,I have many complex problems,,and it's what's saving me to this very day...

[PlaneSimple]

Nerves also travel through the back/spine. I strongly recommend inversion to stretch the spine back out from time to time. Long story short.. doctor wanted me to have carpal tunnel surgery.. but that pain was cured by pull up bar and gravity boots.
An impinged nerve in the spine can create phantom pain that appears in the hand.

[noah finn]

I had some prolems with my ulnar nerve. I hurt it lifting a back of gardening compost. Like you started with tingling in little finger and ring finger. It got so bad I found it hard to lift the handbrake in my car.
I took complete rest from mandolin for four weeks. Someone suggested to me that the problem could be aggravated by sleeping on your arm at night. So I forced myself to sleep on my back and wrapped and large towel loosely around my arm at the elbow joint to keep it straight.After a week of doing this I found a huge improvement in the nerve. I haven't had any more problems with the ulnar nerve.

[sgarrity]

I had this exact problem 2-3 years ago. You need to see a neurologist and get an EMG. You're an RN so you probably know they aren't fun. The "shocking" portion isn't bad but I only let them stick me twice. My Doc said I had a 'traumatic nerve event" that was basically presenting as ulnar entrapment. I was lifting weights regular and heavily in addition to mandolin playing. She told me to keep lifting but back off on the weight, stretch, and give it time. It took about 18 months to get over but now I'm 99% back to normal. I understand the psychological side of it too. I sold a killer mandolin during that time because I just couldn't play it very long. Best of luck to you and get to the doctor!

[Tailgate]

I'm having the same sympyoms and have an appointment scheduled for an EMG in a couple months. For now I am trying to limit my playing to no more than a half hour at a time and only every other day or so. I've also been trying to sleep without bending my elbow. Over the past week or so the tingling in my pinky has mostly disappeared, although I have noticed that the knuckles crack a lot easier than they ever have... not sure if that is a result of anything.
The worst part is that it all started a couple of months ago after going for physio to deal with a joint issue on my index finger. I'm not sure if it's the exercises or stretches that I was given, but it all seems to line up.

[MysTiK PiKn]

Thanks, Scott.
This seems similar to what I have been experiencing. But I have noticed a lot of these symptoms are very similar for seemingly various problems.
Like some others, I find physical activity really helps me - but - I am not about to go out and lift 10000 pounds. I am more of the yoga kind of guy. I think any activity can help - like walking or swimming. Having said that I am prepping for a reroof on a shed, and cleared out some objects that I really could not lift. And the overall activity was helpful. In the yoga dept., there's some exercises referred to as the "Eternal Youth" exercises; aka The 5 Tibetan Rites. Some of those deal with spine alignment - but not by hanging upside down, altho some positions approach that. Exercise 2 pulls from both ends. Similar idea to upside down. I had a friend who bought equipment to hang upside down; and he used it regularly. Offsetting gravity effects, and possible toxic accumulations. This old age stuff is largely optional. Takes some effort tho.
My symptoms showed up on mandolin in the form of heavy lactic acid accumulation in the left arm. I would say it was tension related, and I have changed how I hold mando now. But I don't play much. A week off was not enough. Some 2-3 weeks was better; but I played for half hour recently and it all came back again - not bad; but same problems. Seems like a long term deal, for rest at least. And exercise. Physical fitness. Build the immune system. All of that.
I also noticed my baby finger is shorter than others, and stretching and straining it to reach chopchords and other things, are part of the cause, esp. when combined with bad mando holding position. Wrist bending is a risky business, it seems - a straight wrist might be better.
I am back to playing guitar and dobro. I have no problem w guitar - except, today I put a capo on the 5th fret, making it near mando sized. And immediately felt the nasty pains, then noticed I was all scrunched up like the guitar was a mandolin. That scrunchy position is what I am no longer doing on mandolin. I keep watching for more clues.
I was wondering if your research revealed any cause of the actual socalled "entrapment". The things you mention it might lead to are symptoms, imho. Beyond stretch and strain and lactic acid, I notice when playing, I tend to press too hard on the fb, especially for some chords; but also when picking notes. I noticed some initial crackly noises some 50 years ago - it almost seems natural for someone who has spent years smashing his fingertips against a fretboard. (hammerons). But I also have over the years done various jobs where hand and arm damage may have happened. Once was diagnosed as repetitive strain; and was told I would always be vulnerable to that.
I would appreciate any more info you discover in research. There's been a lot of threads like this lately. There's likely a couple dozen people here with related problems.
Beyond exercise, I find better eating helps. I don't use any drugs, otc or script.

[sgarrity]

.....I've also been trying to sleep without bending my elbow......

I forgot that my Doc mentioned this too. I've trained myself not to do it and I think that was a big help in the healing process.

[Ted Eschliman]

Sometimes a simple change in hand position and technique can help greatly. Link

[Paul Busman]

'Nother RN here...
Check out your left arm playing position. Do you keep the head of the mandolin up close to your body, thereby sharply flexing the elbow? That could be stretching the ulnar nerve tightly around the medial epicondyle of the humerus. A more relaxed arm position, letting the left hand and head of the mandolin drop down so there is a 90deg angle between the upper and lower arm will take off some of that stretch.
By all means get it looked at. You don't necessarily need nerve conduction studies-- there are non invasive tests that can give the Doc a pretty good idea of what's going on.

[Astro]

Yep, some good advice above.

It can get better on its own.
Be sure you dont pinch it further by curling up your elbow and sleeping on it.
Physical exercise can aggravate it or help it. Be careful. Work with orthopedist/physical therapist. When its inflamed, be wary with curls especially if you see/feel the ulner nerve flip across your medial condyle while flexing the elbow.
There is a surgery that can be done to fixate it and keep it from rotating over but it is rarely needed. Avoiding the aggravating factors will let it heal on its own after several months. Just be careful with it.

[Tailgate]

Forgot to mention, I've also adjusted my arm position so the top portion, from the shoulder to the elbow, basically drops parallel to my body and the neck of the mandolin is out in front of me. I used to pull my left arm back so the neck was closer to my body and my elbow was slightly toward my back. This was causing unnecessary tension at the elbow.

[Pete Braccio]

Don't screw around with this. See a Neurologist and get tested and get treatment.

Which of these two hands do you think had an Ulnar Nerve issue at its elbow?

Pete

[MysTiK PiKn]

Forgot to mention, I've also adjusted my arm position so the top portion, from the shoulder to the elbow, basically drops parallel to my body and the neck of the mandolin is out in front of me. I used to pull my left arm back so the neck was closer to my body and my elbow was slightly toward my back. This was causing unnecessary tension at the elbow.

Yup. That's what I was doing also. I now pay serious attention to what I am doing while playing mando. I still have not found the magic combo for posture, arm geometry, and mando strap. I don't know what to do with my right arm - but I am thinking an armrest might be the thing.

What I was doing before, my left arm was going numb and I didn't realize until I stopped playing.

These many threads like this are now overlapping in both the problems, and the solution possibilities.

[Micky Delvesco]

X-Rays of your elbow should show what's up. There is a simple operation to relieve the pressure on the nerve. I ignored the signs (tingling and numbness) until my entire arm would go numb from the elbow to the fingertips. Had the operation a little over a year ago, no problems since.

[Scott L]

Thanks everyone for the great replies. Lots of good advice and suggestions. I reached out to the Cafe forum because I thought that others here may have had similar issues. I agree that I need to address the issue from a number of different angles, including exercise, nutrition, paying close attention to posture and not using more hand and finger pressure than needed. I will also get checked out by a doctor. The irony is that, even though I work in the surgical unit of a hospital, I absolutely do not like taking medications or the thought of having surgery unless absolutely necessary. The problem isn't debilitating yet, but I know if I ignore it things will only get worse. I've gone through many changes in my life, including big career, financial and relationship changes, but the one thing that has been a constant source of comfort and pleasure throughout my life has been music. The thought of eventually not being able to play due to something like this is horrible.

[Paul Busman]

You're an OR nurse? That's my day job too! And I'm on call tonight