Is it Just the Funny Bone Pain or an Elbow Injury?

What's the deal with the funny bone? In reality, nothing. You rapidly realize this if you happen to strike the exact precise area on your elbow by accident. A sharp, tingling, painful sensation runs down your elbow and into your hand.

The Neurophysiology of Funny Bone

It's not even a bone that hurts but another sensitive subject. The ulnar nerve, in particular. This nerve, one of three major nerves in the arm, goes from the neck to the hand. The forearm, hand and two fingers (the ring and pinky fingers) are all innervated by the ulnar nerve. The name "funny bone" is thought to have come from the fact that the nerve correlates to the humerus bone (which sounds humorous, so it’s a kind of a pun). It's also possible that the term originated from the "funny" sensation of hitting it.

How can a gentle tap elicit such a strong reaction? The ulnar nerve runs through a conduit known as the cubital tunnel at its most vulnerable point. There, protection is confined to a thin layer of skin and very little fat.

When you strike the ulnar nerve, you usually give it 30 seconds, shake your arm about, and the pain goes away. But what happens when it's more than just a passing feeling? An injury or overuse might result in long-term elbow pain, numbness, or tingling. In rare cases, a tumor may develop. It is caused by ulnar nerve entrapment, nerve irritation, or inflammation.

Sometimes, if the pain persists and does not appear to be due to an accident, it may indicate a cubital tunnel syndrome. This feels like you've struck your funny bone, with pins and needles in your ring, pinky fingers, and arm weakness, but it lasts for a long time. If this describes your case, speak with your doctor. 

What Exactly is Ulnar Nerve Entrapment?

When the ulnar nerve is squeezed or pinched, it becomes entrapped. Although it can occur in the forearm or hand, ulnar nerve entrapment is most commonly found around or near the elbow, particularly in the cubital tunnel. Cubital tunnel syndrome arises when the ulnar nerve of the elbow is compressed. The cubital tunnel is the body's second most common area for nerve entrapment (the first is the carpal tunnel, found in the wrist).

Some variables make persons more likely to acquire ulnar nerve entrapment. These are some examples:

• Elbow arthritis or bone spurs;
• An elbow fracture or dislocation in the past;
• Repetitive or long-term stress induced by activities that necessitate a bent or flexed elbow.

The following are symptoms of ulnar nerve entrapment:

• Elbow, palm, or ring/pinkie finger pain (or burning sensation);
• Hand weakness (particularly in the pinky finger and upon gripping) or tenderness;
• Ring/pinky finger tingling, numbness, or diminished sensation;
• Cold sensitivity;
• Elbow joint sensitivity;
• The hand and wrist have a claw-like look.

How is Ulnar Nerve Entrapment Treated?

There are several nonsurgical treatments available to help with the pain and potential harm caused by ulnar nerve entrapment. These are some examples:

• Ibuprofen, aspirin, and other over-the-counter pain medicines are examples of nonsteroidal anti-inflammatories;
• Physical or occupational therapy;
• A cubital tunnel syndrome splint or elbow brace.

Surgery may be required in circumstances where these techniques have not improved the problem. Additional indicators of surgery include:

• The ulnar nerve is severely compressed;
• Muscle fatigue;
• The damage caused by nerve compression.

Surgery to decompress the ulnar nerve has been demonstrated to be effective in the vast majority of individuals. This surgery, in addition to providing relief, can prevent further damage or degeneration, which is required to avoid further hand weakening and poor function. Its advantages include simplicity and safety.