What Is Ulnar Nerve Decompression?

• In simple terms: The surgery creates more room for the ulnar nerve at the elbow (or wrist) by removing tight structures pressing on it.
  
  

• Scientifically: Ulnar nerve decompression involves release of fascial bands, Osborne’s ligament, and flexor carpi ulnaris aponeurosis, with or without anterior transposition. The goal is to relieve chronic nerve entrapment and restore conduction.
  
  

Conditions Treated

• Cubital tunnel syndrome (ulnar nerve compression at the elbow)
  
  

• Guyon’s canal syndrome (ulnar nerve compression at the wrist)
  
  

• Progressive numbness, tingling, or hand weakness despite conservative care
  
  

• Muscle wasting in severe cases requiring urgent decompression
  
  

Non-Surgical Care (Tried First)

• Activity modification (avoiding prolonged elbow flexion or leaning on elbows)
  
  

• Night splints to keep elbows straight
  
  

• Anti-inflammatory medications
  
  

• Physical therapy for stretching and nerve gliding
  
  

• Corticosteroid injections (select cases)
  
  

The Ulnar Nerve Decompression Procedure: Step by Step

Plain-English Overview

1. Anesthesia: Local anesthesia with sedation or general anesthesia.
   
   

2. Incision: Small incision made along the inside of the elbow.
   
   

3. Nerve release: Tight tissue (ligaments and fascia) around the nerve is cut to relieve pressure.
   
   

4. Transposition (if needed): The nerve is moved to a new position in front of the elbow for better protection.
   
   

5. Closure: The incision is closed with sutures; patients often go home the same day.
   
   

Surgeon-Level Detail

• Exposure: Small curvilinear incision along medial elbow; ulnar nerve identified proximally and distally.
  
  

• Decompression: Osborne’s ligament, FCU aponeurosis, and arcade of Struthers released under loupe/microscope.
  
  

• Nerve mobilization: Ensure gliding without kinking through elbow ROM.
  
  

• Transposition (if performed): Nerve moved anteriorly into subcutaneous, intramuscular, or submuscular bed; secured to prevent subluxation.
  
  

• Closure: Meticulous hemostasis; layered closure; splinting varies by technique.
  
  

Benefits of Ulnar Nerve Decompression

• Relief of numbness, tingling, and pain
  
  

• Prevents permanent nerve damage and hand muscle wasting
  
  

• Outpatient surgery with small incision
  
  

• Often rapid improvement in night symptoms and grip strength
  
  

Risks & Limitations

• Infection, bleeding, scar tenderness
  
  

• Nerve injury (rare with microsurgical technique)
  
  

• Incomplete relief if nerve already severely damaged
  
  

• Recurrence possible if scar tissue develops
  
  

• Recovery may be slower in chronic cases with muscle wasting
  
  

Recovery Timeline

• Day of surgery: Outpatient procedure; arm in soft dressing
  
  

• Weeks 1–2: Suture removal; light activity only
  
  

• Weeks 2–6: Gradual return to daily use; therapy for nerve glides and strength
  
  

• 3–6 months: Ongoing improvement in sensation and strength
  
  

• 6–12 months: Nerve recovery continues; full benefit realized over time
  
  

Why Choose Desert Spine and Pain?

• Neurosurgical expertise: Dr. Greenwald is highly skilled in precision nerve decompressions
  
  

• Minimally invasive approach: Small incision, less pain, faster healing
  
  

• Comprehensive care: From diagnosis with EMG/NCV testing to surgery and rehab
  
  

• Compassionate focus: We listen, reassure, and guide you through recovery
  
  

Frequently Asked Questions

How do I know if I need ulnar nerve surgery?

If symptoms persist despite splints, therapy, and activity changes—or if weakness is worsening—surgery may be needed.

Will surgery restore full sensation and strength?

Relief of tingling is often rapid. Numbness and weakness improve gradually, but recovery depends on how long the nerve has been compressed.

Is ulnar nerve decompression painful?

Discomfort is usually mild and improves within weeks. Most patients are surprised at how manageable recovery is.

What’s the difference between decompression and transposition?

Decompression simply releases pressure. Transposition moves the nerve to a safer location if instability is present.

How does Desert Spine and Pain perform this differently?

We use microsurgical techniques, careful patient selection, and neurosurgical precision to maximize outcomes while minimizing risk.