Introduction
Ulnar neuropathy is a common nerve injury secondary to nerve entrapment at the elbow. Repetitive compressive forces to the inside or medial side of the elbow can irritate the nerve and cause damage. Damage to the ulnar nerve can be assessed with a nerve conduction study and electromyography. Modern evaluation can also include the use of ultrasound imaging. Nerve conduction, electromyography, and ultrasound are often used to get a precise picture of nerve damage. Ulnar neuropathy can resolve on its own. However, if symptoms of ulnar neuropathy do not improve, an ulnar nerve hydrodissection may be offered.
Story
A 22-year-old collegiate pitcher presented to the clinic to evaluate numbness and tingling in the 4th and 5th digits. He reported decreased throwing speed and mild hand grip weakness with throwing a baseball. At The Fascia Institute and Treatment Center, we performed a nerve conduction study and electromyography that revealed a mild ulnar neuropathy at the elbow secondary to compression. After discussing the diagnosis, he decided to try an ulnar nerve hydrodissection. He was laid back on the table in preparation for the ulnar nerve hydrodissection. The ultrasound machine was set up and the injection site was cleaned and prepared. The ulnar nerve hydrodissection proceeded as shown in the video below.
Conclusion
At a follow-up three months later, the pitcher reported a full resolution of symptoms from the ulnar nerve hydrodissection. He returned to play without limitation and said he would do it again if needed. To the credit of modern technology and ultrasound imaging, procedures that were once surgical can be performed in the office. Hydrodissections can be performed for other injuries, such as hamstring strains. If you are dealing with a non-surgical type of muscle pain, you may consider being evaluated for a hydrodissection.
