Sunday 3 January 2010

Ulnar nerve injury? Don’t panic!

This might seem a very random post, but let me explain. I’ve decided to start the New Year on a good deed…

To my regular readers I doubt that this will have any relevance to you, so you can move along, nothing to see here folks. However if you have stumbled across this post when searching for ‘ulnar nerve damage’ or ‘ulnar nerve injury’ then please read on.

Back in August I found myself sat at my computer keyboard in the middle of the night desperately Googling ‘ulnar nerve damage’. I had broken both bones in my lower right arm clean through and suffered considerable damage to the three major nerves in the arm. As a result most of my right hand was numb (most noticeably the back of my hand and the back of my thumb), I had lost my grip and I could not bend my wrist backwards. My little finger and ring finger were clawed and I could not straighten them (see right). The doc told me that I had damaged my ulnar nerve and this had resulted in a condition known as ‘ulnar claw’. I was also suffering from ‘wrist drop’, otherwise known amusingly as Saturday Night Palsy.

Googling the symptoms was a terrifying experience. There was talk of further surgery, permanent loss of feeling and two scary sounding tests called a nerve conduction study (ECS) and an electromyography (EMG). My anxiety wasn’t helped by expressions such as ‘irreversible damage’ and ‘permanent disfiguration’ that were being banded about during my visits to the fracture clinic.

But then as time passed things started to look up. I had an ECS and an EMG test and the results showed that all three major nerves were badly damaged but they were showing signs of attempted re-growth. Sure enough, feeling started to return in my thumb and the two clawed fingers began to straighten out, albeit painfully slowly, with the help of physiotherapy. Eventually the sensation returned in the back of my hand and my grip improved. I invested in some squishy balls and putty and maintained a strict balance between exercising the hand so that it didn’t seize up completely and resting it in a wrist guard in order to give it a break and allow time for the nerves to recover. It was a difficult balancing act, but it seemed to be effective. Five months later, my fingers are almost completely straight again and I can bend my wrist back further each day. Although my hand has improved much more successfully than I had expected, it is still not 100% ‘in working order’. For example, I can feel contact with the skin on the back of my hand but it feels as though there is a thin barrier over the skin, much like cling film, that is numbing the sensation. But the sensitivity and movement improves a little more each day and the doctors are hopeful. It is still early days.

Researching into an injury on the Internet can be a pretty daunting and scary experience, so I just wanted to fire a little ray of hope out there into the blogosphere. I’m not a medical doctor so I can’t promise that another person’s injury will recover as quickly or as successfully as mine, but please don’t be scared or disheartened by a pessimistic diagnosis. The expression ‘time is a great healer’ is very cheesy but it is also very true. I have been told on numerous occasions that nerves take a long time to recover from an injury and I’ve discovered that this is certainly the case. It’s very frustrating if you’re the kind of person who expects immediate results, but hang in there. Don’t be afraid, take the tests, persevere with the physiotherapy exercises and remain hopeful.

UPDATE: APRIL 2016

Six years on and my hand is 98% back to normal. I don't notice any difficulties on a day-to-day basis and it has regained all feeling, but my hand gets tired if I write for a long time and once in a while I get a trigger-finger feeling that locks my finger for a split second. My little finger was the last to regain sensation and it tingles every once in a while, but I have no problem writing, typing, carrying heavy weights, squeezing etc. Normality returns!

21 comments:

  1. Glad to hear things are improving with your hand! :) Keith Emerson still suffers from a damaged Ulnar nerve that devloped back in the 90's. It's quite evedent in his playing, the way he relies mainly on two fingers and a thumb on his right hand while the other two curl up underneat. It's very clear in this video:

    [Youtube Vid]

    Looks very awkward at times but he's still playing though, and that's the main thing! :)

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  2. You're youtube vid of metallica on organ brought me here, I was horrified (being a musician myself) to hear you had hurt your hand. But I'm glad to see you are healing, hang in there and keep up, before you know it, your hand most likley will be flying down those keys in no time! Good luck, and I'm hoping for you too.

    Take care!
    -Mike

    Badmoon722@yahoo.com

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  3. Thanks for posting. I broke my 5th metacarpal 7 weeks ago and had to have surgery to repair. The bones all look great, but I had the same clawing that you had exactly. No numbness though. The pinky seems fine now, but the ring finger is still messed up although I can straighten it more than I could before. That finger just kind of feels "dead" though. I'm getting pretty worried about it lately, so it was good to read your post. I hope I'm as fortunate. Good to see you are doing largely better and thanks again.

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  4. You know it's weird, I don't have any appreciable numbness and none in that finger at all. I just can't straighten it fully or use it to cup water in my hand. I would think there would be some numbness like you said. Hmm. Anyways, thanks for the well wishes!

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  5. Hope you have recovered by now. Thanks for the well wishes.

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  6. I broke my shoulder badly in August and sustained nerve damage to my arm and hand leaving it almost completely paralysed . I'd been warned by docs that it would be a long,long time before I would hopefully(!) get any movement and feeling back.I stumbled on your comments after googling ulnar injury and they really cheered me up.Stuck them in my favourites bar and referred to them whenever I got frustrated with my gammy hand. 3 months later my hand is pretty much back to normal after lots of physio. Thankyou! And delighted to know you made such a good recovery yourself

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  7. THANK YOU!! So pleased and relieved to hear about your experience as i have suffered a wrist fracture with 2 clawed fingers and just want to get back to doing things again! . I would say fingers crossed, but....

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  8. Thanks for posting this! I have the wrist drop right now and that numb feeling over the back of my hand and so far there's been no progress! But it's only been a month for me, but if I have to wait five then so be it---as long as it's not permanent! Thanks for the reassurance!

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  9. Just wanted to say thanks for this article, as I am a little over 2 months out from a dog bite crushing injury to my ulnar nerve in my wrist. After a long time of no progress and much muscle atrophy in the back of my hand, it has gotten a little better recently but the ring finger is still for the most part useless. I can finally pull the pinky finger into the others and straighten it if fully extended. I also wanted to point out my doctor let me know it was very common to not to have any numbness in the hand and just muscle motor dysfunction if the injury occurred to the nerve on the back on the wrist/hand rather than the "palm" side. I am hoping that I do not have to wait 18 months to heal but even if I do it is still a much better prognosis than "permanent damage"! Thanks again...much love

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    1. Great article! As for the person with the dog bite. I honestly hope you also recovered in full! I was bitten by my own dog on the 13th of December. After wound care and debradement and general clean up I have lost some muscle and soft tissue in my upper outside forearm. I have feeling and blood circulation also grip in my hand. However I have either radial nerve palsy and/or ulnar nerve damage. I can close my hand move my fingers and feel. But I have a dropped wrist and I am unable to extend any of my fingers nor my wrist. Let's hope it heals.. It's a terrible feeling.. having to wait and be patient in the face of posible permanent loss of function.. Oh and happy New Year.

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  10. Thank you for this post! Took internet research a week ago to figure out that my ulnar nerve must be damaged, as my skin had healed form a bike accident that injured the heel of my right palm and edge of hand (where ulnar nerve spreads to fingers/lies unprotected by bone/much tissue. Your post is providing the postitive boost I need as I head to my first occupational therapy exam of my hand. If it weren't for internet finds like yours here, I'd still be in pain, thinking it was still tissue healing. Doctors never once mentioned possible nerve damage -- just kept focusing on possibility of broken bones and new x-rays, after hand still hurt 2 weeks after accident .... thankful for Wikipedia and helpful internet writers like yourself!

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    1. Good to hear it! This kind of injury can be very confusing and worrying but hopefully the docs will sort it out for you. Nerves take AGES to heal, it's not quick like a wound healing, and they're damn painful but once you start treating it you usually see slow improvement. Good luck!

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  11. As I lay here with my 9 year old son, I am desperately searching for some answers. He fell off the back of our couch and broke his ulna and radius bone in his right forearm on Aug 24, 2016, which resulted in a 2 night stay in the hospital as well as surgery to put 2 thin rods in each bone. They will be removed in approximately 9-10 months from the day of surgery. So....I have been having such anxiety about two of his fingers. Not so much The pinky, but the two next to the pinky. They are clawlike. He can move them, but not individually and he can't straighten them out. The doctor said it could take MONTHS to repair the ulnar nerve. And he isn't positive that it isn't permanently damaged. He let me know that there is a test that can be done to find out if it's permanent, but he wouldn't do that just yet, especially bc he is so young. He seems to think that children heal more easily anyway.
    We start physical therapy on Thursday, and I'm hoping to see quick improvement. He is just starting out in life and he LOVES sports! Thank you so much for writing your story. It made me feel a little more at ease. But the fact of the matter is, I think it's going to be a while until I know the true results.
    Thanks again!

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    1. Hi Tricia, I'm so sorry to hear about your son's accident, it must have been awful for you both. The injury sounds exactly like mine and it can look and feel very scary. I had the tests too and they didn't know whether the damage would be permanent from the results, that terrified me! But I'm six years on from my accident now and my arm and hand are completely back to normal. Hopefully with your son being younger the bones and nerves will repair themselves much more quickly. Don't stress if you don't get a fast improvement, it takes months for the nerves to repair and it's a slow process but you should definitely persevere with therapy and hopefully youll start to see improvement. Good luck!

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  12. Feeling alone, UK - desperate internet searches today led to this, after the innumerable worst case scenario sites had me in tears...
    I don't want to believe them. I want to get my hand better, write, paint, make things... You helped more than anything else to believe I can and will...

    Original accident was simply tripping on a root, landing right hand onto rock and against a wall - more rock. Distal ulna fracture, plus one carpal and lots of what was sidelined by weekend emergency staff as ' soft tissue damage' -but the pain which left me
    ( fortunately) speechless was funny bone meets rock - Only my wrist was x-rayed,
    Two days later, they could report fracture healing had begun, no displacement, and used a resin ulna gutter cast, enclosing three fingers.
    which had been badly injured years earlier - (teenage, kitchen accident, student place) ... Crooked ever since, but in good working order.
    They didn't appreciate four weeks compressed in an ulna gutter cast.
    When the cast was removed - after four weeks, UK hospital gave me a small card with a few sketchy exercises, Six week check very basic five minutes at most, including a brief wrist to elbow median check, no mention of ulna nerve, even with an ulna fracture.

    Thank-you

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    1. I am sorry to hear this and I hope this post has given you some hope. I was very afraid when I had my accident and I read some very scary articles online (probably the same ones that you have read) but looking back I had little reason to worry. These kind of injuries take a long time to heal so please be patient and I hope you see some improvement soon.

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  13. Hi Guys - Thought I would contribute my story as well. Good to hear that Helen has made a(n) (almost) full recovery.
    I fell from the back of a Furniture Truck onto a lowered tailgate lifter after my colleague lowered it almost to ground while my back was turned. He thought I had finished putting stuff onto the tailgate lifter and I guess just didn't think. I just turned around with something and stepped out into a void. Fell directly onto a small TV table around 1.2 to 1.5 metres. My shoulder and elbow took my full weight with my arm trapped between the table and my body. Consequences: Shoulder dislocation with a full width, full thickness tear to the supraspinatus tendon, and a properly crushed ulnar nerve. Shoulder op to fix tendon, then an elbow op six weeks later to relocate my ulnar nerve to give it a chance to heal. At the time of the 'accident', I experienced all the symptoms of a classic Cubital Tunnel Syndrome straight away along with not being able to move my shoulder of course with lots and lots of pain. Nearly six months down the track my shoulder is slowly improving, but more to the point, my ulnar damage does not feel like it is improving much. My hand is swollen (a lot) for most of the time, and I still can't feel much along the last third of my hand all the way to the tip of my pinky. My elbow is still swollen on the inside and all along the outside of my lower arm I can't feel much. The ulnar nerve transposition was done on the 17th January and my injury was on 2nd Nov. 2016. It is early days yet my Physio and Elbow surgeon tell me, as nerve damage typically takes a long time to heal. My pinky and index finger have the classic 'claw', but at least I can make a sort of fist after lots of manipulation/physio even though I still cannot feel my pinky. The only advice I can offer to folks with this kind of injury is that we are all different and probably heal at different rates. It also depends on the advice from physios and what type/how much exercise you do with your injury. Rest assured, all the experts say the same thing, nerve damage takes a long time to heal. Stick with physio advice and do not be afraid to get a second opinion from a specialist lower limb surgeon/physio. Good healing, Regards - Steve (Melbourne, Australia)

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  14. Hi there, thank you so much for sharing your story it has really inspired me to stay positive and hopeful. I have a high ulnar nerve injury in the upper arm, i've go slight ulnar claw, weakness in my hand pinch and grip strength and numbness in the pinky finger and half the ring finger. The doctors say the time it will take for my nerve to regenerate to reach my hand is so long that the muscles in my hand might die off before they can be regenerated. They are giving me the option of surgery (supercharge end to side nerve transfer) where they take a donor nerve and hook it up to my ulnar nerve which would ultimately create a shorter distance for the nerver regenerate tp the hand. I'm so scared and and depressed I don't know what to do if i should take the surgery or not. If I don't take the surgery I need to accept the current condition of my hand, which wont get worse but will impriove only 10% . I would love to know from you whetehr surgery was ever an option discussed for your condition? I hope you pick this up - not sure if you will as I've seen the post is a while back. Thanks so much, Van

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    1. Hi Van, I'm sorry to hear about your injury. My doctors did mention surgery to replace the nerves (I think they were going to 're-wire' some ligaments to act as nerves) but they wanted to wait and see whether it improved first. I had absolutely no use of my hand and I honestly thought that I would never regain use of it again, but slowly over time it's pretty much back to normal. It really hurt when the nerves started to re-grow again - I had to take a pile of painkillers - but it was well worth the pain to regain feeling in the hand. I didn't take the surgery route, but if the docs think it will help then there's no harm in exploring that as an option, after all my damage was in my lower arm so the nerves didn't have as far to grow. The muscles suffered in my hands and I had to do exercises to build them back up - simple exercises like squeezing a stressball and wrapping elastic bands across all four knuckles and trying to spread my fingers. I've been surprised how much use of the hand I have regained over time but it takes a *long time*, you won't see improvements overnight, you need to think in terms of months rather than weeks. On the surgery, I would speak to a few doctors and gather their opinions, I suppose in the end any help is a help and if they think it will speed the healing up then I guess there is no harm in considering it.

      I hope this helps, I was really upset and stressed out when I was at the stage that you are now and it's absolutely understandable that you're worried, but hang on in there! Best wishes, Helen

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  15. Thanks so much for your blog. It really made me feel better after I severed my radial nerve. I am also keeping a blog. If people are interested you can find it here: https://severednerve.blogspot.com/

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  16. interesting blog. I am now in similar position. Ulnar nerve totally severed about 6 inches above wrist. My doct or mentioned that a higher injury closer to elbow is worse.. but it looks like I have a ton of physio to get through so I can resume guitar playing. injury is only a few days old so early days.. Ill check back in with my progress..

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