Hi! I'm a 27 year-old, American male living in Egypt. Six feet two inches, 210 lbs. I am right handed.
This began right after a bad cold where I was taking a lot of Ibuprofen (sadly, the strongest pain killer available here).
For the past 5 days my pinky finger, and part of my ring finger, on my left hand has been tingling and numb (becoming more numb than tingly now). The numbness/tingling does not go away at any time during the day. My pinky appears to be very slightly swollen compared to my right pinky (... maybe it is normal for fingers on the dominant hand to be 'leaner' than those on the other?)
This is accompanied by a strange sensation in the inner part of my upper arm (near armpit). It almost feels like something is 'blocked'. Now it is changing/turning into a dull pain, still minor though.
I've read A LOT about Ulnar nerve compression... and, I DO rest my left elbow on my desk quite a bit every day. Do you think this is the problem? What can/should I do?
The numbness and tingling in the area you describe is the dermatome for the ulnar nerve. The ulnar nerve dermatome is the small finger, ulnar half of the ring finger, the ulnar border of the hand (both volar and dorsal), and the ulnar border of the forearm.
By doing a thorough examination, the hand surgeon can usually tell where the nerve is being compressed.
If the compression of the ulnar nerve is at Guyon's canal, located in the base of the palm, the numbness and tingling will not affect the dorsal aspect of the hand, nor the forearm.
If the compression is at the cubital tunnel, located on the posterior medial side of the elbow, the numbness and tingling will then involve the whole ulnar dermatome. The patient usually has a Tinel’s sign over the cubital tunnel. By tapping on the nerve, the patient will experience a shooting, electrical shock feeling going from the elbow to the small finger (as when you hit the “funny bone”).
Compression of the C8 nerve root in the spine can give similar symptoms to ulnar nerve compression. The dermatome for C8 is a little different from that of the ulnar nerve. C8 includes all of the ring finger and can involve the ulnar forearm, passed the elbow, to a little of the distal upper arm. The two dermatomes are very similar, but do have their differences. If the patient has something pressing on the cervical nerve root, then certain examination maneuvers of the spine will produce or exacerbate the symptoms.
However, the nerve can be compressed anywhere along its course, from the brachial plexus in the shoulder all the way to the hand. And, it is possible to have what is known as a “double crush” phenomenon, where the nerve is compressed in more than one location.
The first thing that is tried in the management of ulnar nerve compression is to avoid activities which produce or exacerbate the symptoms. So, you should not rest your elbows on the desk or rest your chin on the palm of your hand. Some patients have problems sitting in arm chairs, where their elbows sit of the armrests. If this is a problem, avoid arm chairs.
Some patients have problems at night, while sleeping. When we sleep, we tend to flex the elbows, bringing the hand up under the chin or behind the head. The flexion of the elbow compresses the ulnar nerve in the cubital tunnel. If this is a problem, it is recommended that patients wear splints at bedtime, to prevent them from flexing the elbow. But, most patients have difficulty with the full arm, hard plastic splints when sleeping. But, this type of splint is really not needed. All that is needed is something small and light to deter the patient from really flexing the elbow. So, a soft sports elbow pad will work. As will, several layers of tube socks. You can take old tube socks, cut off the toes, and make four to six layers of socks up over the elbow. This is usually enough to prevent extreme flexion of the elbow while sleeping.
Other than this, there is not much else to do. Some physicians recommend vitamin B6 (Pyridoxine) for neuropathies. Its use in compression neuropathies has not really been shown to be of much help, but it is worth a try. For the discomfort, most hand surgeons will recommend acetaminophen or one of the NSAIDs. For neuropathy discomfort (nerve pain), some neurologists prescribe either gabapentin (Neurontin) or pregabalin (Lyrica). But, again, in compression neuropathies, their use is still being studied. Again, it is worth a try if you are having a significant amount of nerve pain. But, these are prescription medications.
If the symptoms persist or worsen, or you start to develop weakness in the ulnarly innervated muscles, you will need to see a hand surgeon for a thorough evaluation. An examination can usually tell where the problem is coming from. However, electrical studies (EMG - electromyography, NCV - nerve conduction velocity) are usually done to pin down the exact location of the compression and to tell how significantly the nerve is being compressed (injured).
If the symptoms and/or electrical studies show significant compression of the nerve, then usually a decompression surgery is warranted. It is usually recommended that surgery be done before muscle weakness sets in, because once this occurs the damage to the nerve may not be reversable.
So, again, if the symptoms persist or worsen, you probably need to see someone about it.