Explanation of Diagnosis

Ulnar neuropathy occurs when the ulnar nerve (which runs along the inner elbow and controls sensation in the ring and pinky fingers) becomes compressed or irritated. This commonly happens at the cubital tunnel (inside of the elbow) or Guyon’s canal (wrist area). Symptoms include numbness, tingling, weakness, and pain in the forearm, hand, and fingers. It often worsens with prolonged elbow bending, resting the elbow on hard surfaces, or repetitive gripping.

Specific Work Modifications

• Avoid prolonged elbow flexion (bending the elbow more than 90°) while typing, using tools, or holding a phone.
• Modify workstation setup by using an ergonomic keyboard and mouse to reduce nerve compression.
• Use a headset instead of holding a phone.
• Avoid resting the elbow on hard surfaces (use padding or elbow support).
• Take frequent breaks to straighten and stretch the arm.

Specific Activity Modifications

• Avoid prolonged elbow bending (e.g., cycling, playing an instrument, knitting, or gaming for extended periods).
• Modify grip-intensive activities (e.g., weightlifting, golf, or racquet sports) by using ergonomic grips and lighter resistance.
• Use an elbow brace or wrap for support during activities.
• Take frequent breaks and perform nerve-gliding exercises to prevent stiffness.

Recommended Supplements

• Vitamin B6 100 mg daily – Supports nerve health.
• Alpha-lipoic acid (600 mg daily) – May help with nerve regeneration.
• Magnesium (300-400 mg daily) – Helps with muscle relaxation and nerve recovery.
• Omega-3 fatty acids (1000 mg daily) – Reduces nerve inflammation.
• Turmeric (500 mg twice daily) – Provides anti-inflammatory benefits.

Recommended Nutrition and Hydration

Diet Recommendations:

• Nerve-supporting foods: Avocados, eggs, dark chocolate, almonds, and whole grains (rich in B vitamins and healthy fats).
• Anti-inflammatory foods: Leafy greens, berries, fatty fish (salmon), and turmeric.
• Limit processed foods, excessive sugar, and alcohol, which can worsen nerve inflammation.

Hydration Tips:

• Drink 2–3 liters of water daily to maintain nerve function.
• Limit caffeine and alcohol, which can dehydrate tissues and slow healing.

Home Exercise Prescription

Perform 2-3 times daily to relieve pressure on the ulnar nerve and improve mobility:

1. Ulnar Nerve Glide (Nerve Flossing)

1. • Start with your arm at your side, palm facing forward.
   • Bend the elbow while extending the wrist and fingers (as if holding a tray).
   • Slowly straighten your arm while bending the wrist down.
   • Repeat 10 times per session, 2-3 times daily.

2. Elbow Extension Stretch

1. • Fully straighten your arm and hold the position to gently stretch the nerve.
   • Hold for 20-30 seconds, repeat 3 times.

3. Wrist Flexor & Extensor Stretch

1. • Extend the arm, palm up, and gently pull back on the fingers with the opposite hand.
   • Hold for 20-30 seconds, repeat 3 times.

4. Grip Strength Exercise (if weakness is present)

1. • Squeeze a soft stress ball gently for 5 seconds.
   • Repeat 10-15 reps, 2 times daily.

5. Isometric Wrist Extension

1. • Press your hand against a table without moving the wrist.
   • Hold for 5 seconds, 10 reps.

Avoid prolonged elbow flexion, repetitive gripping, or direct pressure on the elbow until symptoms improve.

Helpful Books

1. "Why Do I Hurt? A Patient's Guide to Overcoming Chronic Pain" – Adriaan Louw
2. "The Pain-Free Program: A Proven Method to Relieve Back, Neck, Shoulder, and Joint Pain" – Anthony Carey

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.