Ulnar Neuropathy (Handlebar Palsy)

What is ulnar neuropathy?

Ulnar neuropathy is an inflammation of the ulnar nerve, a major nerve in your arm that runs down into your hand. It supplies movement and sensation to your arm and hand. Ulnar neuropathy causes numbness, tingling, or pain into the arm and hand on the side of the little finger. Bicyclists call this condition handlebar palsy.

How does it occur?

The ulnar nerve may get inflamed in several areas as it travels from your neck to your hand. The ulnar nerve is commonly inflamed during bicycling from repeated shocks or bouncing while your hand is holding onto the handlebar. The nerve may be stretched when held in the lower position of a drop handlebar. Other activities that involve repetitive movements of the wrist may cause ulnar neuropathy such as using a computer mouse or typing. It may also occur from an injury to your elbow.

What are the symptoms?

The symptoms include numbness, tingling, or pain in the forearm or hand on the side of the little finger.

How is it diagnosed?

Your health care provider will ask about your symptoms and examine your neck, shoulder, arm, and wrist. He or she may refer you to a specialist to have tests done, such as a nerve conduction study (NCS) and electromyogram (EMG).

How is it treated?

It is important to try to find and eliminate the cause of your ulnar neuropathy. You may be prescribed wrist splints to reduce the discomfort. When you are bicycling, it might help to wear padded gloves. You might also try adjusting the position of your hands on the handlebar, such as by changing your grip from the top to the sides of the handlebar. Your health care provider may prescribe anti-inflammatory medications.

When can I return to my sport or activity?

The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your sport or activity will be determined by how soon your nerve recovers, not by how many days or weeks it has been since your injury occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better.

You may return to your sport or activity when you are able to forcefully grip your tennis racquet, bat, or golf club, or do activities such as working at a keyboard without pain or tingling in your elbow or hand.

How can I prevent ulnar neuropathy?

Ulnar neuropathy is caused by activities that inflame the ulnar nerve. Try to eliminate activities that cause repetitive motion of the wrist, which can irritate your ulnar nerve. When you are bicycling, change your hand position on the handlebar frequently.