A Review of Current Concepts in Ultrasound Evaluation and Management of Ulnar Nerve Pain

Purpose of Review Ulnar nerve pathology is a commonly encountered mononeuropathy that can often be diagnosed and evaluated using ultrasound. This review seeks to discuss common causes of ulnar nerve pain, summarize ulnar nerve ultrasound evaluation, and review current management for the common causes of ulnar nerve pain (both surgical and non-surgical options). Recent Findings There is strong support for the use of ultrasound in the evaluation and diagnosis of ulnar nerve pain. It has been shown to have comparable sensitivity and specificity to nerve conduction studies in the diagnosis of upper limb nerve entrapment syndromes. It has also been found to be superior to electrodiagnostic testing for localizing the site of ulnar nerve pathology. Ultrasound of the ulnar nerve (UN) is both a cost- and time-effective means of assessing ulnar nerve pain that allows for more dynamic evaluation of the UN, potential identification of underlying pathology, and assistance with surgical planning. Non-surgical management is typically preferred for mild-to-moderate ulnar nerve compressive syndromes. This should include patient education and activity modification and may also include splinting, nerve-gliding exercises, and ultrasound guided injections. Surgery should be considered for those who fail conservative measures or who have moderate-severe nerve compression. This should be tailored to each patient based upon the location of their compression followed by focused therapy.