Hi, I'm new here and I'm absolutely confused about what is going on right now.
I'm 27, was recently diagnosed by a Neurologist with Ulnar Nerve Compression at the wrist AND elbow according to the EMG study I had done.

A little history about myself prior to this wrist pain I've experienced the last 3 months. I was an avid hockey player and used to work out moderately but haven't done either due to the pain in my wrist. The pain is in my right hand(I'm also right hand dominant). I first started noticing the pain while playing hockey probably 5 or 6 months ago, but ignored it entirely since it wasn't anything major or anything that would cause me to stop playing. However, 3 months ago the pain became so intense in the wrist that at time I'm unable to hold glasses, especially if I'm pouring something into one, turning door knobs and other trivial tasks. I noticed most of the pain comes from when I rotate or bend my wrist, the further it gets bent, the more pain I end up in(although I'm constantly in pain--probably a 3 or 4 on the "pain scale" with a 7 being at the most intense). I have vague symptoms in the elbow of numbness, as if someone was tapping my funny bone, but that doesn't happen all that often(kind of like how my wrist started out as---makes me worried).

So with that in the background, I went to my PCM(family doctor) and explain the symptoms to him and he gave me 7.5mg vicodin to help with the pain(unfortunately this doesn't work all that well... if at all), and order the EMG. So I went to the Neurologist and had the test done and found out a couple days later that I have a compression neuropathy across the wrist and elbow. He told me to also try to wrap my elbow up at night and try to keep it straight and see if that helps(it didn't). He also ordered x-rays for the elbow and wrist, and both were negative. Both of these tests have been done in the last month, and seeing my PCM was about a month and a half to 2 months ago.

I did a follow up with my PCM and he wanted to me to schedule an appointment with a neurosurgeon based on the EMG results, and was told that this would be my last prescription for pain meds(not that it was working well... but it did help for the night) and he wanted me to have the pain addressed with the neurosurgeon. So I got a referral to go there and the Neurosurgeon ran, what I could assume, the standard tests to test for ulnar nerve damage. He concluded that I didn't have ulnar nerve damage and it had to be something else. I asked what could it be, and he didn't have an answer and just said the EMG results had to be wrong. He didn't address any of the pain I was experiencing, especially at the wrist being bent or even slightly rotated or the numbness I occasionally feel in my elbow. <----- This is leaving me so confused!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I already have the paperwork on the way to see another Neurosurgeon to see if a second opinion addresses any of this, as I personally wasn't satisfied with that appointment. If the EMG was wrong, what could this be? I have chronic shoulder problems(subluxations nearly everyday) but I don't think that would attribute to this..

Probably really long but I appreciate any help or feedback on what to do or what this might be...

Thanks,
Steve

Steve,

I am not at all an expert but having ulnar compression myself, I would strongly recommend you see an Orthopedist who is hand certified. You specifically need an Ortho with this certification. He or she should be able to help with the diagnosis. Good luck.

I would find an upper extremity othro specialist, it could be just elbow and wrist or it could have something to do which includes the shoulder.

What where the 'findings' that are stated on your ncs/emg test results?

Thanks for the replies Jack and Cindy. I'll probably end up at the Ortho doctors again, I get the feeling I could be running into two separate problems(possibly wrist instability).
As for the findings on the NCV/EMG, the paper work says the EMG was normal findings.

The NCV study however states that it's "compatible with a compression neuropathy of the right ulnar nerve across the wrist and elbow."
I tried researching the number results a little bit to see what is considered normal but I didn't have any luck. (I can post the numbers if that would help.)

I'm not entirely sure if this has anything to do with my shoulders, as I've had this problem for years; but at the same time, it's something I definitely shouldn't rule out.

It should say on your report what the 'norm' values are for ncv. I just go by the findings section. If they found slowing at the elbow then that is cubital tunnel. I'm sorry.

Have your shoulder looked at too. Sometimes you can have compression higher up like in your neck or shoulder which causes everything below it to be more prone to damage.

Look up double crush syndrome on the internet.

Steve,

To reiterate: I am not an expert nor have I done a ton of research to become one. I can only describe what I have been through and hope it is helpful to you.

Two years ago I had a very bad fall (30 feet) and broke my arm and destroyed my elbow along with some ribs etc. Worst was my elbow. I have had three elbow surgeries and am actually feeling pretty good with only fairly good range of motion in my arm but whatever, I survived a 30 foot fall and my pain is tolerable. Surgery three was to improve my range of motion which it did although recovery was grueling. Coming out of my third surgery though my fourth and fifth fingers were numb, stiff and I had alot of pain. I also developed muscle weakness and atrophy in my hand. I have since learned this is not uncommon due to scarring. My surgeon diagnosed cubital compression and sent me to a Neurologist.

A month ago I had a nerve conduction study and an EMG. My reports are in my office at work so I don't have all the #s but the Neurologitst at one point was measuring my nerve conduction and said that normal is 50-60 and that my elbow conduction was 7. At that point he looked at me and said "you have cubital compression, it won't get better, it may get worse and you need surgery and soon". I saw a different elbow specialist last week for a 2nd opinion and he agreed. So, based on the little I know and three doctors whom I trust (my Ortho, Neurologist and the Ortho I saw for a 2nd opinion), I am scheduled for CuTs surgery at the end of the month.

I do know that the longer you wait the worse it is for your nerve. Prolonged compression decreases the liklihood of a good outcome.

Again, be very careful with my selected information as frankly I don;t know if the numbers vary based on the specific area of the arm being measured.

From one hockey player to another, good luck. We were taught to suck it up and ignore pain. Don't ignore this. See the specialists you need to see (this is beyond what a PCP can deal with) and if surgery is warranted, do it. You may want to ask the Ortho about Neurontin. It is prescribed for nerve pain and has really helped me deal with the nerve pain. It doesn't cure anything but it did help my compression pain.

Lastly, if you can get to Boston, I would be happy to give you the names of the two ortho's I have been seeing. I really like both of them and was impressed. Good luck.