Conditions We Treat

Ulnar Neuropathy at the Wrist (Guyon’s Canal Syndrome)

What Is It?

Ulnar neuropathy at the wrist occurs when the ulnar nerve is compressed within Guyon’s canal on the palm side of the wrist.

Common causes include repetitive pressure, trauma, mass lesions, or prolonged tool or bicycle handlebar use.

Symptoms

  • Numbness and tingling in the ring and little fingers
  • Weakness in grip and fine motor control
  • Muscle wasting in chronic or severe cases
  • Symptoms worsened by wrist pressure or prolonged extension

Diagnosis

  • Physical exam including Tinel’s sign at Guyon’s canal
  • Nerve conduction studies and EMG to localize compression
  • Ultrasound or MRI to evaluate for cysts or space-occupying lesions

Treatment

Conservative Options:

  • Avoidance of pressure and aggravating activities
  • Padding or wrist splinting
  • NSAIDs for discomfort

Surgical Options:

  • Ulnar nerve decompression in persistent or severe cases

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