Compression of both sensory and motor branches of the Ulnar nerve at the Guyon’s Canal is is called Guyon's canal syndrome and it is also known as “Handlebar Syndromeâ€. Tingles in the little finger can be a sign of this condition.
It is commonly seen in cyclists due to regular, prolonged pressure on the Guyon's canal in the wrist against bicycle handlebars. Office workers who use a wrist rest or mouse for prolonged periods are also at risk.
If guyon's canal syndrome is activity related, such as cycling, it may easily be relieved by wearing gel padded protective gloves or changing the handlebar shape.
Likewise, keyboard or mouse users should consider investing in an ergonomic mouse that removes pressure from the guyon’s canal or make other suitable work practice changes.
Symptoms which do not resolve soon after you have stopped performing the provoking activity means the risk of motor wasting and paralysis in the little and ring fingers is higher.
Please note:
If you are in the habit of resting your mobile phone on the inside part of your little finger when holding it, you may have noticed associated tingles and numbness in the tip of the little finger. This is not Guyon's canal syndrome. Try holding your phone differently to prevent the phone from pressing on the digital nerve to the little finger and the problem should resolve.
As with all signs and symptoms of nerve compression, it is important to consider all areas of likely compression along the length of the nerve as it travels down the arm. Ulnar nerve compression at the elbow, called
cubital tunnel syndrome produces similar symptoms.
The following provocative activities can however lead to symptoms suggestive of Guyon's canal syndrome:
- Cycling: External pressure on the ulnar nerve as it passes through the wrist caused by handlebars
- Repetitive mouse use (particularly if the mouse is too small for your size hand)
- Wrist rests at a keyboard (gel wrist supports are known to cause problems at the wrist as the temptation is to lean on them constantly)
- Chopping sticks with a hatchet
- Jogging while pushing as pram
Certain occupations are more at risk of developing the condition as well such as:
- Taxi drivers (holding a steering wheel for hours on end)
- Lorry drivers
- Landscapers
- Roofers/ carpenters who have prolonged periods of hammering or using a nail gun (the kick back from the gun increases pressure on the nerve)
- Graphic designers/ architects who lean on an electronic design pad
If the reason for your symptoms is not due to occupational risks then these other causes need to be considered. Please attend your GP if you are not sure.
At Hand Kinetics we analyse the ergonomics of the activity likely to have caused the problem and show you how to modify your grip technique or posture.
It may be necessary to wear padding in the outside palm of the hand for selected activities and we can help with this.
If your condition has been there for a while, you may already notice that your little and ring fingers are curling towards the palm. A small custom fabricated anti claw splint made at Hand Kinetics may be necessary to prevent contractures in these fingers.
Occasionally surgery is required to take pressure off the nerve if conservative measures haven't been fully effective. If you require medical management of your condition Hand Kinetics can make a recommendation to a Hand surgeon based on the conservative options already tried. Following surgery we can liaise with your hospital team to provide you with post-surgical treatment.
Hand Kinetics Telephone: 0044 28 417 72301
www.handkinetics.com
contactus@handkinetics.com
