Ulnar Nerve Dysfunction: Symptoms, Diagnosis, and Treatment - Neurology

Ulnar nerve neuropathy

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Hello Doctor: I began experiencing slight numbness in my left little finger and an unusual sensation when touched around mid-last year, which is not like the normal feeling of my fingers.
I have tried various folk remedies, chiropractic treatments, and medical consultations, but the issue remains unresolved and has worsened over time.
So far, the only confirmed finding from my examinations is ulnar nerve dysfunction.
My self-reported symptoms include: unusual sensations in the left little and ring fingers, pain and frequent inflammation along the ulnar side of the little finger and the palm below it, as well as pain and inflammation in the elbow and upper arm (at its worst, the pain radiated from my shoulder to the left side of my neck); there is a noticeable tightness and slight pain when I extend or bend my arm or rotate it (most often from the elbow down to the fingers), and when there is inflammation in the back of my hand at the little and ring fingers, there is a significant tight and painful sensation; at night, when lying flat on my back, I experience noticeable cramping pain in my arm; occasionally, I feel abnormal tightness and pain in my left armpit and the left side of my chest (the sensation comes quickly and goes just as fast).
Below, I will outline my daily activities and the information the doctor has provided me, and I kindly ask for your guidance on how to proceed: 1.
I spend long hours sitting in front of the computer, with my elbow resting on the armrest of the chair and my wrist resting on the edge of the table while using the keyboard (mostly using the left half of the keyboard, with the area around the little finger being the main pressure point).
My wrist and elbow are in a suspended position, relying solely on my wrist and elbow as pivot points.
2.
I started an exercise program around May, initially focusing on walking and simple core exercises.
After more than two months of exercise, I began to challenge myself with "burpees." Shortly after my first attempt at burpees, I felt a very intense pain in my left palm (like a strain or tear).
The pain came quickly and went just as fast, so I didn't pay much attention and continued with my self-designed exercise routine.
3.
After exercising one day last year, I had difficulty taking off my shirt due to sweating and forcefully pulled my arm back, causing my elbow to collide violently with the corner of a wall, resulting in numbness and pain in my left hand for several days, making it difficult to bend it.
(I can't recall if this collision occurred before or after the onset of the unusual sensations.) 4.
Pain and inflammation began to appear in my left little finger, the ulnar side of the palm, and my wrist, with the ulnar nerve area in the elbow being abnormally sensitive to touch.
I have consulted with a traditional Chinese medicine clinic and a chiropractic clinic.
Below are the reports from the examinations the doctor has shared with me: 1.
I had X-rays taken of my left metacarpals, cervical spine, and left shoulder (the doctor said the bones were normal).
2.
I underwent nerve conduction studies twice, and the doctors reported no abnormalities; I also had an electromyography (EMG) test, which indicated ulnar nerve dysfunction.
The doctor who performed the EMG suggested an MRI of the brachial plexus.
3.
I had two MRIs: one of the cervical spine and one of the brachial plexus (the neurosurgeon reported no abnormalities in the brachial plexus; the rehabilitation physician noted slight degeneration at the third and fourth cervical vertebrae, which could cause some compression, but not to a severe extent).
4.
I visited a cardiologist for an electrocardiogram, and the doctor reported no abnormalities; I chose not to undergo further testing.
5.
I had two ultrasounds: one of my shoulder and one of my elbow, palm, and lower edge (the doctor reported no abnormalities in the shoulder, palm, or lower edge, and no muscle strains; the ulnar nerve in the elbow was slightly flattened, but not to a severe extent).
Currently, I feel that my treatment is ineffective.
I also want to inform the doctor that I am taking medications (anti-inflammatories, nerve pain treatment, muscle stiffness treatment, mood stabilizers, and pain relievers including Tramadol, which the doctor advised contains morphine and should be stopped immediately if any abnormalities occur; I have not experienced any significant issues, just occasional fatigue and drowsiness).
I attend physical therapy three times a week (including heat therapy, neck traction, and electrical stimulation for the elbow and neck areas).
I smoke and have asked the doctor if it could be a lung apex tumor, but the doctor said the likelihood is very low, and the brachial plexus examination showed no findings.
There is a family history of diabetes, but my blood test results for diabetes were negative.
Thank you, Doctor, and I wish you good health.

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Yang Xuan, 20~29 year old female. Ask Date: 2021/01/26