Brain & nerves Neurological Rehabilitation
Ulnar Nerve Palsy
- Pins and needles in the ring and little fingers
- Weak grip and difficulty spreading the fingers
- Wasting between the thumb and index finger
- Clawing of the ring and little fingers in severe cases
Quick answer
Ulnar nerve palsy is compression or injury of the ulnar nerve, most often at the elbow, causing numbness in the ring and little fingers and weakness of the small hand muscles. Early cases respond to positioning, nerve gliding and activity modification over three to six months.
Typical recovery
3–6 months, depending on severity
A typical range, not a promise — how long it takes depends on how long it has been going on, and on what you do between appointments.
The ulnar nerve runs behind the inner elbow — the "funny bone" — where it lies close to the surface and is easily compressed. It supplies sensation to the little and ring fingers and powers most of the small muscles that give the hand its dexterity.
What it feels like
Pins and needles and numbness in the little finger and the adjacent half of the ring finger. Weakness shows up as difficulty spreading the fingers, gripping firmly, or performing fine tasks. In longer-standing cases there is visible wasting of the muscle between thumb and index finger, and the ring and little fingers may begin to claw.
Symptoms are often worse when the elbow is bent for long periods — on the phone, or sleeping with the arm curled.
Why it happens
Most commonly compression at the elbow from sustained bending or leaning on the elbow. Less often at the wrist, from pressure at the base of the palm — cyclists are a classic example. It can also follow elbow fracture or dislocation.
How physiotherapy helps
- Positioning advice and night splinting to keep the elbow from staying fully bent, which is the single most effective early measure
- Nerve gliding exercises to restore the nerve's mobility
- Strengthening the hand and forearm muscles as reinnervation allows
- Modifying leaning, phone use and workstation setup
- Where the hand is significantly weak, splinting to prevent fixed clawing while the nerve recovers
How long it takes
Mild compression often improves within three months of removing the aggravating position. More significant nerve injury recovers slowly — nerve regenerates at roughly a millimetre a day — so six months or more is realistic.
When to seek further assessment
Visible muscle wasting, persistent weakness or worsening symptoms warrant nerve conduction studies and a surgical opinion. Prolonged compression eventually causes irreversible loss.
Medically reviewed by Nasir Mughees, BPT, MPT, Orthopaedic Physiotherapy · Last reviewed September 2026