Compression on Tunnel of Guyon

By Carolyn Kisner PT, MS and Lynn Allen Colby PT, MS on February 24th 2009

Etiology of Symptoms
Injury or irritation of the ulnar nerve in the tunnel between the hook of the hamate and pisiform results from sustained pressure, such as prolonged handwriting or leaning forward onto extended wrists while biking; from repetitive use of the gripping action of the fourth and fifth fingers, as with knitting, tying knots, or using pliers and staplers; or from trauma, such as falling on the ulnar border of the wrist.

Tests of Provocation

There can be other causes of ulnar nerve symptoms, such as tension, compression, or restricted mobility of the nerve roots in the cervical intervertebral foramen, the brachial plexus in the thoracic outlet, or the ulnar nerve as it courses through the bicipital groove; or there could be impingement between the heads of the flexor carpi ulnaris muscle. Therefore, each of these sites must be examined to rule out or determine if any is the cause of the symptoms. In addition, with nerve irritability it is possible to develop what is known as a double crush injury7 so the nerve develops symptoms at other areas along its course as well as at the primary site.
History. Description of symptoms in the little finger and ulnar side of the ring finger; history of provoking activity.
Observation and Tests. May have atrophy in the hypothenar eminence and present with partial claw; positive Tinel’s sign (tapping ulnar nerve) over the tunnel of Guyon.

Buy the Book that holds this excerpt: Therapeutic Exercise: Foundations and Techniques (Therapeutic Exercise: Foundations & Techniques)

Related Articles

Filed Under: Jeff, Physical Therapy
Tags: etiology, Guyon, test

No Comment Received

Leave A Reply

« Summary of Guidelines for Nonoperative Management of Carpal Tunnel Syndrome

Critical Areas of Emphasis and Selected Exercise Techniques »

Tag Cloud

abdomen abdominal abdominals abdominis acetabulum acromioclavicular activities Acute adhesions Administration Aerobic Aerobic Exercise aerobics agonist ambulation aids anatomical anesthesia annulus fibrosus anterior/posterior shear anterior pillar anterolateral antigravity aponeurosis arthritic arthritis Arthrokinematics arthroplasty arthroscopy Assisted atrophy back pain Balance Benefits biomechanical body mechanics Breathing Cancer capsulitis capsulotomy cardiopulmonary Cardiovascular Causes cemented cementless cervical Cervical Spine Characteristics chest chondromalacia patella Chronic chronic fatigue circuit weight training Clinical closed-chain concentric concentric contractions conditioning contracture contraindications contralateral coracohumeral Core Muscle curves DCER Decision deformity degeneration degradation delayed-onset muscle soreness dermatome Diagnosis disability Disablement Model disease disuse duration dynamic dynamic exercise dynamic exercises dysfunction eccentric efficiency environment equilibrium Equipment Ethical etiology Euthanasia Evaluation Examination exercise exercises Expiration extremity facet joints facilatation Fatigue Femur Fetal Response fibrocartilage fibrocartilagenous lip fitness Flexibility flexion flexor foramina fossa frequency frontal plane motion Full-Arc Exercise Function functional functional limitation functional limitations glenohumeral glenoid glenoid fossa gluteus medius Gratf Guidelines Guillain-Barre syndrome Health-care hemiarthroplasty hemiarthroplasy hip history hybrid arthroplasty hydraulic hyperextension hypermobility iliac crest iliofemoral iliolumbar iliotibial ilium immobilization impairment impairments inflammation infraspinatus Injuries injury Inspiration intensity Intervention intervertebral Intra-abdominal intradiskal pressure ischiofemoral ischium isokenitic isokenitic regimen isokinetic Isokinetic exercise isometric joint mobilization kinesiologic kinesthetic Labor lateral shear leg limb-girdle longus colli lordosis Lower lower extremity lumbar lumbar spine lumborum lumbosacral Management Manual Resistance Exercise Maternal Maternal Response mechanical resistance mechanoreceptors Medical clearance Medications meniscoid Methods microtrauma Mobility Mobilization Model Modified motor movement Multifidus multiprofessional approach Muscle muscle contraction Muscle endurance Muscle performance muscles Muscle strength Muscoloskeletal musculoskeletal myotomes neck nerve Neural Neurogenic neurological Neuromuscular neuropathy non-weight-bearing Occupational Therapy osteoligamentous osteonecrosis Osteoporosis osteotomy Overload Principle pain palliative palpation Passive patella femoral joint pathological fracture pathologies pathology Patient patients Pelvis percentages performance periarthritis Phases physical fitness Physical Therapist Physical Therapy physician physiological plyometric training pneumatic PNF posterior posteriorly posterior pillar posterolatera postimmobilization Postoperative Postpartum Postpolio syndrome postsurgica postsurgical Postural Posture power PRE Precautions Pregnancy Preoperative Prevention Preventive Principles Procedure Process Prognosis progressive resistance exercise protocols psychological pulleys Pulmonary pulposus radiculopathy radiographic evidence Rationale re-examination recovery Rehabilitation Rehablitation Relaxation repetitions resistance Resistance Exercise resistance training Respiration Respiratory rest rheumatoid arthritis ROM safety sagittal plane motion SAID principle scapular posture scapulothoracic Short-Arc Shoulder shoulder girdle sling spinae spinal column Spine spondylolisthesis spondylolysis spondylosis stability stabilization Stage 1 stenosis sternoclavicular Sternoclavicular Joint stiffness strength stress stretch Stretching structure subacromial submaximal subscapularis suprascapular nerves supraspinatus surgery Surgical symptoms synovial fluid synovial joints systems review technique techniques temporomandibular joint test Testing testing procedures Therapeutic Exercise therapist therapy thoracolumbar Thoracolumbar fascia Thorax TOS training transverse plane motion transversus abdominis trapezius trauma treatment triaxial joint Trimester tuberosity Types Upper Uses Valsalva Valsalva maneuver Varicose Veins Velocity Ventilation volume weight-bearing weights Withholding