Unless your nerve compression has caused a lot of muscle wasting, your doctor will most likely first recommend nonsurgical treatment.

Nonsurgical Treatment Nonsteroidal anti-inflammatory medicines. If your symptoms have just started, your doctor may recommend an anti-inflammatory medicine, such as ibuprofen, to help reduce swelling around the nerve. Although steroids, such as cortisone, are very effective anti-inflammatory medicines, steroid injections are generally not used because there is a risk of damage to the nerve. Bracing or splinting.Your doctor may prescribe a padded brace or splint to wear at night to keep your elbow in a straight position. Nerve gliding exercises. Some doctors think that exercises to help the ulnar nerve slide through the cubital tunnel at the elbow and the Guyon's canal at the wrist can improve symptoms. These exercises may also help prevent stiffness in the arm and wrist. Examples of nerve gliding exercises. With your arm in front of you and the elbow straight, curl your wrist and fingers toward your body, then extend them away from you, and then bend your elbow.

Surgical Treatment Your doctor may recommend surgery to take pressure off of the nerve if: Nonsurgical methods have not improved your condition

The ulnar nerve is very compressed

Nerve compression has caused muscle weakness or damage There are a few surgical procedures that will relieve pressure on the ulnar nerve at the elbow. Your orthopaedic surgeon will talk with you about the option that would be best for you. These procedures are most often done on an outpatient basis, but some patients do best with an overnight stay at the hospital. Cubital tunnel release. In this operation, the ligament "roof" of the cubital tunnel is cut and divided. This increases the size of the tunnel and decreases pressure on the nerve. This illustration shows the path of the ulnar nerve through the cubital tunnel. Structures that may compress the nerve — such as the medial epicondyle and ulnar collateral ligament — are also shown. Reproduced from J Bernstein, ed: Musculoskeletal Medicine. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2003. After the procedure, the ligament begins to heal and new tissue grows across the division. The new growth heals the ligament, and allows more space for the ulnar nerve to slide through. Cubital tunnel release tends to work best when the nerve compression is mild or moderate and the nerve does not slide out from behind the bony ridge of the medial epicondyle when the elbow is bent. In this surgical photo, a cubital tunnel release has been performed to decompress, or relieve pressure on, the ulnar nerve. The arrow shows the portion of the nerve that has become narrowed over time due to compression. Ulnar nerve anterior transposition. In many cases, the nerve is moved from its place behind the medial epicondyle to a new place in front of it. Moving the nerve to the front of the medial epicondyle prevents it from getting caught on the bony ridge and stretching when you bend your elbow. This procedure is called an anterior transposition of the ulnar nerve. The nerve can be moved to lie under the skin and fat but on top of the muscle (subcutaneous transposition), or within the muscle (intermuscular transposition), or under the muscle (submuscular transposition). For anterior transposition of the ulnar nerve, an incision is made along the inside of the elbow (pictured) or along the back side of the elbow. Medial epicondylectomy. Another option to release the nerve is to remove part of the medial epicondyle. Like ulnar nerve transposition, this technique also prevents the nerve from getting caught on the boney ridge and stretching when your elbow is bent.

Surgical Recovery Depending on the type of surgery you have, you may need to wear a splint for a few weeks after the operation. A submuscular transposition usually requires a longer time (3 to 6 weeks) in a splint. Your surgeon may recommend physical therapy exercises to help you regain strength and motion in your arm. He or she will also talk with you about when it will be safe to return to all your normal activities.