What non-surgical management strategies are recommended for patients with mild to moderate ulnar nerve entrapment?

For patients with mild to moderate ulnar nerve entrapment, non-surgical management strategies primarily focus on activity modification, splinting, and physiotherapy to alleviate symptoms and prevent progression. Activity modification involves avoiding prolonged elbow flexion and repetitive elbow movements that exacerbate nerve compression, which is a key initial approach recommended in UK neurological condition guidelines ². Elbow splinting at night to maintain the elbow in a near-extended position can reduce nerve irritation and is commonly advised to improve symptoms without surgery ². Physiotherapy interventions including nerve gliding exercises and strengthening of surrounding musculature may help restore nerve mobility and reduce symptoms, supported by evidence from clinical rehabilitation guidelines ¹. Additionally, ergonomic adjustments in daily activities and workplace modifications are recommended to minimize nerve stress ¹. Conservative management should be monitored closely, and if symptoms persist or worsen, referral for further specialist assessment is indicated ².

These recommendations align with findings from Caliandro et al. (2011), who emphasize that conservative treatment including splinting and activity modification is effective in mild to moderate ulnar neuropathy at the elbow, with surgery reserved for refractory or severe cases (Caliandro et al., 2011). Thus, a combined approach of patient education, splinting, and physiotherapy forms the cornerstone of non-surgical management for mild to moderate ulnar nerve entrapment in UK practice.