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Guyon's Canal Syndrome

What is Guyon’s Canal Syndrome?

Guyon's canal syndrome refers to compression of the ulnar nerve while it passes from the wrist into the hand through a space called the ulnar tunnel or Guyon's canal.

Guyon’s canal syndrome is also called ulnar tunnel syndrome or handlebar palsy. 

Anatomy and Function of the Ulnar Nerve

The ulnar nerve is one of the 3 major nerves of the arm that travels from your neck down to your hand. It passes under the muscles of the forearm and into the hand on the side of the palm, towards the little finger. The ulnar nerve controls movement and provides sensation to specific areas of the hand. 


A compressed ulnar nerve affects your hand, wrist and little finger. The symptoms include:

  • Pain
  • Weakness
  • Tingling
  • Numbness
  • Problem grasping objects

Causes or Risk Factors

The common risk factors or causes may include:

  • Working with vibrating tools
  • Joint arthritis
  • Ganglion cysts 
  • Acute or repetitive trauma
  • Tumors
  • Blood clots
  • Broken hamate bone (one of a cluster of hand bones near the wrist)
  • Synovitis (inflammation of the synovial membrane)


Your doctor will assess your symptoms, take your medical history and perform a physical exam. Imaging tests such as X-ray, MRI or CT-scans may be ordered. Specific tests such as doppler ultrasound may be ordered to evaluate blood flow in the ulnar artery.

Diagnosis is confirmed through evidence of a nerve conduction velocity test, a specialized test that checks how quickly electrical signals move through a nerve. 


Your doctor first recommends non-surgical options to treat Guyon’s canal syndrome including:

  • Using padded tools
  • Applying ice packs
  • Avoiding activities that aggravate pain
  • Immobilization with a brace or splint
  • Massage therapy
  • Physical therapy

Surgery is recommended if conservative options fail to relieve pressure on the ulnar nerve. 

Ulnar Nerve Decompression

This surgery involves the following steps:

  • An IV sedation is given to make you feel comfortable. Local anesthesia of the wrist may be needed.
  • A small incision is made along the ulnar nerve in your palm region.
  • Your surgeon will release any tissue overlying the affected nerve to relieve the compression. This may include removing a ganglionic cyst or repairing a fracture.
  • The incision is closed and dressed.

Recovery after Surgery

Your wrist is supported with a splint or cast. You are instructed to keep your arm raised above the level of your heart to decrease swelling. Physical therapy instructions will be given to teach exercises for flexibility and range of motion.

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