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What is Guyon's Canal Syndrome?

Pain or numbness in the wrist can indicate Guyon's canal is being pinched.
Guyon's canal is where the ulnar nerve passes through two small bones in the wrist, the pisiform and the hamate.
Wearing a wrist brace may help treat early stages of Guyon's canal syndrome.
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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 21 October 2014
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Two small bones in the wrist, along the lower edge of the palm, called the pisiform and the hamate, form a canal of sorts through which the ulnar nerve passes. This is called Guyon’s canal, and any obstruction or narrowing of this space can result in sensitivity and numbness or pain in the ring and pinky finger and the wrist. When something obstructs or compresses the ulnar nerve in this location, it is called Guyon's canal syndrome.

Causes of Guyon's canal syndrome are variable. They can include injury or fracture of either the pisiform or hamate bones. Tiny tumors can also form near the nerve obstructing it. Constant pressure on the site, as when someone holds onto the handlebars of a bike can also be a cause, and as a result, it is sometimes called handlebar palsy. Arthritis in the wrist bones may also create problems in Guyon's canal.

Early symptoms include “pins and needles” feelings in the ring and little finger of the affected hand. When this is ignored, Guyon's canal syndrome may progress to a very painful and “burning” sensation in the wrist. The condition also may result in continual numbness of the pinky and ring finger.

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The condition often gets worse without medical intervention, and eventually will result in difficulty controlling the muscles in the hands. Spreading the fingers may be difficult and even thumb movements can be challenging. Pain in the wrist often increases.

Usually, the pain and numbness signals a problem. Most people with the condition assume they have carpal tunnel syndrome. It’s actually easy to differentiate between the two syndromes, because carpal tunnel initially causes numbness in the thumb, index and middle finger, while Guyon's canal syndrome first affects the pinky and ring finger.

Diagnosis of the condition is made by taking a thorough medical history and determining what activities the patient engages in. X-rays may be taken if the doctor suspects a broken or fractured bone. Another common test is called nerve conduction velocity (NCV), which measures the speed of nerve impulses and allows the healthcare provider to definitively diagnose where the nerve is working more slowly.

If Guyon's canal syndrome is diagnosed in its early stages, stopping the activities that created the situation can sometimes treat it. Patients may wear a brace at night and during the day to keep the wrist in a stable position. If a fracture is the cause, patients may wear a cast. Some medical professionals also prescribe physical therapy to help patients practice better body alignment and arm and hand positioning to release pressure on the nerve.

When early intervention doesn’t resolve the issue, surgery may be performed to remove any obstruction to the ulnar nerve and rebuild a stable passage for it. This is frequently an outpatient surgery, and patients usually can go home the same day. The hand must stay heavily bandaged for several weeks, and a patient may work with physical therapists after the surgery. The outcome of this surgery is usually good, especially when a physical therapy regime is followed.

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anon939684
Post 5

Self diagnosis: I am an active 55 year old lady. My issues began 10 years ago. I started working on computers at school job. I was resting my palms on tables while bent over PCs a lot. I noticed swelling and pain and research showed me it was the ulnar nerve area.

Soon after, I started having numbness in my last two fingers, which again confirmed the issue. I can rub the nerve in the wrist and feel the tingling up to my elbow (funny bone).

When doing some flooring, I aggravated the heck out of my ulnar nerve. I have tried hard not to over-aggravate my palm area. I just got a motorcycle and after about 20 minutes of driving it, my ulnar nerves in both hands hurt. I have old people's skin things -- my palms now have less padding. I am trying hard not to grip so hard on handlebars, but am going to see a doc and surgery may be in my future. Darn it.

anon150959
Post 4

I'm 19 and have had ulnar nerve compression surgery at the elbow on both arms, due to numbness of little finger and ring finger. however, i have now started to have a lot of wrist pain with a constant burning on both wrists - but my fingers were already numb. i hope its not guyons canal syndrome otherwise i will have to have surgery again!!

anon64623
Post 3

About six months ago, I started experiencing a sharp, electric, unbearable pain between my pinky and ring finger. It would always be the same nerve that's so excruciating painful.

The pain comes on at anytime, and now when I'm sleeping. At first I thought I might have arthritis at 34 years, then carpal tunnel, but that's still not it. Then I read up on Guyon's Syndrome. I'd never heard of it.

anon6044
Post 2

I`ve had guyon`s canal syndrome at the wrist for 2 years now! When I was using my hand I also had pain up to my elbow and weakness in grabbing things! When I stopped using my hand it got better, but the pain in the hand hasn`t gone away! I guess I`ll have to have surgery! I heard korean ginseng is good for the pain!

anon4854
Post 1

I saw nothing stated about pain running up the underside of the forearm up to the elbow. I have continuous numbness in my pinky and ring finger, and pain that runs up the underside of my forearm all the way to the elbow. Also seems that I don't have as much strength in my hand while doing certain tasks. Can this be helped with exercise, to avoid surgery?

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