Guyon’s Canal Syndrome – Causes, Symptoms, Diagnosis, and Physiotherapy Treatment at Physio360 Chennai.

INTRODUCTION;

When you experience numbness, tingling, or weakness in your little finger and ring finger, it might not just be fatigue — it could be Guyon’s Canal Syndrome, a condition caused by ulnar nerve compression at the wrist. At Physio360 Chennai, our expert physiotherapists specialise in diagnosing and treating such nerve entrapment syndromes for fast and long-lasting recovery.

What is Guyon’s Canal Syndrome?

Guyon’s Canal Syndrome, also known as Ulnar Tunnel Syndrome, occurs when the ulnar nerve becomes compressed as it passes through a narrow space in the wrist called the Guyon’s canal. This canal is located between two small wrist bones, the pisiform and hamate, and a ligament that bridges them.

When pressure builds up in this area, the ulnar nerve gets irritated or pinched, leading to pain, numbness, tingling, and weakness in the hand, particularly affecting the ring and little fingers.

Anatomy of Guyon’s Canal.

Understanding the anatomy helps in identifying why this condition occurs.

• Boundaries of the canal:

  • Roof: Palmar carpal ligament and palmaris brevis muscle

  • Floor: Transverse carpal ligament and pisohamate ligament

  • Medial wall: Pisiform bone

  • Lateral wall: Hook of hamate

• Contents:

  • Ulnar nerve and its branches

  • Ulnar artery and vein

Compression of the ulnar nerve within this confined tunnel results in the characteristic symptoms of Guyon’s canal syndrome.

Causes and Risk Factors.

Several factors can contribute to ulnar nerve entrapment at the wrist, including:

✅ Repetitive wrist movements – Common in cyclists (called “cyclist’s palsy”) due to prolonged pressure on the handlebars.

✅ Prolonged wrist flexion or extension – Such as typing, gym workouts, or prolonged mouse usage.

✅ Trauma or fracture – Especially of the hamate or pisiform bones.

✅ Ganglion cyst or tumour – A cyst pressing on the nerve within the canal.

✅ Arthritis or inflammation – Swelling can compress the nerve.

✅ Repetitive gripping or vibration exposure – Common in mechanics, carpenters, and construction workers.

At Physio360, we often see patients with this condition caused by occupational strain, repetitive motion injuries, or sports activities such as cycling and racquet sports.

Symptoms of Guyon’s Canal Syndrome.

The symptoms vary based on which part of the ulnar nerve is compressed (motor, sensory, or both).

Common symptoms include:

• Numbness and tingling in the little finger and part of the ring finger

• Weak grip strength

• Clumsiness or dropping objects due to hand weakness

• Burning or electric-shock pain in the wrist or palm

• Muscle wasting in severe cases (especially of the hypothenar muscles)

If left untreated, it can lead to permanent nerve damage or muscle atrophy. That’s why early intervention at Physio360 Chennai is essential for effective nerve recovery.

How is Guyon’s Canal Syndrome Diagnosed?

At Physio360, diagnosis begins with a detailed physiotherapy assessment that includes:

Clinical History:

Our physiotherapist will inquire about:

• Duration and onset of symptoms

• Occupational activities (e.g., cycling, typing, lifting)

• Any history of wrist trauma or fracture

  
  

Physical Examination:

• Observation: Wasting of hypothenar muscles, clawing of fingers

• Palpation: Tenderness over the pisiform-hamate region

• Range of Motion (ROM): Limited wrist or finger movement due to pain

• Special Tests:

  • Tinel’s sign: Tapping over the Guyon’s canal reproduces tingling in the little and ring fingers.

  • Froment’s sign: Weakness of the adductor pollicis muscle when holding paper between the thumb and index finger.

  • Wartenberg’s sign: Involuntary abduction of the little finger.

    
    

Diagnostic Imaging:

If necessary, the physiotherapist may refer for:

• Nerve conduction studies (NCS) to detect nerve signal slowing

• Ultrasound or MRI to rule out cysts or fractures

  
  

Physiotherapy Management at Physio360 Chennai.

At Physio360, our goal is to reduce nerve compression, restore wrist mobility, and strengthen the hand muscles for long-term recovery.

Here’s how we approach Guyon’s Canal Syndrome physiotherapy treatment:

1. Pain and Inflammation Reduction.

• Modalities used at Physio360:

  • Ultrasound therapy – Promotes deep tissue healing and reduces inflammation.

  • TENS (Transcutaneous Electrical Nerve Stimulation) – Reduces pain by modulating nerve signals.

  • Cryotherapy – Ice therapy to relieve swelling and tenderness.

  • Laser therapy – For enhanced tissue regeneration and pain control.

    
    

2. Activity Modification and Ergonomic Advice.

• Avoid repetitive wrist strain or prolonged wrist extension.

• Use padded gloves for cycling or vibration-prone jobs.

• Adjust workstation ergonomics – keyboard and mouse placement.

• Educate on wrist-neutral postures for typing and gripping.

Our physiotherapists at Physio360 Chennai ensure patients learn how to protect their wrists in daily and work activities.

3. Nerve Gliding and Mobilisation Exercises

Special ulnar nerve gliding exercises help maintain nerve mobility within the canal and prevent adhesions.

Example:

• Ulnar nerve glide:

  • Start with the arm extended and the palm facing up.

  • Slowly bend the elbow and wrist while bringing the palm toward the face.

  • Repeat 10 times with a gentle motion.

These are performed under the supervision of a qualified physiotherapist near you at Physio360.

4. Stretching and Strengthening Exercises

Once pain subsides, the focus shifts to muscle flexibility and strengthening:

✅ Wrist flexor and extensor stretches

✅ Finger abduction and adduction exercises

✅ Grip strengthening using soft balls or putty

✅ Isometric hand exercises to improve stability

✅ Resisted wrist and finger exercises with elastic bands

These exercises help in preventing recurrence and enhancing hand function.

5. Manual Therapy and Soft Tissue Release

Our expert physiotherapists at Physio360 may perform:

• Myofascial release around the flexor retinaculum and hypothenar area

• Joint mobilisation of carpal bones to restore wrist mechanics

• Tissue desensitisation techniques for chronic nerve pain

This holistic approach ensures both symptomatic relief and functional recovery.

6. Splinting and Bracing

In acute or post-surgical stages, a neutral wrist splint helps minimise stress on the ulnar nerve. It supports healing and prevents further irritation during sleep or work. At Physio360, splints are custom-fitted to ensure comfort and correct positioning.

7. Postural Correction and Functional Training

Because wrist posture is often linked with shoulder, neck, and upper limb alignment, our Physio360 experts also assess cervical and scapular mechanics. We include:

• Postural re-education

• Core and shoulder stabilisation exercises

• Functional activity retraining

This ensures that the entire kinetic chain is corrected for optimal wrist function.

Medical and Surgical Options (if required).

If conservative physiotherapy fails or nerve compression is severe, doctors may recommend:

• Corticosteroid injections to reduce inflammation

• Surgical decompression of the ulnar nerve (Guyon’s canal release)

After surgery, post-operative physiotherapy at Physio360 plays a crucial role in restoring movement, preventing stiffness, and regaining grip strength through a structured rehabilitation plan.

Recovery Time.

Recovery duration depends on the severity and duration of compression. With early physiotherapy intervention at Physio360 Chennai, mild cases recover in 3–6 weeks, while chronic cases may take 2–3 months for full functional improvement.

Difference Between Guyon’s Canal Syndrome and Cubital Tunnel Syndrome

Feature	Guyon’s Canal Syndrome	Cubital Tunnel Syndrome
Site of Compression	Wrist (Guyon’s canal)	Elbow (Cubital tunnel)
Area of Numbness	Little and ring fingers, palm	Little and ring fingers (dorsal aspect)
Muscle Weakness	Hand intrinsic muscles	Forearm and hand muscles
Common Cause	Cycling, trauma, cyst	Prolonged elbow flexion, resting on elbow
Treatment	Wrist-based physiotherapy	Elbow-based physiotherapy

Knowing the difference ensures accurate diagnosis and focused treatment by Physio360’s best physiotherapists.

Prevention Tips from Physio360 Experts

✔ Avoid prolonged wrist flexion or extension

✔ Use ergonomic supports while typing or cycling

✔ Strengthen forearm and wrist muscles

✔ Take micro-breaks during repetitive activities

✔ Maintain good posture and avoid direct pressure on the wrist base

Why Choose Physio360 for Guyon’s Canal Syndrome Treatment in Chennai?

At Physio360, we combine advanced physiotherapy techniques, modern equipment, and personalised care to ensure the best outcomes.

Here’s why patients trust us:

Experienced physiotherapists trained in nerve entrapment management

Comprehensive assessment with postural, occupational, and ergonomic evaluation

Customised exercise programs for safe, fast recovery

Manual therapy and advanced modalities for pain relief

Friendly and professional care environment

Convenient locations in Chennai for easy accessibility

Call to Action

If you’re experiencing numbness, tingling, or weakness in your hand or fingers, don’t ignore it — it could be a sign of Guyon’s Canal Syndrome. Visit Physio360 Chennai today for a comprehensive physiotherapy assessment and targeted rehabilitation plan designed to restore your hand function and relieve pain effectively.

REFERENCE AND RESEARCH ARTICLE ;

1.Guyon's canal syndrome resulting from an ulnar artery aneurysm: A case reporthttps://doi.org/10.1016/j.ijscr.2024.109978.

2.Guyon Canal: The Evolution of Clinical Anatomyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC4791630/.