Ulnar deviation what it is and how to treat it

Ulnar deviation, or ulnar drift, is a medical condition that causes the joints in the wrist and hand to move so that the fingers bend toward the ulnar bone on the outside of the forearm. Inflammation in the knuckle joints and problems affecting the ligaments or muscles of the wrist and hand can lead to an ulnar deviation.

People who have ulnar deviation can still use their hands and fingers. However, over time, they may find certain activities, such as tying shoelaces or grasping small objects, more difficult. In this article, learn more about the symptoms and causes of ulnar deviation, as well as treatment options.

Symptoms of ulnar deviation

The main symptom of ulnar deviation is that the hand is bent towards the wrist. Other symptoms of ulnar deviation include:

  • Swelling, warmth, or pain in the joints of the wrists, hands, and fingers
  • Limited range of motion of the fingers
  • Reduced grip force

Causes of ulnar deviation

People can develop ulnar deviation as a result of chronic inflammation, problems with the ligaments or muscles, or structural birth defects. Some underlying medical conditions can also cause ulnar deviation, including:

Rheumatoid arthritis

Ulnar deviation can occur due to the chronic inflammation of rheumatoid arthritis (RA). RA is a chronic inflammatory disease in which the body’s immune system attacks the soft tissue or synovium that lines the surface of the joints.

RA often affects the synovium between the small joints of the hands and wrists, especially the metacarpophalangeal (MCP) joints, or knuckles, in the fingers.
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Prolonged inflammation of the MCP joints can make the fingers look swollen and bend at abnormal angles.

As RA progresses, inflamed synovial cells can invade and damage the surrounding cartilage and bone, causing pain, joint deformities, and permanent joint damage.

RA does not have a specific cause, but its known risk factors include:

  • Genetics and family history
  • Infections
  • Physical injury
  • Emotional stress or trauma
  • Environmental exposures


Lupus is an autoimmune disease that can affect any part of the body, including the joints, skin, and organs. According to the Office on Women’s Health, women represent approximately 90% of adults with lupus in the world. Lupus can affect the joints of the fingers and wrists, and can cause ulnar deviation over time. Other symptoms of lupus include:

  • Muscle and joint pain
  • Skin rash
  • A fever
  • Fatigue
  • Chest pain
  • Hair loss
  • Sensitivity to light
  • Mouth ulcers
  • Blood clots
  • Anemia
  • Kidney problems


Osteoarthritis (OA) is another possible cause of ulnar deviation. OA is the most common type of arthritis, affecting more than 30 million adults in the United States, according to the Centers for Disease Control and Prevention (CDC). This condition causes pain, stiffness, and inflammation in the joints. OA develops gradually as the cartilage between the joints breaks down due to use and aging.

Psoriasic arthritis

There is an association between this type of arthritis and psoriasis, a chronic autoimmune disease that causes scaly, painful patches on the skin. Like other forms of arthritis, psoriatic arthritis can cause ulnar deviation over time. About a quarter of people with psoriasis have psoriatic arthritis, according to a 2019 study.

Brachial plexus palsy

Brachial plexus palsy is a congenital condition that affects the nerves in the arm. It can cause weakness and loss of movement in the shoulder, arm, hand, and fingers. Children born with brachial plexus palsy often develop ulnar deviation later in life.

Treatments for ulnar deviation

Treatments for ulnar deviation focus on managing symptoms and preventing the problem from getting worse.

  • The first step in treating ulnar deviation involves diagnosing and treating the underlying condition.
  • Using over-the-counter or prescription anti-inflammatory medications can control chronic inflammation and help reduce swelling and pain in the hand.
  • Splints and braces can keep the fingers in place while adding additional support to the wrist.
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