[Noah930]

The last branch off the ulnar nerve is the muscular branch to the adductor pollicis. That's the fleshy muscle in the first webspace of your hand. Look at the back of your hand. Look between the thumb and the index (pointer) finger. That's the first webspace, and it's filled with the adductor pollicis. If you have waited until that muscle starts to atrophy away, you've waited too long for the surgery. Go get it immediately, and maybe it'll come back (fill back in).

Not all surgeons believe in the steroid injection prior to surgery, so just because you're not offered it doesn't necessarily mean a step was missed in the treatment algorithm. But unless you're presenting with late findings (like first webspace atrophy) or constant, dense numbness in the ring and small fingers, I think it's worthwhile to try things like therapy, nocturnal bracing, home stretching exercises, behavioral modification, ergonomic changes, etc.