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Cubital Tunnel Syndrome

Cubital tunnel syndrome occurs when the ulnar nerve (commonly referred to as the “funny bone” nerve) is compressed or stretched at the elbow. This can lead to numbness or tingling that is more common in the ring and little fingers. In some cases, it may also cause hand weakness and forearm pain. The ulnar nerve travels through a groove on the inside part of the elbow, near the body.

Symptoms

The most prevalent symptoms of cubital tunnel syndrome include:

  • Numbness and tingling in the hand or the ring and little fingers, particularly when the elbow is bent
  • Numbness and tingling that worsens at night
  • Weak grasp and clumsiness because of muscle weakness in the impaired hand and arm
  • Hand pain
  • Aching pain on the inner side of the elbow

These symptoms can resemble conditions such as golfer’s elbow (or medial epicondylitis). It is important to see a health practitioner for a correct diagnosis.

Causes

Cubital tunnel syndrome can develop from frequent elbow bending, such as during pulling, lifting, and reaching, as well as from prolonged pressure on the elbow or an injury to the region. Conditions like bone spurs, arthritis, and past elbow fractures or dislocations may as well contribute to its onset. However, in most cases, the exact cause remains unknown.

Diagnosis

A healthcare provider may conduct a thorough medical history review and physical examination to diagnose cubital tunnel syndrome. They may also recommend the following tests:

  • Nerve conduction test: Measures how quickly signals move along the nerve to determine if there is compression or tightening.
  • Electromyogram (EMG): Evaluates nerve and muscle function, particularly in the forearm muscles regulated by the ulnar nerve. Abnormal muscle function might indicate a problem with the ulnar nerve.
  • X-ray: Assesses the elbow bones to determine if arthritis or bone spurs are linked with the condition.

Treatment

Treatment for cubital tunnel syndrome can be either non-surgical or surgical, depending on the severity of symptoms.

Non-surgical options:

Conservative treatments are normally effective for mild to moderate cases and may include:

  • Steering clear of activities that trigger symptoms. These involve leaning on the elbow and keeping the elbow bent for long periods (e.g., while using a phone or reading)
  • Wearing a brace or using a pillow/towel wrap at night to prevent excessive elbow bending.
  • Physical therapy. Various exercises and techniques to reduce nerve compression and improve mobility.

Surgical options:

If non-surgical treatments fail, surgical intervention may be considered. The type of surgery depends on the severity of the condition as well as the underlying cause:

  • Simple decompression: This involves releasing the pressure on the ulnar nerve by cutting the tissue so as to constrict it. This can be performed as an open surgery or via an endoscope.
  • Ulnar nerve transposition: The nerve is moved to a new location in front of the elbow to relieve pressure and prevent stretching.
  • Medial Epicondylectomy: A less common procedure in which part of the bone over the nerve is removed in order to alleviate compression.

Hand therapy:

Special hand therapy may be highly beneficial for individuals with cubital tunnel syndrome as a conservative treatment and during post-surgical recovery.

  • Nerve and tendon gliding exercises: Gentle and targeted exercises help improve mobility and reduce nerve irritation.
  • Range of motion training: Patients learn controlled movements that lower pressure on the ulnar nerve and support healing.
  • Activity modifications: Hand therapists guide ergonomic adjustments (including workplace evaluations) to minimise positions triggering nerve compression.
  • Custom orthoses: Specialised splints or braces are designed to optimise finger mobility and facilitate recovery after surgery in advanced cases of nerve injury.

How to Prevent Cubital Tunnel Syndrome

You can lower the risk of developing cubital tunnel syndrome by:

  • Keeping your arms flexible and strong.
  • Not resting your elbows on hard surfaces for extended periods.
  • Always warming up before participating in sports or repeated arm movements.

Conclusion

Cubital tunnel syndrome can lead to numbness, pain, tingling, and muscle weakness, affecting hand function. Early diagnosis and treatment, whether through activity modification, splinting, or surgery, can help prevent long-term nerve damage and improve quality of life.

Schedule an appointment with us any time to receive an accurate diagnosis and treatment plan.