What is Cubital Tunnel Syndrome?
Cubital tunnel syndrome is a pinched nerve at the elbow and occurs when your “funny-bone nerve”, known as the ulnar nerve, is compressed on the medial (inside) portion of the elbow.
Similar in concept to carpal tunnel, cubital tunnel is typically caused by chronic pressure or stretch being placed on the nerve. This can be positional, leaning on the inside of the elbow, bending the elbow for long periods such as when on the phone.
Symptoms usually consist of:
- Tingling and/or numbness in the ring and small fingers
- Pain over inside aspect of elbow
- Forearm pain
- Hand weakness in more severe cases
Most people notice this affects them worse at night and often times can wake them up from sleep.
How is Cubital Tunnel Syndrome Diagnosed?
Cubital Tunnel is diagnosed using the following:
- A thorough examination of the arm
- A detailed history, that includes your symptoms, medical conditions, activities and prior injuries
X-rays may also be taken to check for deformities about the elbow. In some cases, electro diagnostic studies (nerve conduction tests) are performed to confirm the diagnosis.
How is Cubital Tunnel Syndrome Treated?
Initial treatments are conservative, and involve decreasing the pressure and stretching of the nerve. They include:
- Activity Modification. Avoiding leaning on elbow when sitting at desk or in chairs with armrest. An elbow pad can be helpful with this. Avoiding prolonged flexion of elbow, such as using an ear piece for phone.
- Towel or pillow wrapping. When wrapped around the elbow, a soft bath towel will pad the elbow, and prevent it from full flexion. This can be especially helpful at night during sleep.
- Bracing. Wearing a brace during the day and/or at night takes pressure off the nerve by keeping the elbow straight.
- Hand therapy. Stretching and strengthening the muscles of the forearm, wrist, and hand may help decrease pain.
- Anti-inflammatory medications. Over-the-counter and prescription medications are used to decrease inflammation and pain.
When symptoms do not respond to conservative treatment options, surgical intervention may be required.
There are several ways to surgically remove the pressure from the nerve. A simple release of the nerve may be sufficient. In revision surgery or in severe cases moving the nerve to the front of the elbow, and/or removing a part of the bone can be necessary.
Like carpal tunnel, the numbness and tingling may improve quickly or slowly. It may take many months for recovery after surgery. Cubital tunnel symptoms may not totally go away after surgery, especially if symptoms are severe.