Cubital Tunnel Syndrome

What is Cubital Tunnel Syndrome?

Cubital Tunnel Syndrome is a condition that involves pressure or stretching of the ulnar nerve (also known as the “funny bone” nerve), which can cause numbness or tingling in the ring and small fingers, pain in the forearm, and/or weakness in the hand.

What Causes Cubital Tunnel Syndrome?

Cubital tunnel syndrome — also known as ulnar neuropathy — is caused by increased pressure on the ulnar nerve, which passes close to the skin’s surface in the area of the elbow commonly known as the “funny bone.” You’re more likely to develop cubital tunnel syndrome if you:

• Repeatedly lean on your elbow, especially on a hard surface.
• Bend your elbow for sustained periods, such as while talking on a cell phone or sleeping with your hand crooked under your pillow.

Sometimes, cubital tunnel syndrome results from abnormal bone growth in the elbow or from intense physical activity that increases pressure on the ulnar nerve. Baseball pitchers, for example, have an increased risk of cubital tunnel syndrome, because the twisting motion required to throw a slider can damage delicate ligaments in the elbow.

What are the Symptoms of Cubital Tunnel Syndrome?

Early symptoms of cubital tunnel syndrome include:

• Pain and numbness in the elbow.
• Tingling, especially in the ring and little fingers.

More severe symptoms of cubital tunnel syndrome include:

• Weakness affecting the ring and little fingers.
• Decreased ability to pinch the thumb and little finger.
• Decreased overall hand grip strength.
• Muscle wasting in the hand.
• Claw-like deformity of the hand.

If you have any of these symptoms, the doctors at Select Orthopedic Specialists may be able to diagnose cubital tunnel syndrome by physical examination alone. They also may order a nerve conduction study and a test called electromyography. Electromyography is a procedure in which electrodes placed into muscles and on the skin measure the health of muscles and the nerve cells that control them, to confirm the diagnosis, identify the area of nerve damage, and determine the severity of the condition.

What are the Treatments for Cubital Tunnel Syndrome?

Cubital tunnel syndrome often can be managed conservatively, especially if electromyography reveals that there is minimal pressure on the ulnar nerve.

Mild cases of cubital tunnel syndrome often respond to physical therapies such as:

• Avoidance of undue pressure on the elbow during daily activities.
• Wearing a protective elbow pad over the “funny bone” during daily activities.
• Wearing a splint during sleep to prevent over-bending of the elbow.

In cases where splinting doesn’t help or nerve compression is more severe, about 85% of patients respond to some form of surgery to release pressure on the ulnar nerve. These include surgeries that:

• Result in simple decompression of the ulnar nerve.
• Shift the nerve to the front of the elbow.
• Move the nerve under a layer of fat, under the muscle, or within the muscle.
• Trim the bump of the inner portion of the elbow — the medial epicondyle — under which the ulnar nerve passes.

If you undergo surgery for cubital tunnel syndrome, recovery may involve restrictions on lifting and elbow movement, and rehabilitation therapy. Although numbness and tingling may or may not quickly improve, recovery of hand and wrist strength may take several months.