CUBITAL TUNNEL SYNDROME
What Is Cubital Tunnel Syndrome?
Cubital tunnel syndrome is the second most common nerve entrapment syndrome after carpal tunnel syndrome and can cause similar pain and weakness in the affected hand(s). If you’ve heard of the “funny bone,” you’re already familiar with the intense tingling and dull pain that comes from tapping the inside of your elbow in just the right spot. What many call the funny bone sensation is actually caused by the ulnar nerve, which runs down the inside of the elbow and supplies feeling to half of the ring finger and the pinky finger. Left untreated, the condition can cause permanent nerve damage and disability. Usually, nonsurgical treatment can cure cubital tunnel syndrome, although in more severe cases where there is significant pain or disability, surgery may be recommended. This is usually the case for those who suffer from severe hand pain, tingling, muscle weakness, or numbness.
The cubital tunnel is a structure inside the elbow and is a 4-millimeter passageway that the ulnar nerve passes through. Cubital tunnel syndrome results from ulnar nerve compression, usually the result of bending the elbow and stretching the ulnar nerve. Symptoms arise gradually and may affect those who frequently rest their head in their hand, but it may also happen from repetitive motion, traumatic injury, or medical conditions.
What are the symptoms of cubital tunnel syndrome?
The following are the most common symptoms of cubital tunnel syndrome:
- Numbness and tingling in the hand or ring and little finger, especially when the elbow is bent
- Numbness and tingling at night
- Hand pain
- Weak grip and clumsiness due to muscle weakness in the affected arm and hand
- Aching pain on the inside of the elbow
The symptoms of cubital tunnel syndrome may seem like other health conditions or problems, including golfer’s elbow (medial epicondylitis)
Diagnosis & Treatment
How is cubital tunnel syndrome diagnosed?
Your doctor will take a medical history and do a physical examination to determine how well your nerves function and to locate areas of nerve compression. Your doctor may be able to narrow down what is causing your symptoms by asking you about your everyday habits, such as if you frequently lean on your elbows, sleep with bent arms, or do repetitive movements with your arm(s). Direct trauma to the inside of the elbow can also cause symptoms of ulnar nerve compression. In fact, one simple test is to tap the ulnar nerve area or simply press on the inner elbow to check if the patient feels tingling and heightened symptoms.
Treatment for cubital tunnel syndrome starts with conservative treatments, such as nonsteroidal anti-inflammatory medications (NSAIDs), bracing, splinting, and hand physical therapy, which may include ultrasound and electrical stimulation. As the patient, you can do many things to help relieve your symptoms, such as avoiding activities that require bending your arm for extended periods of time, keeping your elbows straight at night (try wrapping a towel around your straight elbow, or wear an elbow brace as you sleep).
Surgical treatment may be necessary if conservative therapies have not produced satisfactory pain relief and/or function restoration. Your orthopedic surgeon will discuss which type of operation would best suit your needs, but in general, surgery aims to increase the size of the cubital tunnel while decreasing ulnar nerve pressure.
Most patients recover from cubital tunnel syndrome, whether through conservative or surgical means. If the ulnar nerve is severely compressed or if the patient has experienced muscle wasting, nerve damage may be irreversible, meaning some symptoms of pain and/or tingling and numbness will remain even after surgery. However, nerves recover very slowly, so while it may seem like your surgery was unsuccessful, you may regain some function over time.
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