Cubital Tunnel Syndrome
Cubital Tunnel Syndrome is caused by pressure on the ulnar nerve at the elbow. Nerves are responsible for carrying messages between the brain, spinal cord, and body parts. When the nerve is compressed, it cannot function properly. Cubital Tunnel Syndrome is the second most common nerve entrapment syndrome, after Carpal Tunnel Syndrome.
The Ulnar Nerve is responsible for carrying signals for sensation in one half of our ring finger and our small finger and to our muscles that perform hand movements. Individuals with Cubital Tunnel Syndrome will have difficulty handling objects and performing anything that requires a gripping motion. Individuals may feel pain, numbness, or a tingling sensation. When you hit your “funny bone”, the feeling is actually caused by the Ulnar Nerve.
Ulnar Nerve Anatomy
The Ulnar Nerve runs from the side of the neck, down the arm, and to our fingers. Ulnar Nerve compression typically occurs at the elbow. This is because at the elbow joint, the Ulnar Nerve passes through a passageway, formed by muscle, ligament, and bone. This is often referred to as the Cubital Tunnel. If the Ulnar Nerve is compressed at the Cubital Tunnel, it will send faulty messages as it travels down the forearm into the hand and fingers.
The Ulnar Nerve is also responsible for sending messages to some of the muscles that move our hands and fingers. These muscles are the Interossei and the Adductor Pollicis. The Interossei muscles work to move our fingers together and apart. When the fingers and thumb spread open, the Adductor Pollicis is responsible for moving the thumb back towards the hand.
Cubital Tunnel Syndrome Causes
Cubital Tunnel Syndrome is caused by pressure on the ulnar nerve at the elbow. Its direct cause is unknown, but several factors seem to contribute to it, the most common appearing to be from repeated elbow movements. The Flexor Carpi Ulnaris muscle may press on the Ulnar Nerve as it runs through the Cubital Tunnel. Elbow fractures, trauma, bone spurs, swelling, or cysts are also factors that can cause Ulnar Nerve compression and lead to Cubital Tunnel Syndrome.
Cubital Tunnel Syndrome Symptoms
Cubital Tunnel Syndrome frequently causes numbness and tingling in the ring finger and little finger. The symptoms of cubital tunnel syndrome may come and go. The symptoms may happen more often when the elbow is bent. The most common symptoms also include poor finger coordination and a weak grip. If the Ulnar Nerve compression is not treated, more serious symptoms will start to occur. For instance, it can cause muscle deterioration and lead to permanent impairment. You should always contact your doctor if the symptoms of Ulnar Nerve compression last more than a few weeks and interfere with normal activity.
Cubital Tunnel Syndrome Diagnosis
A doctor will perform an examination and review your medical and activity history to make a diagnosis of Cubital Tunnel Syndrome. Then, once the diagnosis is made, will attempt to find where the Ulnar Nerve is compressed. This is done by examining your forearm, elbow, hand strength and movement. More specifically, the doctor may tap on your Ulnar Nerve in the cubital tunnel to see if it reacts and will test for sensation. It is important to note that the examination may cause a bit of discomfort as the physician is looking for the cause of the symptoms. Your doctor may use X-rays, a CT scan, or MRI.
In some cases, the doctor may use nerve conduction studies to measure how well the Ulnar Nerve works. This is also to help specify the site of compression. Electromyography, or EMG, is usually performed with nerve conduction studies.
Cubital Tunnel Syndrome Treatment
Most cases of Cubital Tunnel Syndrome respond well to non-surgical treatments. Cubital Tunnel Syndrome treatment typically includes activity restriction, rest, and pain relief. It is advised that you avoid repetitive elbow movements and avoid leaning or putting pressure on the elbow. You should take frequent breaks to rest. Your doctor may give you a splint to keep your elbow straight, especially during sleep. Anti-inflammatory medications may provide pain relief.
You may need to undergo some physical therapy. These exercises may help keep the forearm and wrist muscles healthy while preventing joints from becoming stiff.
Cubital Tunnel Syndrome Surgery
Surgery is only recommended if non surgical options fail to work or if by the rare chance that you have muscle wasting. The surgery may be done as an outpatient procedure or may require an overnight stay at the hospital, depending on the severity.
The surgeon has various options for relieving the pressure on the Ulnar Nerve:
- In simple decompression, the “roof” is removed from the Cubital Tunnel.
- The most common surgical procedure is called an Anterior Transposition of the Ulnar Nerve, where the surgeon makes an incision at the elbow and moves the Ulnar Nerve from behind the elbow to a new place in front of the elbow.
- If the Ulnar Nerve is relocated under the skin and fat but on top of the muscle, the procedure is called a Subcutaneous Transposition of the Ulnar Nerve.
- When the Ulnar Nerve is placed under the muscle it is called a Submuscular Transposition of the Ulnar Nerve.
Following surgery, a splint will need to be worn on the elbow for a few weeks. Individuals who receive a Submuscular Transposition of the Ulnar Nerve may need to wear a splint from three to six weeks. Physical therapy will more than likely be recommended following surgery of any kind.
Cubital Tunnel Syndrome Recovery
If you require surgery for Cubital Tunnel Syndrome it may take several months to recover. Individuals having muscle or nerve damage will take a longer time to recover. This is because, in general, nerves take a long time to heal. For those individuals with severe nerve or muscle damage, complete healing may not be possible, meaning they may have some symptoms even after surgery.
At SPORT, we will identify the source of your pain and then utilize state-of-the-art therapeutic techniques that focus on restoring your range of motion.
Depending on the specific condition and its severity, these treatment options may include physical therapy, over-the-counter anti-inflammatory medication, slings and supports, cortisone shots, or shoulder or elbow surgery.
If you have an acute or chronic shoulder or elbow injury that needs medical attention, call SPORT at (469) 200-2832 to arrange a consultation or you can request one online. Hurt today? We can arrange a same-day urgent care visit to ensure you get fast, effective relief.