Cubital Tunnel Syndrome
Cubital tunnel syndrome is the condition that results from increased pressure on one of the nerves (the ulnar nerve) in the elbow. In patients with cubital tunnel syndrome, this nerve is compressed as it passes along the inside of the elbow (one’s “funny bone” area).. Because of the compression, the nerve does not function properly.
One can have a wide variety of cubital tunnel syndrome symptoms, but the condition typically causes numbness and tingling (paresthesias) in the hand (particularly the ring and “pinky” fingers), weakness in some of the muscles of the hand, and pain in the hand and wrist. Many of these symptoms become more pronounced at night, and patients with this condition often complain of inability to sleep.
The most common symptoms of carpal tunnel syndrome are:
*Numbness and tingling in the hand and small and ring fingers
*Night symptoms
*Hand and finger pain
There are several suggested causes for cubital tunnel syndrome. Part of the reason might reside in the very way the elbow is designed to work. One common factor might be the constant bending of the elbow itself–reaching, lifting, or pulling levers. When this occurs, the ulnar nerve is stretched several millimeters. At times the ulnar nerve will shift or snap over the bony point on the inside of the elbow called the medial epicondyle. Over time, this can progressively irritate the nerve, resulting in the pain, tingling, and numbness along with weakness of some of the muscles of the hand and forearm. Nerve damage can result. The ulnar nerve can also be damaged from trauma inflicted directly to the cubital tunnel.
Conservative Treatment
The earliest symptoms of cubital tunnel syndrome generally lessen with the cessation of repetitive or irritating activities. In addition, the symptoms may also be controlled through anti-inflammatory medications. It is far more important, however, to simply stop or modify the activity that is causing the pain in the first place. When performing a task that demands frequent elbow bending, limit the amount of time you apply toward it. Remember to take frequent breaks and, if necessary, simply modify your work-related activities.
If the symptoms are more severe at night, an athletic arm pad or a plastic arm splint may limit movement and ease irritation while you sleep. Always remember to wear the pad in the bend of the elbow to help keep the elbow straight. The elbow pad can also be worn during the day at work.
Your doctor may recommend that you consult with an occupational or physical therapist. This should provide helpful tips on how to rest the elbow and how to perform necessary activities without placing extra strain on the elbow joint. Your therapist might apply heat or other treatments to help ease the pain. Exercises and stretching techniques can help strengthen the forearm muscles while also providing pain relief.
Surgical Treatment
If symptoms do not disappear despite conservative medical treatment and changes in your daily activities, your doctor may determine that surgery is the best treatment to stop further damage to the ulnar nerve.
The aim of surgical treatment is to simply release the pressure and stress on the ulnar nerve as it passes through the cubital tunnel. This procedure is called nerve decompression or transposition. With this technique, the surgeon creates a brand new tunnel where the nerve is in a more comfortable position.
Cubital tunnel surgery is an outpatient procedure. A soft dressing and occasionally a splint is applied after surgery, and sutures are removed about 7 – 10 days after the procedure. Occasionally, physical therapy may be useful for functional return. |
