Cubital tunnel syndrome occurs when the ulnar nerve that travels down the elbow behind the “funny bone,” becomes compressed or entrapped. Many medical conditions such as bone spurs, ganglion cysts or tumors in the cubital tunnel can be the cause of pressure and irritation of the ulnar nerve, but sometimes repetitive motion can serve as the culprit.
At OrthoAspen, our elite-grade shoulder and elbow specialists are accustomed to treating a number of conditions, including cubital tunnel syndrome. We understand and value how much our patients enjoy living active and pain-free lifestyles. For that reason, we apply comprehensive treatment methods to have you back to doing what you love most as quickly and safely as possible.
The cubital tunnel is a narrow passageway on the inside of the elbow formed by bone, muscle and ligaments with the ulnar nerve passing through its center. The roof of the cubital tunnel is covered with a soft tissue called fascia. When the elbow is bent, the ulnar nerve can stretch and catch on the bony bump.
When the ulnar nerve is compressed or entrapped, the nerve can tear and become inflamed. A number of scenarios can cause this to happen, which include:
- Unexpected trauma or injury
- Repetitive motion
- Frequent pressure on the elbow for extended periods (due to sitting posture)
- Various medical conditions such as bone spurs, ganglion cysts or tumors that apply pressure to the cubital tunnel
Signs and symptoms of cubital tunnel syndrome arise gradually. It’s likely that an individual may not seek medical attention unless symptoms have progressed. Left untreated, cubital tunnel syndrome can lead to permanent nerve damage in the hand. If you experience any of the symptoms listed below, it’s best to seek medical attention as soon as possible.
Common symptoms associated with cubital tunnel syndrome include:
- Intermittent numbness, tingling and pain in the little finger, ring finger and the inside of the hand (occurring more frequently at night, with elbow bent or from prolonged resting on the elbow)
- Aching pain on the inside of the elbow
- Weakness in hand with diminished grip strength
- Diminished sensation in the hand, leading to disruption of fine motor control (causing an individual to drop objects or have difficulty in handling small objects)
- Atrophy of the hand muscles and permanent nerve damage (if left untreated)
To properly address and diagnose cubital tunnel syndrome, your OrthoAspen physician will thoroughly examine the area of concern, go over past medical history and order additional diagnostic tests. X-rays and electromyography and nerve conduction studies may be utilized to assist your doctor in determining how well the nerve is functioning, and to locate areas of muscle wasting and nerve compression.
At OrthoAspen we always try to implement conservative treatment options whenever possible to address symptoms.
As long as there isn’t any indication of muscle wasting or nerve damage, your OrthoAspen specialist may suggest the following conservative treatment protocols:
- Avoid frequent bending of the elbow
- Avoid pressure to the elbow by not leaning on it
- Utilize elbow pads to decrease pressure when working at a desk
- Wear a brace or splint at night while sleeping to keep the elbow in a straight position
- Wrap the arm loosely with a towel and apply tape to hold it in place
- Refrain from activities that tend to elicit or aggravate symptoms
- Take NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) such as ibuprofen or aspirin to reduce swelling
- Referral to occupational therapy (OT) for instruction in strengthening and stretching
If conservative treatment options fail to resolve cubital tunnel syndrome symptoms or if muscle wasting or severe nerve compression is present, your surgeon may recommend a surgical procedure.
The goal of cubital tunnel surgery is to reduce the pressure on the ulnar nerve by providing more space for the nerve to move freely and to increase blood flow. This promotes healing of the ulnar nerve. There are different surgeries that can be performed to treat the condition, such as:
- Medial Epicondylectomy
This surgery involves removing the medial epicondyle, the bony bump on the inside of the elbow. This, in turn, enables the ulnar nerve to glide smoothly when the elbow is flexed and straightened.
- Ulnar Nerve Transposition
This surgery involves creating a new tunnel in front of the medial epicondyle and transposing (moving) the ulnar nerve to the new tunnel. Your surgeon will decide which options are best for you depending on your specific circumstances.
Regardless of the treatment method for cubital tunnel syndrome, the shoulder and elbow experts at OrthoAspen are committed to helping you return to the activities you love most—efficiently and safely.