Cubital Tunnel Syndrome


 

What is Cubital Tunnel Syndrome?

Cubital Tunnel Syndrome is a condition caused by pressure on the ulnar nerve at the elbow.  Nerves carry messages between the brain, spinal cord, and body parts. When a nerve is compressed, it cannot function properly.

The Ulnar Nerve carries signals for sensation in one half of our ring finger and our small finger and to our muscles that perform fine hand movements.  

Is Cubital Tunnel Syndrome common?

Cubital Tunnel Syndrome is the second most common nerve entrapment syndrome, after Carpal Tunnel Syndrome.

What are the symptoms of Cubital tunnel Syndrome?

Patients with Cubital Tunnel Syndrome have difficulty handling objects and performing gripping motions. They may also feel pain, numbness, and a “tingly” sensation, similar to when the “funny bone” is hit. Cubital Tunnel Syndrome frequently causes numbness and tingling in the ring finger and little finger.  Your symptoms may come and go. They may happen more often when your elbow is bent, such as at night when sleeping in one position. You may experience poor finger coordination and a weak grip. This may interfere with activities such as holding objects in your hand, using a keyboard, or playing an instrument.
 

What are the causes of Cubital Tunnel Syndrome?

Cubital Tunnel Syndrome can result from Ulnar Nerve compression. Its cause is unknown, but several factors appear to contribute to it. Its most common cause appears to be from repeated elbow movements. The Flexor Carpi Ulnaris muscle can press on the Ulnar Nerve as it runs through the Cubital Tunnel. The Ulnar Nerve can also become irritated from pressure on the elbow. This can occur when the elbow is leaned on or pressed on for long periods of time. Elbow fractures, trauma, bone spurs, swelling, or cysts are additional factors that can cause Ulnar Nerve compression and lead to Cubital Tunnel Syndrome.


What is the treatment for Cubital Tunnel Syndrome?


Non- Surgical

Most cases of Cubital Tunnel Syndrome respond to non-surgical treatments.  Treatment typically includes activity restriction, rest, and pain relief. You should avoid repetitive elbow movements and avoid leaning or putting pressure on the elbow.  In other words, you should refrain from the movements and postures that cause discomfort. You should take frequent breaks to rest when performing such movements. Elbow splints may be worn to keep your arm straight, especially while sleeping.  Anti-inflammatory medications may provide pain relief.

Occupational or physical therapy can help.  The occupational or physical therapists focus on gentle exercises to help the Ulnar Nerve slide through the Cubital Tunnel.  The exercises may help keep the forearm and wrist muscles healthy while preventing joints from becoming stiff.


Surgery

Surgery may be recommended for you if you do not receive relief from non-surgical treatments.  Surgery can remove pressure from the Ulnar Nerve and prevent further damage. Your surgeon may also recommend surgery if you have muscle wasting.  


How is the surgery done?

The surgery may be done as an outpatient procedure or may require an overnight stay at the hospital.  You may be sedated for surgery or remain alert with a regional anesthesia that blocks the feeling in your arm.

Your surgeon has various options for relieving the pressure on the Ulnar Nerve.  In one procedure, the “roof” is removed from the Cubital Tunnel. This method is called simple decompression.  The most common surgical procedure is called an Anterior Transposition of the Ulnar Nerve. In this procedure, 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.  

Your surgeon will consider many factors when selecting which method to use and will discuss the appropriateness of each with you.

What is recovery like?

Following surgery, a splint is typically worn on the elbow for a few weeks.  Individuals who receive a Submuscular Transposition of the Ulnar Nerve may need to wear a splint for a longer time, from three to six weeks.  Occupational or physical therapy is recommended to regain strength and motion in the arm.

If you suffer from any of the symptoms of Cubital Tunnel Syndrome, please contact Arizona Center for Hand to Shoulder Surgery for a consultation. Our caring staff will be honored to take care of you.

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