About cubital tunnel syndrome

What is cubital tunnel syndrome?

Cubital tunnel syndrome is a nerve entrapment at the elbow which can cause symptoms in the arm and hand including pain, numbness, and muscle weakness, particularly in the fingers 4 and 5. In severe cases you might experience clawing of the fingers.

The cubital tunnel is located in the elbow and is a small passage between the bones and tissue which the ulnar nerve passes through. The ulnar nerve supplies feeling and movement to the arm and hand and it runs from the neck to the shoulder, down the back of the arm, around the inside of the elbow and ends at the hand in the fourth and fifth fingers.

Due to the narrow opening of the cubital tunnel, it can be easily injured or compressed through repetitive activities or trauma.

What causes cubital tunnel syndrome?

Causes of nerve compression include daily habits like leaning on your elbows for long periods of time, sleeping with your elbows bent, or repetitive movement of the arm such as throwing. Direct trauma to the inside of the elbow, like when you hit your funny bone, can also cause symptoms of ulnar nerve pain.

Patients who have osteoarthritis of the elbow joint may develop bony spurs called osteophytes which may cause pressure on a nerve. Elbow fractures or dislocations or Ganglia (small fluid filled lumps) may also lead to nerve irritation.

How is cubital tunnel syndrome diagnosed?

Your physiotherapist will take a detailed history from you, about your pain followed by conducting a physical examination to diagnose cubital tunnel syndrome

Treatments for cubital tunnel syndrome

Conservative treatments to reduce pain include use of nonsteroidal anti-inflammatory medications (NSAIDs) like ibuprofen, heat and ice, bracing and splinting. Sleeping with a pillow or rolled up towel in the elbow to reduce elbow flexion may help alleviate symptoms. Avoid leaning on the elbow and modify repeated arm activities which aggravate your symptoms.

Certain exercises like nerve gliding exercises for the arm and hand can also help decrease pain associated with cubital tunnel syndrome. Repeat these exercises once a day, three to five times per week, or as tolerated.

Watch the video on nerve pain and numbness surrounding the elbow:

If these activities cause an intense shooting pain, stop immediately and discuss with your physiotherapist. These exercises may cause a temporary tingling or numbness in the arm or hand. If this feeling persists after rest, discontinue and seek help.

Patients may be referred for nerve conduction studies in more severe cases and sometimes if cubital tunnel syndrome is not alleviated by conservative measures then surgery may be required to relieve pressure on the ulnar nerve.