Cubital Tunnel Syndrome
What is cubital tunnel syndrome?
The ulnar nerve is one of the three main nerves in the arm. It travels down the upper limb and through a tunnel of tissue called the cubital tunnel, located behind a bump of bone at the inner side of the elbow. Beyond the elbow, the ulnar nerve travels along the inner forearm and into the little finger side of the hand. It controls the sensation, movement and strength over the little finger and half of the ring finger.
Cubital tunnel syndrome is a condition that involves pressure or stretching of the ulnar nerve at the elbow, resulting in numbness or tingling in the ring and little fingers and/or weakness in the hand.
There are several causes for ulnar nerve compression at the elbow, including:
- Direct pressure on the nerve by leaning on the elbow for long periods of time.
- Keeping the elbow in a bent position for a long time or bending the elbow repeatedly can stretch the nerve behind the elbow, resulting in nerve irritation.
- In some individuals, the nerve does not stay in place and slides back and forth over the bony bump of the inner elbow with elbow movement, irritating the nerve as well.
- Swelling over the elbow may compress the nerve.
- A direct blow to the inner elbow can cause pain, electric shock sensation and numbness in the ring and little fingers.
How do I know if I have cubital tunnel syndrome?
Signs and symptoms of cubital tunnel syndrome may include:
- Numbness, tingling and/or pain over the ring and little fingers (especially at night).
- Clumsiness when using their hands to perform daily activities.
- Muscle wasting over hand muscles innervated by the nerve.
- Loss of strength and dexterity over the fingers, making it difficult to grasp and manipulate objects.
How is cubital tunnel syndrome diagnosed?
Your specialist Doctor will obtain your health history and perform a physical examination. Your Doctor may also order medical diagnostic tests (e.g. nerve conduction studies, electromyography studies, ultrasound scans, MRI scans) to help with the diagnosis.
How is cubital tunnel syndrome treated?
It is important to seek early treatment for cubital tunnel syndrome to prevent permanent damage to the nerve and corresponding small muscles of the hand. Treatment options for cubital tunnel syndrome depend on the severity and duration of the disease and include both surgical and non-surgical interventions.
Your specialist Doctor may refer you to our Hand Therapist, who will be able to provide the following services:
If you require protective immobilisation for your finger, your specialist Doctor may refer you to our Hand Therapist for a customised splint. Once you are able to start therapy for your finger and hand, our Hand Therapist can then help you in your recovery through treatment options such as:
- Advice and education pertaining to your condition
- Wax therapy
- Advice on lifestyle and activity modifications so as to eliminate or minimise daily activities or or upper limb postures which may further aggravate the condition
- Provide a customised elbow splint for night wear, so as to minimise the risk of poor elbow positioning during sleep
- Exercises to improve finger joint and muscle movements
- Nerve and tendon gliding exercises to help the ulnar nerve move better within the cubital tunnel
- Personalised home exercise program
Your Doctor may suggest other non-surgical interventions such as oral medications (e.g. anti-inflammatory drugs, vitamin B supplements) to help reduce any existing inflammation and improve nerve function.
Surgical interventions to help relieve the pressure within the cubital tunnel may be recommended in the following situations:
- The symptoms of cubital tunnel syndrome do not improve over time with non-surgical interventions.
- Cubital tunnel syndrome has been persistent for prolonged periods of time (i.e. more than six months) and has been diagnosed to be severe in nature.
- The small muscles of the hand, which are controlled by the ulnar nerve, show signs of wasting and hand weakness becomes more pronounced.
Recovery from cubital tunnel surgery can take anywhere from several weeks to several months. Hand therapy is often required after surgery to help regain the movement, strength and function of the affected hand and elbow.