Cubital Tunnel
What is Cubital Tunnel Syndrome?
Cubital Tunnel Syndrome occurs when the ulnar nerve, located on the inside of the elbow (near the "funny bone"), becomes compressed or irritated. This nerve provides sensation to the little finger and part of the ring finger and helps control some of the small muscles in the hand.
Symptoms of Cubital Tunnel Syndrome
The first sign of Cubital Tunnel Syndrome is usually numbness or tingling in the little and ring fingers. These sensations are often intermittent but may become constant over time. Symptoms can be triggered by activities such as leaning on the elbow, holding it in a bent position (e.g., when using the phone), or sleeping with the elbow bent.
As the condition progresses, the numbness may become persistent, and hand weakness can develop. In severe cases, muscle loss may be visible, particularly on the back of the hand, leading to a reduction in strength and dexterity.
Causes of Cubital Tunnel Syndrome
Cubital Tunnel Syndrome can be caused by several factors:
- Anatomy: Thickening of tissues over the ulnar nerve or the presence of extra muscle can interfere with its function.
- Pressure: Simple actions like leaning on the elbow can compress the ulnar nerve, leading to the sensation of "falling asleep" in the hand and fingers.
- Snapping: The ulnar nerve may snap over the medial epicondyle (a bony part of the elbow), irritating the nerve with repeated movement.
- Stretching: Bending the elbow for long periods, such as while sleeping, can overstretch the nerve, contributing to symptoms.
Risk Factors for Cubital Tunnel Syndrome
Certain factors increase the likelihood of developing Cubital Tunnel Syndrome, including:
- Arthritis in the elbow
- Prolonged elbow bending
- Bone spurs or cysts near the elbow joint
- Previous elbow dislocations or fractures
- Swelling in the elbow joint
How is Cubital Tunnel Syndrome Diagnosed?
A diagnosis is typically based on a thorough medical history and physical exam. Additional tests may include:
- Nerve conduction studies: These tests measure the speed of nerve signals to identify any compression.
- Electromyography (EMG): This test checks nerve and muscle function, helping to assess how well the muscles controlled by the ulnar nerve are working.
- X-rays: These are used to examine the bones of the elbow for signs of arthritis or bone spurs.
Conditions That May Mimic Cubital Tunnel Syndrome
Other conditions can cause symptoms similar to Cubital Tunnel Syndrome, including:
- Nerve lesions in the wrist (e.g., Guyon’s canal syndrome)
- Acute nerve palsy from pressure on the elbow
- Neurological issues from conditions like cervical spondylosis, thoracic outlet syndrome, or motor neurone disease
- Carpal Tunnel Syndrome
- Polyneuropathy due to diabetes, renal disease, or alcohol use
Treatment for Cubital Tunnel Syndrome
Treatment usually starts with nonsurgical options. If these don't provide relief or if the condition progresses, surgical intervention may be recommended.
Nonsurgical treatments include:
- Bracing or splinting: Wearing a padded splint while sleeping can help keep the elbow straight and reduce pressure on the ulnar nerve.
- Nerve gliding exercises: These exercises can help the ulnar nerve move more freely through the cubital tunnel and prevent stiffness in the arm and wrist.
- Hand therapy: A hand therapist can teach strategies to avoid putting pressure on the ulnar nerve.
- Anti-inflammatory medications (NSAIDs): Medications like ibuprofen can reduce inflammation and alleviate pain.
Surgical treatments may be necessary if the nerve compression is severe or if muscle weakness is present. Surgical options include:
- Cubital tunnel release: This procedure involves cutting the ligament over the cubital tunnel to reduce pressure on the ulnar nerve.
- Ulnar nerve anterior transposition: In this surgery, the ulnar nerve is moved to the front of the elbow to prevent it from getting caught on the bone.
- Medial epicondylectomy: This surgery removes part of the medial epicondyle to relieve pressure on the nerve.
Outlook for Cubital Tunnel Syndrome
If left untreated, Cubital Tunnel Syndrome can lead to muscle atrophy and weakness in the hand. This can result in difficulty performing everyday tasks and a noticeable loss of hand function.
Prevention of Cubital Tunnel Syndrome
To reduce the risk of developing Cubital Tunnel Syndrome, consider the following:
- Avoid leaning on your elbow for extended periods.
- Don’t put pressure on the inside of your arm.
- If you use a computer chair often, keep it at a high enough setting to avoid resting your elbow on the armrest.
- Sleep with your elbow straight to prevent overstretching the nerve.
- Minimize activities that require bending your elbow for prolonged periods.
By following these preventive measures and seeking early treatment, you can manage and potentially avoid more severe complications of Cubital Tunnel Syndrome.
Further information
Last updated24 Apr 2025