The Carpal Tunnel Clinic
Cubital Tunnel Syndrome
Cubital tunnel syndrome is a condition that involves pressure or stretching of the ulnar nerve (also known as the "funny bone" Nerve), which can cause numbness or tingling in the ring and small fingers, pain in the forearm, and/or weakness in the hand. The ulnar nerve runs in a groove on the inner side of the elbow.
Cubital Tunnel Syndrome usually occurs gradually with commonly reported symptoms being intermittent numbness, tingling and pain in the little finger, ring finger and the inside of the hand. These symptoms are caused by injury to the ulnar nerve which can be due to ulnar nerve entrapment.
The symptoms often occur at night time when sleeping with a bent elbow or with leaning on the elbow, bending it repetitively, during the daytime. Patients often report symptoms coming on when on the phone for prolonged periods of time with a bent elbow.
If untreated the symptoms can become worse and the muscles in the hand can waste leading to permanent damage to the hand.
Bone spurs, ganglion cysts or tumours may also be the cause of nerve entrapment in the cubital tunnel.
Treatment Options
Hand therapy and conservative treatment
A night time extension splint/foam splint to be worn at night time to relax the nerve by reducing any tension on it. Keeping the arm straight can help reduce tension on the nerve and thereby reducing the inflammation overnight. This together with education about aggravating factors in the hope to avoid these activities can help resolve inflammation and may reduce the symptoms. Hand therapy is usually the first port of call in treatment of Cubital Tunnel Syndrome depending on the severity of the symptoms, this may be very beneficial.
Anti-inflammatory agents and analgesics and cortisone injections into the sheath of the tendons, which is performed by a radiologist under ultrasound guidance.
Surgical treatment
Failure of conservative treatment usually over 6 weeks does often lead to surgical treatment. This often requires a general anaesthetic or a local anaesthetic and sedation and can be done as a day case. Typically, an incision is made at the back of the elbow and the ulnar nerve is released and sometimes a new tunnel is created and the nerve is transposed (moved) to the new tunnel.
Rehabilitation involves early movement of the elbow and wrist with a hand therapist and usually results in full resolution of symptoms by 4-8 weeks.
