Cubital tunnel syndrome is a condition that occurs when there is irritation or pressure on the ulnar nerve. The ulnar nerve (the nerve responsible for the tingling sensation felt when you hit your “funny bone”) runs from the neck, down the arm, and into the palm side of the hand. The nerve controls small muscle movement and provides feeling to the little finger and half of the ring finger.
The compression or irritation linked to cubital tunnel syndrome occurs in the elbow. The condition is named for the ulnar nerve tract, since it runs through the cubital tunnel (a tunnel made up of tissue) under the bony prominence (medial epicondyle) located on the inner aspect of the elbow.
Causes of cubital tunnel syndrome
Cubital tunnel syndrome develops as a result of the following:
- Stretching – when the elbow moves into the bent position the ulnar nerve stretches around the medial epicondyle. Repeated, or prolonged, bending can irritate the nerve and cause pain
- Direct pressure – leaning on the elbow can put pressure on the nerve, since there is little padding, leading to cubital tunnel syndrome
- Injury – hitting your elbow can elicit the painful response often referred to as “hitting your funny bone.” Sometimes swelling and fluid build-up can cause pressure to increase around the nerve, causing pain
Some factors can increase the risk of cubital tunnel syndrome, such as: chronic elbow injuries, arthritis, bone spurs, cysts, and elbow fractures or dislocations.
Symptoms of cubital tunnel syndrome
Symptoms of cubital tunnel syndrome usually occur in the hand. Irritation or compression of the ulnar nerve can lead to numbness and/or tingling in the ring finger and little finger. If the condition is severe, it can weaken the grip and interfere with fine motor coordination in the fingers supplied by the ulnar nerve. Sometimes there is also pain or discomfort in the affected elbow.
Treatment of cubital tunnel syndrome
It is not always necessary to seek medical treatment for cubital tunnel syndrome. Sometimes, the condition resolves on its own, over time. Tips for speeding recovery include:
- Avoid resting elbow on surfaces such as tables or open car windows
- Take frequent breaks from the computer or writing and make it a point to gently straighten the elbow every few minutes
If the condition does not resolve on its own within one month to six weeks, your doctor may recommend x-rays or a nerve conduction study. This will help determine the location of the nerve compression and the severity of the condition.
Non-surgical treatment options include non-steroidal, anti-inflammatory medications, padded braces or splints for nighttime use and nerve gliding exercises to help with movement of the ulnar nerve.
Surgery is reserved for severe cases of cubital tunnel syndrome where there is serious compression, muscle wasting or damage that does not improve with non-surgical treatment. Surgical options include:
- Releasing the entrapped ulnar nerve by cutting the top of the cubital tunnel
- Ulnar nerve transposition, a procedure where the ulnar nerve is repositioned to the front of the medial epicondyle
- Medial epicondylectomy – removal of a portion of the medial epicondyle resulting in release of the entrapped ulnar nerve
Most patients who undergo surgical treatment for cubital tunnel syndrome experience good results, although nerve recovery can be slow.