Cubital Tunnel Syndrome
By Diana Cratem, OT, CHT
The cubital tunnel is behind your “funny bone” on the inside of your elbow, behind the funny bone (medial epicondyle), the tunnel is formed, a bone surrounded by muscles and ligaments. The ulnar nerve passes through the cubital tunnel from the arm to the forearm and hand.
What is Cubital Tunnel Syndrome?
Cubital tunnel syndrome is pressure on the ulnar nerve behind the funny bone, causing numbness and tingling in the hand’s ring and small fingers.
What Causes Cubital Tunnel Syndrome?
In normal individuals, bending the elbow causes the ulnar nerve to stretch several millimeters. When this is done for activities that require repeated bending and straightening of the elbow, the nerve becomes inflamed. In some patients, the nerve shifts and can snap over the medial epicondyle bone prominence, which stretches and irritates the nerve. Leaning on the elbow or maintaining the elbows in a bent position for a long period of time (talking on the phone, sleeping) may cause repetitive pressure and irritation on the nerve. Direct trauma (fall, fracture) by the cubital tunnel may also damage the ulnar nerve.
Symptoms of Cubital Tunnel Syndrome
- Numbness or tingling in the ring and little fingers (early symptom)
- Loss of finger or hand strength (later symptom)
- Inability to straighten fingers
- Sharp, sudden pain when the elbow is tapped or touched
Tests to confirm Cubital Tunnel Syndrome
- The nerve conduction study measures the speed of the nerve signals running through the ulnar nerve.
- Electromyogram (EMG) testing reveals problems with the muscles in your arm and hand.
- Radiographs (x-rays) can rule out fractures, arthritis, or other problems that may cause your symptoms.
Treatment
- Rest: stopping the activity that is causing the symptoms
- PT/OT to resolve impairments and return the patient to function
- Medications to decrease inflammation
- Switching to a headset-style phone
- Using pads under the elbow
- Sleeping with your arm straight
- Wearing a special elbow splint at night
- Surgery (ulnar nerve transposition) if conservative measures fail. This shifts the ulnar nerve from the back to the front of the cubital tunnel. Surgery also may remove part of the medial epicondyle bone. This can release the nerve from the tunnel.
Hand Therapy
Related Articles: Rheumatoid Arthritis Overview and cubital tunnel release.
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