Cubital Tunnel Syndrome

By Diana Cratem, OT, CHT

Cubital Tunnel Syndrome Overview

Elbow Pain is a common occurrence.

Image of pain in the elbow.

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 on its way 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 ring and small fingers of the hand.

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 prominence of the medial epicondyle bone, 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

  • 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 elbow is tapped or touchedMaking a DiagnosisFollowing a physical examination:
    The following tests can be performed to confirm cubital tunnel syndrome:
  • 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 causeyour symptoms

Treatment

  • Rest: stopping the activity that is causing the symptoms
  • PT/OT to resolve impairments and return patient to function
  • Medications to decrease inflammation
  • Switching to headset-style phone
  • Using pads under elbow
  • Sleeping with your arm straight
  • Wearing a special elbow splint at night
  • Surgery (ulnar nerve transposition) if conservative measures fail. This shifts the ulnarnerve 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.Resources:1. www.healthpages.org/AHP/LIBRARY/HLTHTOP/CTD/cubtun.htm 2. www.indianahandcenter.com/medical_cubital.html
    3. www.handsurgeon.com/cubital.html
    4. www.e-hand.com/hw/hw007.htm

Hand Therapy

If your injury does require physical therapy or surgery, our JOI team has the expertise and technological advances to get you back to your ideal level of function.

If you are interested in scheduling an appointment at JOI Rehab for physical therapy, call (904) 858-7045. To schedule with a JOI Hand Physician, please call JOI-2000 or click below.

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By: Diana Cratem, OT, CHT


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