Cubital Tunnel Syndrome

What is Cubital Tunnel Syndrome?

Cubital Tunnel Syndrome is a common condition in the elbow that results from pressure or stretching of the Ulnar Nerve. This is the same nerve that is felt when hitting your "funny bone". 

With this condition numbness or tingling in the ring and small fingers are common as well as pain in the forearm and sometimes hand weakness.

Click to View this video on Cubital Tunnel Syndrome by Dr. David Taormina of JOI Nassau.

Overview of Cubital Tunnel Syndrome

There are many different reasons for elbow pain. When searching for information you are likely to see conditions such as Golfer’s or Tennis Elbow both of which are problems related to the tendons that attach to the elbow. 

You will find that Cubital Tunnel Syndrome is a condition related to irritation of the nerve that runs along the inside border of the elbow. 

If diagnosed early, it responds well to conservative treatments. In more chronic cases surgical intervention has proven to be effective. Your healthcare providers will be a good resource for the proper diagnosis of your elbow condition.

Anatomical image of the ulnar nerve as it passes through the cubital tunnel with label showing nerve compression with cubital tunnel syndromeImage of Cubital Tunnel Syndrome.

Anatomy of Cubital Tunnel Syndrome

The ulnar nerve travels down the length of the arm from the neck all the way to the hand and fingers. As it travels past the elbow it goes through the cubital tunnel just behind the inner edge of the elbow. 

This tunnel is formed by the ligaments, tendons, muscle and bone of the elbow. The ulnar nerve innervates some of the muscles in the hand and provides for sensation to the little finger and half of the ring finger.

Causes of Cubital Tunnel Syndrome

Typically Cubital Tunnel Syndrome is caused by pressure or stretching of the ulnar nerve. 

Because this nerve must stretch around a boney ridge in the elbow, it can often get irritated if the elbow stays in a bent position for a long time (i.e. sleeping with elbows bent and hands behind head). 

Sustained pressure on the ulnar nerve can also cause nerve irritation. This is noted when someone is sitting for a long time with elbow propped on armrest of chair or car door if driving.

Symptoms of Cubital Tunnel Syndrome

Common symptoms are numbness and tingling in the ring and little fingers. This is usually noticed more when the elbow is in a bent position. 

Along with finger numbness, there may be pain along the inside border of the elbow or forearm.  Weakness may be noticed with gripping activities. 

If the nerve irritation has been going on long enough muscle atrophy may be noted in the hand.

Test and Diagnosis For Cubital Tunnel Syndrome

Cubital Tunnel Syndrome is usually diagnosed with a thorough medical history and physical exam by your doctor. 

Simple tests such as tapping on the involved nerve for reactivity and examining its position and stability along the elbow can give useful information on its condition. 

Also on physical examination the doctor will check for strength or weakness and sensation in the areas that the ulnar nerve innervates.

X-Rays may be performed to look for things such as bone spurs or arthritis that may cause symptoms or irritation to the nerve as well.

Nerve Conduction Tests are performed to look at the speed at which the nerve signal travels along the ulnar nerve. Slower conduction speeds can be indicative of nerve irritation.

Treatment of Cubital Tunnel Syndrome

Early intervention is important. The nerve irritation will usually respond to anti-inflammatory medications in the early phase. Avoiding the positions or activities that irritate the nerve is the most successful way to improve the condition. 

Often times doctors will refer patients with Cubital Tunnel Syndrome to occupational or physical therapy for pain management techniques and education regarding nerve protection and activity modification. 

Exercises are performed to address any weakness or flexibility deficits that have developed. For more chronic or severe cases that do not respond to conservative efforts surgery may be required. 

There are 2 common surgical procedures which may be called a cubital tunnel release

  1. Ulnar Nerve Transposition - With an Ulnar Nerve Transposition procedure the ulnar nerve is repositioned into a new tunnel. This allows it to travel through muscles and avoid the boney ridge of the original cubital tunnel.
  2. Medial Epicondylectomy - This surgical procedure removes the boney ridge along the inside edge of the elbow which is known as the medial epicondyle. By doing this the ulnar nerve is able to travel along the elbow without the pressure caused from the bone.

Home Remedies for Cubital Tunnel Syndrome

Most important is to avoid putting direct pressure on the elbow for any length time. This means that you will need to modify sitting habits while working at your desk, sitting in your favorite chair to watch TV or when driving your car. 

For those that have nerve irritation from sleeping with their elbow bent, consider wearing some type of light brace that will prevent the elbow from bending.

Related Links:

f you have Elbow pain or tingling/numbness in the hand, the Jacksonville Orthopaedic Institute can help!  To see a JOI Orthopedic Elbow and Hand Specialist, call (904)JOI-2000, schedule online, or click the link below. Tp see a JOI Certified Hand Therapist in 1 of our 12 locations, call (904)858-7045.

SEE A HAND & WRIST SPECIALIST

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By: Belinda Kirkland PT/ATC/CHT

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