Cubital Tunnel Syndrome

Cubital Tunnel Syndrome results when the ulnar nerve, which runs through the cubital tunnel on the inside of the elbow, is irritated by an injury or unusual pressure. The condition may occur when the elbow is frequently bent as in pulling and lifting, or from constant leaning. It can also occur from a direct injury.

In establishing a cause for the condition, it is thought that the ulnar nerve – which stretches several millimeters when the elbow is bent – occasionally shifts or snaps over the bony medial epicondyle on the inside edge of the elbow and, over time, becomes irritated. The nerve may also become irritated when pressed for long periods against a hard service, or if it becomes damaged from a blow to the cubital tunnel.

The pain resulting from the condition is similar to that experienced when the “funny bone” is hit. What many refer to as the “funny bone” is actually the ulnar nerve, which originates at the side of the neck, crosses at the elbow and ends in the fingers. The most common symptoms related to cubital tunnel syndrome include: numbness in the hand and/or ring and little fingers; general pain in the hand; and muscle weakness in the hand and thumb affecting grip strength and ability to perform certain activities.

These symptoms are similar to other elbow conditions such as medial epicondylitis (golfer’s elbow) and should be accurately diagnosed by a physician.

Those at Risk
Cubital tunnel syndrome is most often seen in adults and can affect the athlete, laborer and office worker alike. An ambitious weekend project subjecting the elbow to unusual stress and pressure can result in the condition as well.

Diagnosis
Following a complete medical history and physical examination, patients may require a nerve conduction test, which helps determine the speed of signals traveling down a nerve – in order to determine if there is a compression or constriction. An electromyogram (EMG) targeted at the forearm muscle may be used in order to evaluate nerve and muscle function, which is controlled by the ulnar nerve. Poor muscle function may indicate a problem with the ulnar nerve and confirm diagnosis.

Treatment
A number of conservative nonsurgical treatment options are available for cubital tunnel syndrome – including the cessation of irritating activity, a removable splint to limit movement and reduce irritation, an elbow pad to protect against hard surfaces and anti-inflammatory medication. And a patient-specific physical or occupational therapy program can also show significant improvement.

In chronic cases nonresponsive to conservative treatment, surgery is indicated in order to release the pressure on the ulnar nerve, where it passes through the cubital tunnel. A number of different surgical procedures can accomplish this and are done as an outpatient procedure.