What is Cubital Tunnel Syndrome?
Cubital tunnel syndrome is a nerve compression syndrome that occurs when a nerve called ulnar nerve or the funny bone nerve is squashed or irritated where it crosses the elbow. The ulnar nerve originates in the neck and travels all the way down to your hand and fingers. At the elbow, this nerve transits a space under the bony bump on the inside of your elbow known as the cubital tunnel.
The ulnar nerve provides feeling to your pinky finger and half of the ring finger. It is also referred to as the “musician nerve” as it supplies most of the small muscles of your hand that control fine movements of your fingers. It also controls movements of certain muscles of your forearm that help you make a tight grip.
What are the Signs and Symptoms of Cubital Tunnel Syndrome?
Symptoms of cubital tunnel syndrome include:
- numbness or tingling in the fingers, in particular, the ring and pinky fingers — felt like these fingers have “fallen asleep”
- pain or soreness along the forearm (the pain feels a lot like the pain that occurs when you hit the “funny” bone of your elbow)
- weakness in the affected hand
- reduced hand grip
- difficulty carrying out activities that require fine movements of hand such as typing, cutting with scissors, or buttoning clothes
- wasting of the muscles of hand in the very last stages
Common Causes of Cubital Tunnel Syndrome
Certain factors/activities put you more at risk for developing cubital tunnel syndrome such as:
- Activities that require the elbow to be bent repeatedly can stretch and irritate the ulnar nerve across the bony bump, making your hand and fingers — especially the ring and little fingers —“fall asleep”
- A habit of leaning on your elbow puts pressure on the ulnar nerve, and because the nerve doesn’t have enough padding here, it gets compressed and irritated
- Baseball pitchers who are required to twist their elbows while throwing a slider are also prone to cubital tunnel syndrome
- A previous fracture at the elbow still irritating the nerve
- Arthritis (inflammation) of the elbow joint
- Sometimes, the ulnar nerve keeps snapping back and forth across the bony bump on the inside of the elbow with the movement of the arm. Frequent snapping irritates the nerve, resulting in cubital tunnel syndrome.
Treatment of Cubital Tunnel Syndrome
Your doctor will perform the necessary evaluation and establish the diagnosis.
If your symptoms are at the beginning stage, your doctor may recommend an anti-inflammatory medicine to curb inflammation and the associated pain and swelling.
Wearing a brace or splint at night helps limit movement, keep your elbow from bending, and give your arm the needed rest and a chance to heal, thus preventing the symptoms from getting worse.
Exercises called nerve gliding exercises may be recommended to help the ulnar nerve glide easily through the cubital tunnel at the elbow. These exercises can restore the range of motion of your arm and wrist and improve symptoms.
In severe cases of ulnar nerve entrapment, your doctor may surgically:
- widen the tunnel to release the pressure on the ulnar nerve at your elbow — a procedure called cubital tunnel release, or
- move the ulnar nerve to a position where that it’s more protected from injury
Cubital tunnel release can be done in two different ways:
Open cubital tunnel release: During this operation, the ligament that forms the roof of the cubital tunnel is divided. This increases the size of the tunnel while reducing the pressure on the nerve.
Endoscopic cubital tunnel release: Nowadays, surgeons prefer this approach as it’s minimally invasive and safer than the open approach. After locating the bony bump on your elbow, the surgeon makes a cut and passes a camera called endoscope to divide the tunnel’s roof and decompress the ulnar nerve.
What to expect during the Recovery period?
After surgery, physiotherapy is recommended to help resume the strength in your elbow and hand. Overall recovery time varies by individual. It can take anywhere from several weeks to a few months to regain the normal strength of the operated arm.