Cubital Tunnel Syndrome

What is Cubital Tunnel Syndrome?

Cubital Tunnel Syndrome is a condition characterized by compression of the ulnar nerve in an area of the elbow called the cubital tunnel.

Anatomy of the Cubital Tunnel

The ulnar nerve travels down the back of the elbow behind the bony bump called the medial epicondyle, and through a passageway called the cubital tunnel. The cubital tunnel is a narrow passageway on the inside of the elbow formed by bone, muscle, and ligaments with the ulnar nerve passing through its center. The roof of the cubital tunnel is covered with a soft tissue called fascia.

When the elbow is bent, the ulnar nerve can stretch and catch on the bony bump. When the ulnar nerve is compressed or entrapped, the nerve can tear and become inflamed leading to a variety of symptoms, called cubital tunnel syndrome.

What are the Signs and Symptoms of Cubital Tunnel Syndrome?

In general, signs and symptoms of Cubital Tunnel Syndrome arise gradually, progressing to the point where the patient seeks medical attention. Left untreated, Cubital Tunnel Syndrome can lead to permanent nerve damage in the hand. Commonly reported symptoms associated with Cubital Tunnel Syndrome include:

  • Intermittent numbness, tingling, and pain to the little finger, ring finger, and the inside of the hand. These symptoms occur more frequently at night, and with elbow bending or prolonged resting on the elbow.
  • Aching pain to the inside of the elbow
  • Weakness in hand with diminished grip strength
  • Diminished sensation and fine motor control in the hand causing the person to drop objects or have difficulty in handling small objects.
  • Muscle wasting in the hand and permanent nerve damage, if left untreated.

What are the Causes of Cubital Tunnel Syndrome?

The common causes responsible for cubital tunnel syndrome include:

  • Trauma
  • Repetitive motion
  • Frequent pressure on the elbow for extended periods due to sitting posture
  • Medical conditions such as bone spurs, ganglion cysts, or tumors in the cubital tunnel leading to pressure and irritation of the ulnar nerve

Diagnosis of Cubital Tunnel Syndrome

Your physician will review your medical history and perform a thorough physical examination of your elbow.

Your physician may order X-ray and electro diagnostic tests such as electromyography and nerve conduction studies. These tests can assist your doctor in determining how well the nerve is functioning and locate areas of muscle wasting and nerve compression.

Treatment Options for Cubital Tunnel Syndrome

Your physician will recommend conservative treatment options initially to treat the symptoms unless muscle wasting or nerve damage is present.

Conservative Treatment Options for Cubital Tunnel Syndrome

Conservative treatment options may include:

  • Avoid frequent bending of the elbow.
  • Avoid pressure to the elbow by not leaning on it. Elbow pads may be worn to decrease pressure when working at a desk.
  • Wear a brace or splint at night while sleeping to keep the elbow in a straight position. You can also wrap the arm loosely with a towel and apply tape to hold it in place.
  • Avoid activities that tend to bring on the symptoms.
  • NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) such as ibuprofen or aspirin may be ordered to reduce swelling.
  • Referral to OT (Occupational Therapy) for instructions in strengthening and stretching exercises may be recommended.