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Cubital Tunnel Syndrome

Cubital Tunnel Syndrome is a compression or impingement of the ulnar nerve which passes through the cubital tunnel, a cavity of muscle, ligament & bone in the elbow. Causes can include prior injury, bone spurs, fractures, dislocations, and overuse of the elbow.

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Understanding Cubital Tunnel Syndrome

What is cubital tunnel syndrome?

Cubital tunnel syndrome occurs when the ulnar nerve, which passes through the cubital tunnel (a tunnel of muscle, ligament and bone) on the inside of the elbow, is compressed. It can then become inflamed, swollen and irritated.

Cubital tunnel syndrome causes pain that feels a lot like the pain you feel when you hit the "funny bone" in your elbow. The "funny bone" in the elbow is actually the ulnar nerve, a nerve that crosses the elbow. The ulnar nerve starts in your neck as a group of nerves that form the main ulnar nerve at the level of your shoulder and ends in your fingers.

What causes cubital tunnel syndrome?

Cubital tunnel syndrome may happen when a person bends the elbows often (when pulling, reaching or lifting), leans on their elbow a lot or has an injury to the area.

Arthritis, bone spurs and previous fractures or dislocations of the elbow can also cause cubital tunnel syndrome.

In most cases, the cause is not known, or idiopathic.

What are the symptoms of cubital tunnel syndrome?

The following are the most common symptoms of cubital tunnel syndrome:

  • Numbness and tingling in the hand or ring and little finger, especially when the elbow is bent.

  • Numbness and tingling at night.

  • Hand pain.

  • Weak grip and clumsiness due to muscle weakness in the affected arm and hand.

  • Aching pain on the inside of the elbow.

The symptoms of cubital tunnel syndrome may seem like other health conditions or problems, including golfer's elbow (medial epicondylitis). Always see a healthcare provider for a diagnosis.

How is cubital tunnel syndrome diagnosed?

In addition to a complete medical history and physical exam, diagnostic tests for cubital tunnel syndrome may include:

  • Nerve conduction test. A test to find out how fast signals travel down a nerve to find a compression or constriction of the nerve.

  • Electromyogram (EMG). This test checks nerve and muscle function and may be used to test the forearm muscles controlled by the ulnar nerve. If the muscles don't work the way they should, it may be a sign that there is a problem with the ulnar nerve.

  • X-ray. This is done to look at the bones of the elbow and see if you have arthritis or bone spurs.
  • Ultrasound. This test may be performed at the same time as a nerve conduction study or EMG.  This test does not require any needles or electrodes and may evaluate the compression of the nerve or position of the ulnar nerve as it crosses the elbow.

How is cubital tunnel syndrome treated?

The most effective treatment for cubital tunnel syndrome is stopping the activity that is causing the problem. Treatment may include:

  • Resting and stopping any activity that aggravates the condition, such as bending the elbow.

  • A splint or foam elbow brace worn at night (to limit movement and reduce irritation).

  • Using an elbow pad (to protect against chronic irritation from hard surfaces).

  • Anti-inflammatory medicines (such as ibuprofen or naproxen).

  • Nerve-gliding exercises.

If these treatments don't work, the healthcare provider may talk to you about surgery.

What can I do to prevent cubital tunnel syndrome?

To prevent cubital tunnel syndrome:

  • Keep your arms flexible and strong.

  • Don't rest on your elbows, especially on a hard surface.

  • Warm up before exercising or using your arms for sports or other repetitive movements.

When should I call my healthcare provider?

Call your healthcare provider if you have:

  • Pain or trouble moving that affects your regular daily activities.

  • Pain doesn’t get better or gets worse with treatment.

  • Numbness, tingling or weakness in the arm or hand.

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