Cubital Tunnel Syndrome

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What is cubital tunnel syndrome?

Cubital tunnel syndrome is compression or pinching of the ulnar nerve on the medial (inner side) of the elbow. The nerve is located behind the medial elbow bump (epicondyle) and is responsible for pain when one bumps their medial elbow ("funny bone"). This nerve is responsible for sending sensory information from the ring and small fingers to the brain. It is also responsible for the function of many small muscles within the hand. 

Compression of the ulnar nerve usually results in tingling and numbness running down the forearm into the ring and small fingers. In advanced cases, one can experience loss of function in the hand. This can lead to loss of grip strength and difficulty with fine motor skills.

The physicians at Midwest Orthopaedics at Rush (MOR) Hand, Wrist & Elbow Institute who perform surgeries at Rush University Medical Center, Chicago and Rush Oak Park Hospital are among the most experienced surgeons in the country for treating cubital tunnel syndrome in a minimally invasive manner.

What are the symptoms of cubital tunnel syndrome?

Symptoms of cubital tunnel syndrome include:

  • Pain in the small and ring fingers
  • Numbness and tingling in the small and ring fingers
  • Loss of strength in the hand
  • Loss of fine motor skills in the hand (for example, difficulty buttoning one's shirt)

People with cubital tunnel syndrome are prone to dropping things or having symptoms worsen when the elbow is bent.

What are the causes of cubital tunnel syndrome?

Excessive compression of the ulnar nerve causes it to stretch and become impaired. Most cases have no identifiable cause. Symptoms can worsen when a person spends a lot of time leaning on their elbow or bending the elbow for prolonged periods. Cubital tunnel syndrome may also result from abnormal bone growth in the elbow or from intense physical activity that increases pressure on the ulnar nerve, such as throwing a baseball. Sleeping with a bent elbow can worsen cubital tunnel symptoms, because the ulnar nerve is put under tension when the elbow is flexed.

How is cubital tunnel syndrome diagnosed?

The orthopedic surgeons at the MOR Hand, Wrist & Elbow Institute will listen to a patient's symptoms and carefully examine his/her arm to determine whether cubital tunnel syndrome is present. Sometimes nerve tests, called electromyography (EMG) or a nerve conduction study (NCS), will be recommended to measure the function of the ulnar nerve. During an EMG test, tiny wires are inserted into muscles to measure the electric nerve response while the muscles are resting and contracted. During an NCS test small metal plates are taped to the skin and emit an electrical charge to measure how well and fast the nerves are sending electrical signals.

What are treatments for cubital tunnel syndrome?

Non-surgical Treatment Options

Most cases can be treated by:

  • Taking anti-inflammatory medications, such as ibuprofen
  • Using an elbow splint for sleep
  • Using an elbow pad while working or during certain activities
  • Activity modification

Surgical Treatment Options

Surgery to relieve pressure on the ulnar nerve is necessary only in more advanced cases of cubital tunnel syndrome. One surgical option is to remove part of the medial epicondyle, which can relieve pressure on the ulnar nerve. Another surgical procedure involves releasing the nerve or moving it to the front of the elbow where it is not as exposed to tension when the elbow is flexed. The doctors at Midwest Orthopaedics at Rush (MOR) Hand, Wrist & Elbow Institute in Chicago use newer, minimally invasive methods to treat cubital tunnel syndrome when surgery is necessary. That's why patients from all over Illinois and Northwest Indiana travel from near and far to be seen by the physicians who have a great track record and reputation.

After surgery, symptoms may subside within days or weeks; however, in severe cases improvement can continue for many months. Patients with less advanced nerve compression generally improve more rapidly. Therefore, patients with cubital tunnel syndrome should see a board certified hand and upper extremity physician at the first onset of symptoms.