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Guide to Cubital Tunnel Syndrome

What is Cubital Tunnel Syndrome?

Cubital tunnel syndrome which is also known as Ulnar nerve neuropathy is a condition whereby there is increased pressure on the nerve which passes just under the skin on the inside of the elbow near the “funny bone.”

Some of the symptoms you can experience from cubital tunnel are as follows:

  • Pain or numbness/tingling from the inside of the elbow extending into the hand and wrist usually around the ring and pinkie finger.
  • Pain that is worse in the night or when you wake up

More severe symptoms would impact the motor function of the nerve and the symptoms would be:

  • Weakness that affects the pinkie and ring finger
  • Reduced overall grip in the hand
  • Muscle wasting in the hand

What causes Cubital Tunnel Syndrome?

Cubital tunnel syndrome occurs as a result of increased pressure on the nerve. There are things that you do on a daily basis that may make it more likely to develop cubital tunnel syndrome such as:

  • Having your elbows bent for long periods of time.
  • Bending and leaning on your elbows repeatedly on hard surfaces
  • Compression from direct or repetitive trauma.

Cubital tunnel can be commonly seen in athletes such as baseball, tennis and racquetball players. Workers who have to maintain a bent elbow position, such as holding the phone or type with bent elbows at work.

How is Cubital Tunnel Syndrome diagnosed?

The diagnosis of cubital tunnel will mainly be based on the presenting symptoms and the completion of a complete physical examination which will include orthopaedic and neurological testing. There are a few special tests that if positive may indicate the presence of a cubital tunnel syndrome.

How is Cubital Tunnel Syndrome treated?

The management of this condition includes activity modification such as:

  • Limiting prolonged bending of the elbow during the day
  • Wearing elbow pads to reduce day time trauma from repetitive movements
  • Splinting the elbow while going to sleep

Other treatment modalities would involve:

  • Nerve mobilization
  • Rehab that is focused on strengthening the muscles around the elbow
  • Stretching exercises

If none of these work, the next step would be to consider a surgical approach to decompress the nerve.​

References

Nicholas, J.A. The Upper Extremity in Sports Medicine, CV Mosby, 1990 p.343.2. Wilgis EF, Murphy RD. The significance of longitudinal excursion in peripheral nerves. Hand clinics. 1986 Nov;2(4):761-6. https://europepmc.org/abstract/med/3025228

Sarwark JF. Essentials of musculoskeletal care. American Academy of Orthopedic Surgeons.
Rayegani SM, Raeissadat SA, Kargozar E, Rahimi-Dehgolan S, Loni E. Diagnostic value of ultrasonography versus electrodiagnosis in ulnar neuropathy. Medical Devices (Auckland, NZ). 2019;12:81. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390865/

Kooner S, Cinats D, Kwong C, Matthewson GD, Dhaliwal G. Conservative treatment of cubital tunnel syndrome: A systematic review. Orthopaedic Reviews. 2019 Jun 12;11(2). https://www.ncbi.nlm.nih.gov/pubmed/31281598

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