Cubital Tunnel Syndrome: What is it?
Cubital Tunnel Syndrome happens when the ulnar nerve, which runs along the inside of your elbow, becomes compressed or irritated. The ulnar nerve controls feeling in your ring and pinky fingers and gives strength to some of the hand’s small muscles. When there is not enough room for the nerve, it causes symptoms like numbness and tingling in your hand.
Symptoms: What Does Cubital Tunnel Syndrome Feel Like?
The symptoms of Cubital Tunnel Syndrome often include:
- Numbness and tingling in the ring and pinky fingers.
- “Pins-and-needles” sensation, especially along the inner hand or forearm.
- Sudden pain or an electric shock feeling down to the fingers when you bump your elbow.
- Weakness or dropping objects.
- Difficulty with fine motor skills, like buttoning a shirt or gripping objects.
- In severe cases, muscle wasting in the hand, particularly between the thumb and index finger.
Causes
There is not always one clear cause of Cubital Tunnel Syndrome. It is usually a mix of factors that put pressure on the ulnar nerve:
- Anatomy: Some people may have an extra muscle or bone around the elbow that squeezes the nerve. Previous injuries like a broken elbow or arthritis can also shrink the space around the nerve.
- Activity: Repetitive motions like bending your elbow or resting it on hard surfaces (like armrests) can irritate the nerve.
Evaluation: How Is It Diagnosed?
Orthopedic specialists will examine your symptoms and perform physical tests, such as gently tapping on the ulnar nerve at the elbow. Tests to confirm the diagnosis may include:
- X-ray: To check for any bone issues like arthritis.
- Nerve tests (EMG or Nerve Conduction Studies): These measure how well the ulnar nerve is working and whether it is compressed.
- MRI: In some cases, an MRI can show if something is pushing on the nerve.
Treatment Options
Non-Surgical Treatments
Most cases of Cubital Tunnel Syndrome can be treated without surgery. Orthopedic experts at Orthopedic Institute recommend:
- Activity Changes: Avoid positions that over-bend your elbow or put pressure on it, like talking on the phone or sleeping with your elbows bent.
- Night Splints: Wearing a splint or elbow pad at night keeps your arm in a straight position, reducing symptoms.
- Therapy: Nerve gliding exercises or physical therapy can help reduce pain.
- Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may ease discomfort but will not cure the problem.
Surgical Treatment
If symptoms worsen or do not improve with non-surgical methods, surgery may be necessary. Orthopedic surgeons specialize in procedures like:
- In Situ Decompression: The tight tissue pressing on the nerve is cut to release it.
- Ulnar Nerve Transposition: The nerve is moved to a new position in front of the elbow, either beneath the skin or muscles.
- Medial Epicondylectomy: A small part of the bone near the nerve is removed to create more space.
Your surgeon at Orthopedic Institute will discuss the best option based on your specific situation.
Recovery: What to Expect After Surgery
Cubital Tunnel surgery is typically an outpatient procedure, meaning you can go home the same day. Right after surgery, light use of the hand is usually okay. Your doctor may recommend using a splint or sling to rest the arm. Therapy may begin within a few weeks to restore range of motion and strength.
Numbness in your fingers might take a while to recover. If you had muscle loss before surgery, some of it might not fully return, but it won’t get worse. Rarely, the condition may recur after surgery.