Cubital Tunnel Syndrome

What is it?

The symptoms of cubital tunnel syndrome are caused by compression or irritation of the ulnar nerve at the elbow. The ulnar nerve travels around the inside of the elbow (side closest to your body). The ulnar nerve gives sensation to the little finger, a portion of the ring finger, and the back of the hand on the side towards the little finger. When you "hit your funny bone", you have actually bumped your ulnar nerve. This is one of a group of syndromes called compressive neuropathies. The most common is carpal tunnel syndrome.

The problem can occur without an obvious cause or it can begin after an injury to the nerve. Keeping the elbow bent for a prolonged time (like when talking on the phone) or placing pressure on the nerve can cause the problem.

What are the symptoms?

The most common symptom of Cubital tunnel syndrome is tingling or numbness in the ring and little finger. Some people also have pain on the inside of the elbow or in the forearm. The ulnar nerve controls most of the small muscles in the hand. Because of this, a common symptom is a sense of weakness or slight decrease coordination. In more advanced cases, the muscles in the hand may become visibly smaller (atrophy).

How is it evaluated?

Cubital tunnel syndrome is typically diagnosed by the patient's history and an examination. The nerve at the elbow may be tender or irritated. An assessment of sensation in the hand and fingers can show numbness in the distribution of the ulnar nerve. Muscles controlled by the ulnar nerve may be weak.

There is a test to evaluate the function of the nerve. Your doctor may order it in some cases. Numbness and weakness can also be caused by nerve compression in the neck (sometimes described as having a "pinched nerve"). Therefore your doctor may ask about neck symptoms or order tests to evaluate this.

How is it treated?

The treatment of Cubital tunnel syndrome begins with education. Simply knowing what daily activities contribute to the problem is important in treatment and prevention. At night it is important to avoid having your elbow continuously bent. A soft pad worn on the elbow at night can help keep your arm in an ideal position.

If these treatments are not successful surgery is also an option. The surgery is designed to decrease compression on the nerve as it passes around the inside of the elbow. Your doctor can review the specifics of the procedure in detail with you. The operation is performed as an outpatient procedure. General anesthesia is usually required. Maximum recovery takes several months. Improvement of symptoms is typical, though, not everyone will recover full function of the nerve.