Cubital Tunnel Syndrome
Cubital tunnel syndrome is the second most common nerve compression syndrome after carpal tunnel syndrome. It is a condition that occurs as a result of pressure on the ulnar nerve at the elbow. The ulnar nerve is one of three major nerves to the hand and forearm. When it is compressed, a variety of problems can occur. These include weakness or clumsiness of the hand, and numbness and tingling of the ring and small fingers. It occasionally causes pain in the elbow or hand.
Compression of the ulnar nerve occurs as it travels from the upper arm and crosses the elbow. The nerve curves around the side of the humerus closest to your chest (the medial epicondyle). This area is referred to as the “funny bone” because when this area of the elbow is bumped, the nerve is irritated and gives a brief tingle or electric shock. Bending the elbow can stretch the nerve and cause symptoms of nerve compression as well. Nighttime symptoms are common because many people sleep with their elbows bent.
Diagnosis and Treatment
Studies may be ordered to confirm the diagnosis of cubital tunnel syndrome. An Electromyelogram (“EMG”) with Nerve Conduction Velocities can be useful in diagnosing the condition.
Initial treatment of cubital tunnel syndrome includes over-the-counter medications such as nonsteroidal anti-inflammatory drugs. Elbow splints can be used at night to prevent bending the elbow during sleep.
Left untreated, cubital tunnel syndrome can result in loss of sensation of the small and ring fingers, as well as in muscle wasting of the small muscles in the hand which are important for gripping objects and in fine motor control of the fingers. Eventually, there can be permanent nerve damage.
Surgery is necessary when splinting and over-the-counter medications are not effective, or if during a physical exam the physician sees signs of nerve damage. The goal of surgery is to relieve the compression and to prevent the nerve from further injury. Several procedures are available, and the approach your surgeon chooses depends on their training and experience with the procedures. A fellowship trained Hand Surgeon will be able to tailor the operation to your specific needs.
Recovery after surgery depends on the extent of nerve damage present and the surgical procedure performed. Most patients are able to return to most of their usual activities by 2-4 weeks after surgery. About 80% of patients will see significant improvement in their symptoms after surgery.