Cubital Tunnel Syndrome: Causes | Symptoms | Treatment with Elbow Splint | Surgery

WHAT IS CUBITAL TUNNEL SYNDROME?

Cubital tunnel is an area located on inside of our elbow through which the ulnar nerve enters the forearm. In simple words, cubital tunnel syndrome is a condition that occurs when there is pressure on the ulnar nerve at the elbow, either in the region above or below the elbow or in the cubital tunnel itself. If there is intense pressure on the ulnar nerve, pain may start to occur at the elbow which sometimes starts to radiate down the inside of the forearm to little and ring fingers. Cubital tunnel pain is accompanied with numbness and tingling in the fingers. There may also be a feeling of weakness of the hand or loss of dexterity of the hand.

CAUSES OF CUBITAL TUNNEL SYNDROME

Any cause that results in sustained pressure on ulnar nerve at the elbow region may trigger cubital tunnel syndrome. In some cases, fibrous band within the muscle below or above the elbow can compress the ulnar nerve triggering CTS. Certain repetitive activities which involve prolonged elbow flexion can also apply pressure on ulnar nerve, such as relying on the inside of the elbow for prolonged periods. Also, swelling or inflammation around the elbow joint of any origin can cause ulnar nerve compression as a secondary problem.

SIGNS AND SYMPTOMS OF CUBITAL TUNNEL SYNDROME

Cubital tunnel syndrome signs and symptoms usually include pain in the inner elbow accompanied by numbness and tingling in the little and ring fingers plus weakness or clumsiness of the hand. All these sensations together or separately may occur with activity or at rest. Some positions of elbow flexion may tend to worsen symptoms. In chronic cubital tunnel syndrome, small hand muscles can become atrophied and lose power.

DIAGNOSIS OF CUBITAL TUNNEL SYNDROME

Orthopedic doctors diagnose cubital tunnel syndrome after a detailed history of pattern of pain and activities which produce the problem. The physical examination includes assessing the sensitivity of the ulnar nerve and checking the muscle strength of the hand. If your orthopedic specialist finds a problem in the elbow joint or if there has been an injury to the elbow joint, he/she may request an x-ray for further evaluation of the joint. Orthopedic doctors may also send the patient to neuroradiology for performing EMG/nerve conduction studies to confirm the diagnosis of cubital tunnel syndrome and also to rule out nerve compression if any in other parts of the joint.

TREATMENT OF CUBITAL TUNNEL SYNDROME

In some acute cases of cubital tunnel syndrome, symptoms get relieved without surgery with the use of conservative measures like prescription of effective anti-inflammatory drugs to reduce inflammation and pain meds to reduce pain. In cubital tunnel syndrome, it becomes very important to avoid activities and positions of the limb triggering the symptoms. The cubital tunnel elbow pads are useful to prevent hyperflexion of the elbow and also to relieve pressure on the nerve. Occasionally, a cubital tunnel elbow splint may be used to prevent sagging. If the symptoms get more severe and do not get any better with conservative measures, surgery may be needed to treat ulnar nerve compression at the elbow. Cubital tunnel surgery frees or decompresses the nerve from above the elbow to the forearm and moves the nerve from behind the elbow to the front. The nerve can be transposed in the muscles above or below the elbow. Sometimes, an orthopedic surgeon can remove a flick of bone on the inside of the elbow to help decompress the ulnar nerve. After the patient undergoes surgery on the ulnar nerve, the ortho doctor prescribes a cubital tunnel splint or cast for several weeks after surgery. After that, doctor recommends to undergo some physical therapy or to have a period of rehabilitation to regain mobility of the elbow and arm. Full recovery from cubital tunnel surgery can take a few months.