Cubital Tunnel Syndrome

Understanding the Symptoms, Causes and Treatments

Understanding Cubital Tunnel Syndrome

The elbow is a hinge joint that connects the upper arm and lower arm. It consists of three bones; the humerus, radius, and ulna. Each bone is capped with cartilage and a complex array of ligaments and tendons from various muscles that cross over the joint. On the inside of the elbow is the ulnar nerve. It runs through a structure called the cubital tunnel and it is a common site where the nerve can be irritated. This is also what gets injured when you hit your funny bone!

Causes of Cubital Tunnel Syndrome

Cubital tunnel can occur for a variety of reasons:

Decreased space in the cubital tunnel, impinging on the nerve (for many reasons)
Elbow dislocation, fracture, or other injury
Significant elbow arthritis
Certain systemic diseases affecting nerves

Symptoms of Cubital Tunnel Syndrome

Pain and tenderness over the inside of the elbow.
Numbness and tingling in the ring and pinky finger
Weakness with your grip
A sensation of popping or snapping on the inside of the elbow when you bend your arm
Atrophy in certain hand muscles

Diagnosing Cubital Tunnel Syndrome

A comprehensive history and physical examination is the most important piece to determine if the ulnar nerve is involved in your elbow pain. Electrodiagnostic studies (EMG/NCS) look at the health and quality of your nerves. It can determine how severely the nerve may be damaged and at what location you nerve symptoms originate. Ultrasound is used to visualize the nerve and determine if there is any injury or swelling within the nerve.

Treatment Options

Bracing may be needed to help off-load the nerve and prevent the elbow from bending to reduce nerve compression and facilitate healing
Physical therapy – To help reduce stress on the nerve. Nerve glides are exercises your therapist can teach you to try and reduce nerve irritation.
Medications– Usually NSAIDs or neuropathic pain medicines are used to help with pain and nerve irritability.
Steroid injections- Strong anti-inflammatory medications to reduce pain and inflammation. Typically done with ultrasound to guide the injection around the nerve.
Surgery– In rare circumstances, you doctor may refer you to a specialist to decompress the nerve if symptoms are very severe or non-responsive to conservative treatment.