Cubital Tunnel Syndrome

Cubital tunnel syndrome is a set of symptoms that may occur when the ulnar nerve in the elbow gets pinched. The so called “funny bone” is actually your ulnar nerve and not a bone at all. The exact cause of compression of the ulnar nerve behind the elbow is unknown, although various activities and employment may be a substantial contributing factor to the development of this condition. Holding the elbow in a bent position repeatedly for long periods of time may be a factor, in addition to leaning on the elbows, sleeping with the arms bent, or a direct injury to the area.

Symptoms can be minor at first, but they may worsen over time and include numbness and tingling in the ring and little fingers, loss of finger or hand strength, inability to straighten the fingers, and sharp sudden pain when the elbow is touched. The diagnosis can be made by history and physical examination, and is confirmed by an electrodiagnostic study, for which you may need to be referred to a neurologist. An x-ray of the area may also be necessary. Rest, medication, and changes in how you perform your daily activities may help ease the pain. Treatment includes a protective elbow pad, eliminate leaning on your elbows, rest, anti-inflammatory medications, switching to a headset-style phone, sleeping with your arms straight, and wearing a special elbow splint at night.

The cubital tunnel is a groove in the bone behind your elbow. This narrow groove provides a passage for the ulnar nerve, which is one of the main nerves in your hand. If this area gets bumped, one experience is the “funny bone” sensation. The cubital tunnel helps protect this nerve as it passes through your elbow and down to your fingers. Bending your elbow compresses the ulnar nerve inside the cubital tunnel. The nerve can become inflamed (irritated) after constant bending and pinching or after getting hurt. Over time, this can lead to pain or numbness. The pain is often felt in your ring and little fingers.

When symptoms persist despite nonsurgical treatments, surgery is indicated. There are several different techniques performed for this problem, all of which involve releasing or repositioning the nerve out of its tight tunnel. We usually also remove the bony knob or prominence, known as the medial epicondyle, as part of the surgery. The surgery is performed under general anesthesia, in an operating room, as an outpatient. Scarring, infection, stiffness, and pain are possible complications. As with most hand and upper extremity surgical procedures, post-operative occupational therapy supervised by a certified hand therapist is mandatory. This is why we offer the services of a hand therapist directly on site, as well as at several other locations.