Cubital tunnel syndrome is a condition where the ulnar nerve becomes trapped or pinched. This nerve is one of the three main nerves in the body and travels from the neck down into the hand and can be compressed at several points along the way. This compression can cause numbness or pain in the elbow, wrist, hand, or fingers. When the nerve is pinched at the elbow, doctors call it cubital tunnel syndrome. The ulnar nerve travels through a structure called the cubital tunnel in the elbow, at a bump of bone at the inside of the elbow called the medial epicondyle. The area is sometimes called the funny bone, which is not really a bone, but a nerve which causes a shock-like sensation when bumped.
Cubital Tunnel Syndrome Causes
Doctors are still researching the exact reason why the nerve can become pinched but some of the factors that are likely to help cause the compression are:
- Previous fracture of the elbow
- Bone spurs
- Swelling of the elbow joint
- A direct blow to the inside of the elbow
- Prolonged pressure on the arm
- Leaning on the arm for too long
- Repetitive activity that requires the arm to be bent
Cubital Tunnel Syndrome Symptoms
Symptoms of cubital tunnel syndrome can vary on where they occur, but most people complain of pain in the hand. Other indicators are:
- The feeling that the ring and little finger have fallen asleep, especially when the elbow is bent.
- Difficulty moving the fingers or to manipulate objects.
- Numbness and tingling in the fingers that come and go.
- Weakened grip and difficulty with finger coordination.
During a physical examination, your orthopedist will perform a Tinel’s test, which involves tapping on the cubital tunnel area, which is at the inside of the elbow joint. A positive test will cause shock-like sensations in the pinky and ring fingers of the hand. Other tests may include x-rays of the hand and elbow to assess the bones and joint, or electrodiagnostic testing to localize the problem and assess the severity of the condition. However, a test which has normal results does not rule out cubital tunnel syndrome.
Cubital Tunnel Syndrome TreatmentNon-surgical treatments are normally the first thing that doctors try, but if they do not work, surgery may be recommended. Treatment options may include:
- medicine to reduce swelling around the ulnar nerve.
- Cortisone injections are occasionally administered, but can cause damage to the nerve.
- Brace or splint to be worn at night to keep the arm straightened.
- Physical therapy to improve symptoms.
The three most common types of surgery are: Cubital tunnel release, ulnar nerve anterior transposition, and medial epicondylectomy.
Cubital tunnel release
An incision will be made along the inside part of the elbow and the top of the ligament will be cut and divided. As the ligament heals more space will be created so that the ulnar nerve can move without being pinched. This procedure works best if there is only a mild compression and the nerve does not move from side to side when the elbow is bent.
Ulnar nerve anterior transposition
To stop the nerve from becoming trapped doctors will make an incision along the side of the elbow. Then surgeons will move the nerve so that it lies under the skin and fat, but above the muscle, within the muscle, or under the muscle. By moving the nerve it prevents it from being caught on the boney ridge and stretching when the elbow is bent.
This method takes pressure off the nerve by simply removing the tendon that is causing the nerve to be pinched. The surgery also prevents the nerve from getting trapped on the ridges of the bone and stretched when the elbow is bent.
Once the damage has been repaired, doctors will stitch the incisions closed and bandage the area. Even though arthroscopy is a minimally invasive surgery, it is important to understand all of the risks and to follow the doctor’s instructions.
If compression occurs for long periods of time, it can lead to muscle atrophy and cannot be reversed.
Like with any surgery, there are risks involved that patients need to be aware:
- Persistent weakness
- Damage to the ulnar nerve
- Blood vessel damage
- Loss of strength
Are you tired of pinched or tight nerves? There's finally a simple solution that can successfully rid you of your cubital tunnel. To learn more about the causes, symptoms, and treatment for cubital tunnel syndrome, please contact West Medical at (855) 690-0565, and our helpful medical staff will answer any questions you may have.
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