Cubital Tunnel Syndrome
Many people have probably never heard of cubital tunnel syndrome, but if they had it, they would most certainly know. Cubital tunnel syndrome causes almost “electric” pain that feels a lot like the pain when you hit the “funny bone” in your elbow. The “funny bone” in the elbow is actually the ulnar nerve, a nerve that crosses the elbow. Cubital tunnel syndrome happens when that nerve is irritated or compressed. To determine this often very painful syndrome, the place to go would be the Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado. That way you can trust from the start that you will be getting the best help.
Cubital tunnel syndrome happens when the ulnar nerve, which passes through the cubital tunnel (a tunnel of muscle, ligament, and bone) on the inside of the elbow, is injured and becomes inflamed, swollen, and irritated. Cubital tunnel syndrome is often progressive. Patients often present with mild intermittent symptoms of pins and needles in the little and ring finger and shooting pain from the elbow down toward the fingertips. As the condition progresses, nerve fibers are damaged, and symptoms can become constant.
WHAT IS CUBITAL TUNNEL SYNDROME?
The ulnar nerve is one of the three large nerves that cross the elbow (the others are the median and radial nerves). The ulnar nerve travels down the back of the elbow behind the bony bump called the medial epicondyle and through a passageway called the cubital tunnel. The cubital tunnel is a narrow passageway on the inside of the elbow formed by bone, muscle, and ligaments with the ulnar nerve passing through its center. The roof of the cubital tunnel is covered with a soft tissue called fascia. When the elbow is bent, the ulnar nerve can stretch and catch on the bony bump. The ulnar nerve provides sensation to the little finger and half of the ring finger. It supplies several muscles in the forearm, but most importantly it controls many of the small muscles in the hand responsible for coordinating finger motion and pinch. When the ulnar nerve is compressed or entrapped, the nerve can tear and become inflamed leading to a variety of symptoms called cubital tunnel syndrome.
It is not always easy to narrow down the exact cause of cubital tunnel syndrome. Possible causes include:
- Arthritis in the elbow and/or neck
- Bone spurs
- Decreased space in the cubital tunnel (can occur for several different reasons)
- Cysts near the elbow joint
- Pressure, sometimes as seemingly simple as leaning on an armrest
- Sports or occupations that require repetitive elbow motions
The following are the most common symptoms of cubital tunnel syndrome. However, each person may experience symptoms differently. Symptoms may include:
- Numbness and tingling in the hand and/or ring and little finger, especially when the elbow is bent
- Hand pain
- Aching pain to the inside of the elbow that can happen even from driving, sleeping, or holding a phone
- Weak grip and clumsiness due to muscle weakness in the affected arm and hand
- Diminished sensation and fine motor control in the hand causing the person to drop objects or have difficulty handling small objects.
- Sensation of popping or snapping on the inside part of the elbow
The most effective treatment for cubital tunnel syndrome is stopping the activity that is causing the problem. The first line of treatment may include:
- Resting and stopping any activity that aggravates the condition, such as bending the elbow
- A splint or foam elbow brace worn at night (to limit movement and reduce irritation)
- Using an elbow pad (to protect against chronic irritation from hard surfaces)
- Anti-inflammatory medicines (such as ibuprofen or naproxen)
- Nerve gliding exercises
- Hand therapy
WHEN IS SURGERY INDICATED?
If symptoms are persistent or severe, surgery may be considered. This surgery typically consists of releasing the tight cubital tunnel that is compressing the nerve, and this is referred to as “nerve decompression.” In some cases where the nerve is unstable or does not tend to stay in its normal location, the nerve is moved out of the tunnel altogether and secured in a safer location. This is referred to as a “nerve transposition.
GETTING THE RIGHT DIAGNOSIS
The symptoms of cubital tunnel syndrome may resemble other medical conditions or problems, including medial epicondylitis (golfer’s elbow). These conditions can often be excluded by physical exams. However, it may be necessary to obtain special x-rays, electromyogram (EMG) vascular tests, or nerve conduction tests to help with the diagnosis. Blood tests might be ordered to test for diabetes or thyroid disease. Untreated, you might experience muscle atrophy. Your hand could appear bony and not function at all. You don’t just have to put up with the symptoms of cubital tunnel syndrome. Treatment with the skilled and experienced orthopedic specialists at CCOE in Colorado Springs, Colorado, can improve not just your pain but your quality of life. Isn’t that what you want? Contact CCOE to schedule an appointment with an elbow specialist today.