Conditions Treated

Cubital tunnel syndrome

Cubital Tunnel Syndrome is an arm and hand condition that affects many people. You may have heard of the more common Carpal Tunnel Syndrome. The two conditions are quite similar in how they are present but it is important to differentiate between them in order to treat them effectively.

Definition

In Cubital Tunnel Syndrome your ulnar nerve is squashed at the level of your elbow joint as it passes through the cubital tunnel. The cubital tunnel is more commonly known as the funny bone, which sits just behind the bony bump (medial epicondyle) on the inside of your elbow. If you can think of the last time you hit your funny bone, you might remember that you felt electric shocks or tingling in the ring and little fingers. This is because the ulnar nerve is responsible for the feeling in the half of the ring finger facing the little finger and the whole palm side of the little finger. Pressure on the ulnar nerve in the tunnel can prevent the nerve from sending its normal signals.

Causes

There are many reasons that you might get ulnar nerve entrapment at the cubital tunnel. 

It can occur when there is swelling in the elbow as someone recovers from surgery or an injury. Sometimes the swelling can occur after a big day in the garden or at the gym, or after a period of increased activity or work factors. In other cases, someone might be predisposed to cubital tunnel syndrome because of a small, tight tunnel or large triceps muscles. Otherwise, a healed elbow fracture could leave bone spurs or make the space smaller and increase pressure on the nerve.

Other risk factors include diabetes, some types of arthritis and being overweight.

Whatever the cause, the compression of the nerve means that it is no longer able to send its signals normally.

Signs & Symptoms

Even though the compression of the nerve is happening at the elbow, people usually feel numbness and tingling or pins and needles in the little and ring fingers. This more often happens at night because we often sleep with our elbows flexed. The cubital tunnel is smaller when the elbow is bent and this can compress the nerve. Other activities that are performed with the elbow flexed can also bring on the symptoms of cubital tunnel syndrome. These may include talking on the phone, reading a book or tablet or lying on your stomach propped up on your elbows. The ulnar nerve may also be pressured when the elbow pad is rested against the arm of a chair or your car windowsill. There may also be a pain in the elbow, or down the inside of the forearm.

Cubital tunnel syndrome can be diagnosed by physical examination and performing manual tests in the clinic and completing questionnaires with your doctor or therapist. Your doctor may request nerve conduction studies to find out more about how the nerve is sending signals.

Treatment

Therapy is the first line of treatment. Lots of people have complete relief from seeing a hand therapist for conservative treatments, such as learning how to avoid aggravating activities or positions, such as keeping the elbow flexed for prolonged periods or resting the back of the elbow against surfaces. We can also recommend wearing elbow splints or braces at night to hold the elbow in a more neutral position and therefore, keep the cubital tunnel open. This decreases pressure on the nerve. We may also teach nerve gliding exercises to improve nerve health and recommend strategies to reduce swelling in the soft tissues around the elbow.

If this is unsuccessful after a number of weeks, a surgical review may be indicated.

Different medical procedures can include cortico-steroid injections or cubital tunnel decompression surgery. This is a surgical procedure in which the ligament that makes up the roof of the cubital tunnel is cut open to allow more space for the ulnar nerve and tendons.

Prevention Of Cubital Tunnel Syndrome

  • Keeping fit and healthy by following the Australian government recommendations for physical activity and exercise has been shown to reduce the likelihood of developing cubital tunnel syndrome, as well much other health benefits
    • 2.5-5 hours of moderate activity per week OR
    • 1.25-2.5 hours of vigorous activity per week AND
    • Muscle-strengthening activity at least 2 days per week (this could include activities like gardening or carrying shopping)
  • Quitting smoking or avoiding smoking is really good for the health of your nerves
  • Modify activities that require maintaining prolonged postures, take regular movement breaks during your day.
  • If you have a health condition in your medical history that is a risk factor for cubital tunnel syndrome, try to ensure the condition is well managed with your general practitioner

Melbourne Hand Therapy Can Help You

Like many conditions, cubital tunnel syndrome is more responsive to treatment if diagnosed and treated early. The hand therapists at Melbourne Hand Therapy are experts in diagnosing and treating cubital tunnel syndrome. They will be able to assess you and provide advice regarding the best treatment options. Our therapists have strong professional relationships with excellent surgeons who can be consulted if medical intervention is required.  The sooner cubital tunnel syndrome is diagnosed, the more effective treatments can be, so book an appointment to see a Melbourne Hand Therapist today!

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