Cubital Tunnel Syndrome is a nerve compression affecting the arm and hand. You may have heard of it by the more common name, 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.
In Cubital Tunnel Syndrome, over time, your ulnar nerve can be squashed, stretched or irritated at the level of your elbow joint as it passes through the cubital tunnel causing it to become swollen and inflammed.
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. This tunnel comprises of muscle, bone and ligament.The ulna nerve’s function is both motor and sensory so it provides feeling and function to the forearm, wrist and hand.
It provides sensation to the inside of your forearm and wrist and extends to the palmer surface of the hand through to the little finger, half of the ring finger, and to the tips front and back. It innervates the muscles involved in bending the wrist and fingers and adduction of the thumb.
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 this sensation. Irritation or pressure on the ulnar nerve in the tunnel can prevent the nerve from sending its normal signals.
There are many reasons why the ulnar nerve can be compressed or irritated at the cubital tunnel.
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.
Patients usually present with a specific set of symptoms which is slightly different based on the length of time and how far the condition has progressed. It can loosely be classified as mild, moderate and severe in the degree of symptoms.
The above symptoms can extend all the way down the forearm into the ring and little fingers. There may be reported snapping or popping at the elbow level, with bending/straightening of the elbow.
As the condition progresses then weakness may be observed – in grip strength, pinch strength, and of the little finger. In more severe cases, the little finger may stick out to the side due to weakness. There may be atrophy (wasting) of the muscles in the hand and in the first webspace in the thumb. The little finger and ring finger may be resting in a claw position due to weakness.
Cubital tunnel syndrome can be diagnosed by physical examination and performing manual
tests in the clinic and completing questionnaires with your therapist. Your doctor may request certain tests such as nerve conduction studies or electromyograms (EMG) to find out more about how the nerve is sending signals.
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 Melbourne Hand Therapist today!
Nerve conduction studies measure the time it takes for the electrical signal of the nerve to go from one point of the ulna nerve to another. Several points on the nerve are tested and an increase in time can identify where the nerve may be compressed.
An EMG tests the muscles response and is often done in conjunction with nerve conduction studies. Electrodes are placed on the muscles corresponding to the ulna nerve which measures the electrical activity of the muscle as it contracts. With these studies they can also determine if there is associated muscle damage indicating the level of severity that the nerve is compromised.
Depending on the severity and the time frame of progression of the condition treatment might vary. With a mild condition, therapy would be the first line of treatment. Many patients have complete relief from seeing a hand therapist for conservative treatments which may include:
If the condition doesn’t improve or the severity increases to obvious muscle wasting, then surgical intervention may be indicated.
There are different types of surgeries for this condition. The Surgeon will decide which surgery will be appropriate based on the cause and severity. The surgery options include:
Other risk factors include:
Prior fracture or dislocation of the elbow
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