Cubital Tunnel Syndrome
The ulnar nerve is one of the main nerves that travels down the arm and into the hand. It is the nerve that is affected when you “hit your funny bone”. It can become trapped or irritated at different locations but is most commonly compressed or irritated at the elbow.
Anatomy: The ulnar nerve runs near the medial epicondyle on the inside of your elbow. It travels through what is known as the cubital tunnel. As it makes its way into the forearm and into the wrist it travels through guyon’s canal. The ulnar nerve controls muscles that control grip strength and some of the fine motor movements in your hand. It supplies sensation to the little finger and the ulnar half of the ring finger.
Risk factors for cubital tunnel syndrome include previous trauma to the elbow, arthritis of the elbow, cysts or other swelling around the elbow, repetitive activities that involve flexion of the wrist and severe medial epicondylitis.
Symptoms & Diagnosis
Symptoms include numbness and tingling of the ring and little finger when the arm is bent or with certain sleeping positions. Other symptoms include weakness and difficulty performing fine motor tasks. Muscle atrophy is indicative of long standing compression and needs to be evaluated as soon as possible.
Diagnosis is made by history, physical examination and EMG/Nerve conduction studies. X-rays are used to evaluate for any bony abnormalities.
Non-surgical treatment consists of NSAIDS, splinting, physical therapy and activity modifications.
If non-operative treatment fails, if the nerve compression is severe, or if muscle wasting has occurred surgery is recommended to relieve the pressure on the nerve. The nerve is often transposed to a different location to prevent it from getting caught on the bone and further aggravating the nerve. The elbow is immobilized for a period of time after surgery to allow the soft tissues to heal. Physical therapy is used to help regain strength and range of motion. Recovery time to normal activity is generally 3-4 months.