Cubital Tunnel Syndrome

What is cubital tunnel syndrome?

Like ulnar tunnel syndrome, cubital tunnel syndrome involves the ulnar nerve, located just below the skin's surface, which makes it an easy candidate for being compressed. The ulnar nerve runs from your shoulder to your pinky finger, and it's not protected by muscle or bone, making it all the more vulnerable to compression. The difference between ulnar tunnel syndrome and cubital tunnel syndrome has to do with the location of the nerve.

With ulnar tunnel syndrome, the ulnar nerve becomes entrapped at the wrist, whereas cubital tunnel syndrome involves entrapment of the ulnar nerve at the elbow. The latter is much more common. The nerve becomes entrapped just under a bone called the medial epicondyle, also known as your elbow's funny bone.

When the ulnar nerve is compressed, one typically feels tingling or numbness in the hands, which is why some people get it mixed up with carpal tunnel syndrome, as the symptoms overlap.

Are you at risk for developing cubital tunnel syndrome?

Many of us are at risk for cubital tunnel syndrome, especially if we work at a desk on a computer day in and day out that's not set up in an ergonomically correct fashion. If you suffer from certain conditions or are in the throes of any of the following diseases or states of being, you're more prone to developing cubital tunnel syndrome:

• You're pregnant
• You have diabetes
• You have an autoimmune condition
• Obesity is a problem for you
• You suffer from a thyroid condition
• You've been diagnosed with high blood pressure

What are the known causes of cubital tunnel syndrome

Cubital tunnel syndrome happens due to overuse and repetitive activity involving the elbow area. Any activity that keeps the elbow in a bent position for extended periods of time puts you at risk for this condition. Driving with a bent elbow, holding your phone up to your ear for extended time periods, holding a tool with a bent elbow, and even simply resting your elbow on your desk-all these activities put you at risk.

What are the typical signs and symptoms of cubital tunnel syndrome?

Your symptoms will likely be spotty throughout the day-sometimes you'll feel them, other times you won't, and they'll probably be more annoying at night. The symptoms vary, but most of the following are common:

• It will become more and more difficult to grip things
• You might feel a pins and needles sensation in your arm or hand
• You experience tingling or numbness in the hand
• You lose all sense of feeling in your pinky and/or ring fingers
• You feel pain in the arm and/or fingers
• It's becoming difficult to even move your fingers

In more advanced cases, which can definitely happen, but can also be healed and reversed, you experience:

• Claw-like deformities of your hand, in which your pinky and ring finger begin to curl into each other.
• You experience muscle wasting in your hand or forearm. This is simply an atrophying of the muscle due to this neurogenic condition.

Exercises for cubital tunnel syndrome

Thankfully, there are loads of exercises you can do on your own to help alleviate symptoms and also prevent further damage. Nerve gliding exercises actually work to stretch the ulnar nerve, so that it's not compressed, and should provide relief in more mild cases. Practice these two nerve gliding exercises daily to prevent further damage:

• Simply stretch your right arm out to the side with your palm facing up. Curl your fingers inward into a fist and then bend at the elbow, bringing your fist to your shoulder. Return to the start position and repeat several times. Then switch arms and do the same movement on the opposite side.
• This time, outstretch your arm like before but with the palm facing down. Flex your hand up so that your fingers point to the ceiling. Bend at the elbow, bringing the hand to your shoulder. Repeat several times, then switch to the opposite side and repeat.

What are non-invasive forms of treatment for cubital tunnel syndrome?

If you're not a candidate for surgery, the following non-surgical treatments are known to be effective:

• NSAIDS can alleviate pain in mild cases
• By simply paying attention to how you place your arm you can prevent symptoms. For example, refrain from having the elbow bent for extended periods. Don't rest it on a counter, and don't hold a phone up to your ear. (Opt for earplugs.)
• You may need to try sleeping with your arm extended, as opposed to bending it while you sleep at night. Wrapping a soft towel around the elbow to keep the arm straight at night is helpful. You'll want to sleep this way for at least a few months if you've been suffering symptoms.

Surgery for cubital tunnel syndrome

If you've tried stretching the nerve, and taking the necessary steps listed above and still haven't solved the issue, Dr. Eubanks will recommend surgery. The two primary forms of surgery are done as an outpatient surgery utilizing general anesthesia. They are:

• Decompression surgery - This form of surgery enlarges the area for the ulnar nerve to pass.
• Anterior transposition - This type of surgery involves relocating the ulnar nerve so that it's nearer to your skin. Dr. Eubanks may need to remove the elbow's funny bone to allow for the ulnar nerve to pass freely.

Post-surgery recovery can last months. A splint can be helpful to wear for the first few days to maintain immobility. Soon after, seeing a physical therapist to restore movement and mobility during the recovery period can be highly beneficial. The good news is that the outlook for full recovery post-surgery is good. If you suspect cubital tunnel syndrome might be an issue for you, feel free to contact Dr. Eubanks for an exam and consultation at, 480-969-4138.