Cubital Tunnel Syndrome

Symptoms of cubital tunnel syndrome generally affect the arm, hand, and fingers. Symptoms range from mild to severe. In many cases, the symptoms come and go or worsen when you bend your elbow. Some of the common symptoms include:

• Numbness and tingling in the little finger and ring finger.
• The feeling of your fingers “falling asleep” when you bend your elbow.
• Difficulty manipulating objects with your fingers.
• Aching or shooting pain inside the elbow.
• Muscle weakness or wasting in the fingers and hands, usually in more severe cases.

Any sign of muscle weakness due to cubital tunnel syndrome should be addressed by a doctor ASAP. In many cases, the muscle wasting cannot be reversed.

Common Risk Factors for Cubital Tunnel Syndrome

While this condition can affect just about anyone, there some people who run a higher risk than others. Risk factors for this disorder include:

• Performing repetitive overhead or elbow-bending tasks
• Being >40 years old
• Those with jobs that involve prolonged elbow stretching, such as holding a telephone
• Long periods of resting elbows on hard surfaces
• Athletes who commonly use overhead throwing motions
• History of injury or trauma to the elbow or other related areas
• Obesity or an inactive lifestyle

What Happens During a Medical Exam for Cubital Tunnel Syndrome?

Severe or persistent (more than a few weeks) symptoms of cubital tunnel syndrome need a doctor’s attention. During the initial visit, your doctor will do a full review of your medical history. In addition, the doctor may ask about your work and leisure activities to assess hidden causes of your condition.

After reviewing your medical history, your doctor will perform a physical examination using some of the following tests:

• Elbow Flexion Test: While sitting with the elbow flexed, your doctor will examine your elbow for up to three minutes. During this time, your doctor may apply pressure to areas of the elbow to reproduce pain, numbness, and tingling throughout the arm and hand.
• Nerve Conduction: This test helps to determine how well the ulnar nerve functions and identify where it is compressed. A doctor stimulates different areas of the nerve and observes how long it takes to carry a response. This test also helps detect any muscle damage.
• Tinel Sign: The doctor taps the ulnar nerve in the areas where it passes through the elbow. A patient tests positive if he or she feels tingling or numbness in the ring and/or little finger.
• X-Rays: While a simple x-ray cannot detect cubital tunnel syndrome, it can rule out any problems the elbow such as arthritis or bone spurs.

Luckily, milder cases of cubital tunnel syndrome only require conservative treatments. When a doctor determines the cause, time and rest are the two of the most common treatments. For athletes and people with jobs that can irritate the ulnar nerve, this means taking a break or changing the way you do things.

Patient education plays another key role in treatment. When you understand the causes of your symptoms, you can make lifestyle changes to recover even faster. For example, if you spend long hours at a computer, you may wish to change your setup so you’re not placing added pressure on your elbows.

This may be all you need to resolve the issue. If symptoms persist, there are other treatments available. For example, an elbow brace can be used to immobilize the area. Some doctors may even suggest loosely wrapping a towel around the arm at night to prevent bending the elbow while you sleep.

Some patients may also benefit from physical therapy. A PT can teach exercises and techniques that help you increase flexibility and prevent stiffness. In addition, a PT can suggest ways to avoid putting added pressure on the ulnar nerve during your daily activities.

The most common medication for cubital tunnel syndrome, non-steroidal anti-inflammatory medications (NSAIDs), can aid in reducing any swelling around the nerve. Doctors usually prescribe these medications at the onset of symptoms.

Surgical Treatment Options for Cubital Tunnel Syndrome

Not everyone dealing with symptoms of cubital tunnel syndrome will need surgery. If pain lasts more than three months after other treatments, however, surgery may be an option. Muscle weakness and damage also indicates the need for surgery. Luckily, these minimally invasive procedures only require an outpatient visit or, at most, an overnight stay.

Ulnar Nerve Decompression

This procedure helps relieve pressure on the ulnar nerve. An orthopedic surgeon will cut a band of tissue or remove part of the bone near the nerve. The release of pressure frees up space for the ulnar nerve.

Medial Epicondylectomy

During this procedure, the orthopedic surgeon removes the medial epicondyle. By removing this bony mass on the inside of the elbow, it provides more space for the ulnar nerve. In addition, it allows the nerve to slide along the bone unobstructed. This eases compression and nerve irritation.

Ulnar Nerve Anterior Transposition

This procedure involves moving the ulnar nerve to a better position in the elbow. The surgeon moves the nerve away from the medial epicondyle and places it in a more spacious area of the elbow. After the surgery, the patient usually wears a plaster cast or splint for 2 to 4 weeks as the ulnar nerve gets used to its new position.

Recovery times for these procedures can vary according to a patient’s overall health, the type of surgery, and the severity of the condition. For the first two procedures, you would expect a full recovery within 6 weeks. The anterior transposition recovery usually takes longer and may require added PT sessions.

If severe symptoms of a pinched ulnar nerve impact the quality of your life, consulting with an orthopedic surgeon can help prevent irreversible nerve and muscle damage. Our knowledgeable doctors at NJ Spine & Orthopedic can pinpoint the source of your discomfort and find the best solution to help you get your life back on track. Their minimally invasive procedures promise smaller incisions and shorter recovery times. Don’t wait to schedule a consultation–Get the relief you need today!