Cubital Tunnel syndrome
Cubital tunnel syndrome is a common condition where one of the major nerves to the forearm and hand (the “ulnar nerve”) gets compressed as it passes along the inner side of the elbow. Irritation of the “funny bone” nerve can cause numbness or tingling into the ring and small finger. This oftentimes happens at night when sleeping, and can severely disrupt the quality of their sleep. It can also result in the hand feeling week and clumsy.
Pressure on the nerve
Arm rests on chairs
Console of car when driving
Keeping the elbow flexed for extended periods of time such as when
Talking on the phone
Extra muscle present
Mobile nerve that snaps over the elbow bone when flexing the elbow
Cubital tunnel syndrome can oftentimes be diagnosed by talking with your doctor and having them examine your hand and arm. Occasionally a nerve test (EMG or nerve conduction study) can be used to assess the function of the nerve and determine if its being compressed.
Minimize irritation of the ulnar nerve
Avoid pressure on the "funny bone" -(e.g. arm rests of chairs, leaning on console of car)
Limit prolonged periods of elbow flexion
Wear a splint at night to keep the elbow straight
Ulnar nerve gliding exercises (see below)
Occasionally, surgery may be needed to either release the nerve. Typically an incision is made along the inside of the elbow. The "roof" of the tunnel is released, which eliminates compression of the nerve.
More rarely, if symptoms are associated with the ulnar nerve snapping or moving along the inside of the arm when then elbow is bent, the nerve may be surgically moved to the front of the elbow.
Absorbable sutures are placed underneath the skin, and Dermabond (medical grade "Super Glue") is used to seal the incision. A bandage is placed which remains in place for 3 days.
The hand can be used for normal light activities immediately, and you can get the incision wet once the bandage is removed. More demanding activities (e.g. lifting weights, gardening, manual labor) should be avoided until the skin heals (~10 days).
Improvements in numbness and tingling can be immediate or very gradual. Optimal nerve recovery may take several months after surgery, and if symptoms are severe, they not completely go away.
Dr. Schreiber is a board certified orthopedic surgeon specializing in hand, wrist, and elbow conditions. Dr. Schreiber practices at the Raleigh Orthopaedic Clinic in Raleigh, North Carolina.