What is the ulnar nerve?
The ulnar nerve is one of the three main nerves in the arm, travelling from under the collarbone and along the inside of the upper arm. It passes through a tunnel of tissue (the cubital tunnel) behind the inside of the elbow. Here you can feel the nerve through the skin. It is commonly called the “funny bone.”

Beyond the elbow, the nerve travels under muscles on the inside of the arm and into the hand on the side of the palm, giving sensation to the little finger and the half of the ring finger that is near the little finger. It also controls most of the little muscles in the hand that help with fine movements, and some of the bigger muscles in the forearm that help to make a strong grip.

What are symptoms of Cubital Tunnel Syndrome?
Ulnar nerve entrapment can cause numbness or tingling “falling asleep”  in the ring finger and little finger, especially when the elbow is bent. There may be an aching pain on the inside of the elbow. In some cases, it may be harder moving the fingers in and out or manipulating objects.

Weakening of the grip and difficulty with finger coordination (such as typing or playing an instrument) may occur. If the nerve is very compressed or has been compressed for a long time, muscle wasting in the hand can occur. Once this happens, muscle wasting cannot be reversed. For this reason, it is important to schedule a consultation as soon as any of the symptoms are noticed.

What causes Cubital Tunnel Syndrome?
The two most common locations where the nerve gets compressed is behind the elbow and at the wrist. It is not known exactly what causes compression of the ulnar nerve. Some factors can make it more likely that the nerve will be compressed include prior fractures of the elbow, bone spurs, swelling of the elbow joint, and cysts.

A direct blow to the inside of the elbow, leaning on the elbow for prolonged periods, or repetitive activity that requires a bent elbow can irritate the nerve if it is already compressed. If the ulnar nerve is compressed at the wrist, the cause is more likely to be a cyst in Guyon’s canal.

What are the treatments for Cubital Tunnel Syndrome?
If symptoms have only just started, an anti-inflammatory medicine, such as ibuprofen, may be recommended to help reduce swelling around the nerve. Steroid (cortisone) injections around the ulnar nerve are not generally used because there is a risk of damage to the nerve. Sometimes symptoms can be relieved by simply changing activities or wearing a soft splint on the wrist to help hold it in a straight position. The Graston™ Technique is another option used in The Centre for Working Hands’ Rehabilitation Clinic for treating cubital tunnel.

If the nerve is very compressed or there is muscle wasting, hand surgery may be needed. Ulnar nerve transposition is the most common surgical treatment. The nerve is moved from its place behind the elbow to a new place in front of the elbow. This is called an anterior transposition of the ulnar nerve. There are many factors that go into deciding where the nerve is moved, and your hand surgeon will recommend the best option for you.

Please contact our reconstructive surgeons to schedule a consultation to discuss cubital tunnel syndrome. The Centre for Working Hands offers the latest treatments for ulnar nerve entrapment to patients in Elkhart and South Bend, Indiana, Michiana and the Southern Michigan area.

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