Cubital Tunnel Treatment
Cubital tunnel syndrome is caused by entrapment of the ulnar nerve. The ulnar nerve is one of the three main nerves in the arm. The ulnar nerve travels from under the collarbone, along the inside of the upper arm and passes through a tunnel of tissue referred to as the cubital tunnel behind the inside of the elbow, where you can feel the nerve through the skin. It is commonly referred to as the “funny bone”.
Beyond the elbow, the nerve travels under the muscles on the inside of the arm and into the hand on the side of the palm. The ulnar nerve gives sensation to the little finger and half of the ring finger. The ulnar nerve also controls most of the little muscles in the hand that help with fine movements, as well as some of the bigger muscles in the forearm that help to strengthen your grip.
Cubital tunnel syndrome, or ulnar nerve entrapment can cause numbness or tingling in the ring finger and little finger, especially when the elbow is bent causing more pressure on the nerve. Difficulty with finger coordination while completing tasks such as typing or playing an instrument as well as a change in the ability to grip with the hand may occur and in some cases, it may be more challenging to move the fingers in and out or to manipulate objects. You may also experience an aching pain on the inside of the elbow. If the nerve is very compressed or has remained compressed for an extended period of time, muscle wasting, or weakening, shrinking, and loss of muscle can occur. Once muscle wasting has happened, it cannot be reversed. Thus, it is important to schedule a consultation as soon as symptoms begin.
The two most common areas for the nerve to be compressed are at the wrist and behind the elbow. The cause of compression to the ulnar nerve remains unknown, but some factors can make it more likely to happen such as bone spurs, swelling of the elbow joint, cysts, and prior fractures of the elbow.
A direct blow to the inside of the elbow, leaning on the elbow for extended periods of time, or repetitive activity that requires the elbow be bent can irritate the nerve if it is already compressed. If the compression occurs at the wrist, it is more likely to be a cyst in Guyon’s canal which is the passageway of the ulnar nerve through the palm of the hand.
If symptoms have just begun, an anti-inflammatory medicine may be recommended to help reduce swelling around the nerve. Steroid, or cortisone injections around the ulnar nerve are not used due to the risk of damage to the nerve itself. Sometimes symptoms can be relieved by changing activities or wearing a splint to keep your wrist in the proper position.
If the nerve is very compressed or there is muscle wasting, hand surgery may be required. The most common surgical intervention is ulnar nerve transposition in which the nerve is moved from its place behind the elbow to a new place in front of the elbow. This is referred to anterior transposition of the ulnar nerve. There are many factors that your plastic surgeon will consider when determining where the nerve will be moved to. He or she will discuss your options with you at your consultation.
To learn more about cubital tunnel syndrome treatment, call or email our expert therapists at The Centre for Working Hands to schedule your evaluation.