ConditionCubital Tunnel Syndrome
Cubital tunnel syndrome
WHAT IS CUBITAL TUNNEL SYNDROME?
Cubital tunnel syndrome is a condition brought on by increased pressure on the ulnar nerve at the elbow. The ulnar nerve goes through 2 very tight anatomic spaces: one at the elbow, and one at the side of the wrist. When the pressure on the nerve becomes great enough to disturb the way the nerve works, then numbness, tingling, and pain may be felt in the elbow, forearm, hand, and/or fingers, and over time can even lead to weakness of hand function.
Because the ulnar nerve passes through the elbow, it must stretch around the bony ridge when you bend your elbow. This stretching can irritate the nerve which can be very painful. At night, if you sleep with your elbows bent, you can wake up with your fingers asleep because the nerve was stretched for a long period of time.
SYMPTOMS OF CUBITAL TUNNEL SYNDROME
Cubital tunnel syndrome can cause an aching pain on the inside of the elbow. Most of the symptoms, however, occur in your hand.
- Numbness and tingling in the ring finger and little finger are common symptoms of ulnar nerve entrapment. Often, these symptoms come and go. They happen more often when the elbow is bent, such as when driving or holding the phone. Some people wake up at night because their fingers are numb.
- The feeling of “falling asleep” in the ring finger and little finger, especially when your elbow is bent. In some cases, it may be harder to move your fingers in and out, or to manipulate objects.
- Weakening of the grip and difficulty with finger coordination (such as typing or playing an instrument) may occur. These symptoms are usually seen in more severe cases of nerve compression.
- 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 see your doctor if symptoms are severe or if they are less severe but have been present for more than 6 weeks.
IF YOU ARE SUFFERING FROM SYMPTOMS OF CUBITAL TUNNEL SYNDROME AND EVALUATING YOUR TREATMENT OPTIONS, SCHEDULE A CONSULTATION WITH DR. DANIEL DURAND TODAY.
WHAT CAUSES CUBITAL TUNNEL SYNDROME?
In many cases of cubital tunnel syndrome, the exact cause is not known. The ulnar nerve is especially vulnerable to compression at the elbow because it must travel through a narrow space with very little soft tissue to protect it.
Common Causes of Compression
There are several things that can cause pressure on the nerve at the elbow:
- When your bend your elbow, the ulnar nerve must stretch around the boney ridge of the medial epicondyle. Because this stretching can irritate the nerve, keeping your elbow bent for long periods or repeatedly bending your elbow can cause painful symptoms. For example, many people sleep with their elbows bent, which can aggravate symptoms of ulnar nerve compression and cause you to wake up at night with your fingers asleep.
- In some people, the nerve slides out from behind the medial epicondyle when the elbow is bent. Over time, this sliding back and forth may irritate the nerve.
- Leaning on your elbow for long periods of time can put pressure on the nerve.
- Fluid buildup in the elbow can cause swelling that may compress the nerve.
- A direct blow to the inside of the elbow can cause pain, electric shock sensation, and numbness in the little and ring fingers. This is commonly called “hitting your funny bone.”
HOW IS CUBITAL TUNNEL SYNDROME DIAGNOSED?
This condition is diagnosed by the physical examination of your arm by a certified hand surgeon and is confirmed with a lab test called an electromyogram.
Dr. Durand will discuss your medical history and general health. He may also ask about your work, your activities, and what medications you are taking.
After discussing your symptoms and medical history, Dr. Durand will examine your arm and hand to determine which nerve is compressed and where it is compressed. Some of the physical examination tests your doctor may do include:
- Tap over the nerve at the funny bone. If the nerve is irritated, this can cause a shock into the little finger and ring finger (Tinel’s sign) — although this can happen when the nerve is normal as well.
- Check whether the ulnar nerve slides out of normal position when you bend your elbow.
- Move your neck, shoulder, elbow, and wrist to see if different positions cause symptoms.
- Check for feeling and strength in your hand and fingers.
- If nonsurgical methods do not improve your symptoms, or if the nerve compression is causing muscle weakness or damage in your hand, your doctor may recommend surgery.
- Treatment goals are to relieve the pressure in this area. This can sometimes be done without surgery by avoiding certain elbow positioning, but may benefit from surgery by shifting the nerve to a location with less pressure.
WHEN SEEKING A DIAGNOSIS OR TREATMENT, IT’S BETTER TO SEE A DOCTOR SOONER RATHER THAN LATER. ONCE A CONDITION IS SEVERE, THE DISEASES ARE MORE DIFFICULT TO CORRECT.
EARLY INTERVENTION IS KEY TO AVOIDING PERMANENT DAMAGE. DEPENDING ON YOUR DIAGNOSIS, NONSURGICAL TREATMENT MAY BE AN OPTION.
HOW IS CUBITAL TUNNEL SYNDROME TREATED?
There are a few different procedures to help treat Cubital Tunnel Syndrome. Dr. Daniel Durand will take the time to carefully outline the various options available to you along with the benefits and risks associated with each procedure during your comprehensive one-on-one consultation.
NONSURGICAL TREATMENT
- Nonsteroidal anti-inflammatory medicines. If your symptoms have just started, your doctor may recommend an anti-inflammatory medicine, such as ibuprofen, to help reduce swelling around the nerve.
- Bracing or splinting. Your doctor may prescribe a padded brace or splint to wear at night to keep your elbow in a straight position.
- Nerve gliding exercises. Some doctors think that exercises to help the ulnar nerve slide through the cubital tunnel at the elbow and the Guyon’s canal at the wrist can improve symptoms. These exercises may also help prevent stiffness in the arm and wrist.
SURGICAL TREATMENT
Your doctor may recommend surgery to take pressure off of the nerve if:
- Nonsurgical methods have not improved your condition
- The ulnar nerve is very compressed
- Nerve compression has caused muscle weakness or damage
There are a few surgical procedures that will relieve pressure on the ulnar nerve at the elbow. Dr. Durand will talk with you about the option that would be best for you.
HAND CARE WITH DR DANIEL DURAND
NOT ALL HAND AND WRIST CONDITIONS REQUIRE SURGICAL SOLUTIONS. OTHER TREATMENT OPTIONS ARE AVAILABLE FOR LESS SEVERE ISSUES. IF YOU’VE BEEN EXPERIENCING CUBITAL TUNNEL SYNDROME SYMPTOMS, SCHEDULE AN APPOINTMENT WITH DR. DANIEL DURAND TODAY!
