Cubital Tunnel Syndrome

Cubital tunnel syndrome occurs when the ulnar nerve becomes trapped in its bony groove on the inside of the elbow. It produces symptoms of tingling or numbness in the little and ring fingers, and can result in weakness of the hand and a perception of clumsiness. The muscles on the back of the hand can thin and make the bones seem more prominent to the eye.

In more severe cases, the little and ring fingers become 'clawed' and are difficult to straighten under the power of your own muscles, yet straighten easily when pushed backwards. Sleep disturbance from tingling, or dense numbness on wakening are often reported.

The cause of cubital tunnel syndrome is rarely identified. Local trauma, prolonged pressure (on the 'funny bone' area) or diabetes are all recognised as potential causes. Sometimes, an elbow fracture years before can produce a slow stretching of the nerve which gives the typical symptoms, often decades later.

Arthritis in the neck can give rise to similar symptoms. The nerves are 'pinched' as they leave the spinal column - not as they pass around the elbow - yet the brain perceives the tingling in exactly the same area of the hand. A specialist will examine both regions and, if doubt remains as to the location of the problem, it is likely that special tests (nerve conduction studies) will be undertaken. These provide a 'road map' of the nerves and guide the specialist to provide the most appropriate treatment.

Treatment of milder cases of cubital tunnel syndrome may begin with advice to wear a night splint to try and keep the affected elbow straight during sleep. This prevents stretching of the nerve from sleeping with the elbow bent tightly for several hours each night.

If splinting is unsuccessful, not tolerated, or if the condition is established, surgery is considered. The nerve will be released from its tight overhead roof and either left to run smoothly within the groove at the back of the elbow, or lifted from that groove and transferred around the front of the elbow (called a transposition). The arm will be bandaged for two weeks. The scar can be quite tender to touch for a number of weeks after surgery, and the skin around the scar may be a little numb.

Full recovery of nerve function and feeling usually occurs in milder cases. In more severe cases, recovery can take many months and may, ultimately, be incomplete. Use this link to the website of the American Society for Surgery of the Hand:

cubital tunnel syndrome ASSH

cubital tunnel syndrome info.