Cubital tunnel syndrome

Cubital tunnel syndrome involves a part of your elbow commonly referred to as the “funny bone,” but there is nothing funny about cubital tunnel syndrome!

Have you ever awakened in the morning to find your hand is still “asleep”? You might be experiencing numbness or tingling in your arm; your pinky and ring fingers may be giving you that “pins and needles” feeling. These symptoms occur because your ulnar nerve has been compressed in some manner. Perhaps you slept on your arm, or spent hours holding a cell phone to your ear. Maybe you repeatedly leaned your elbow on a hard surface.

The ulnar nerve controls fine muscle movement in the hand. It moves along the length of your forearm, through your elbow and into the cubital tunnel, a small passage on the inside of your elbow. Here the nerve can be compressed and the resulting impingement cause symptoms like those described above. Cubital tunnel syndrome is also known as ulnar neuropathy.

Cubital tunnel syndrome can sometimes result from abnormal bone growth or from intense physical activity that increases pressure on the ulnar nerve. Baseball pitchers are at an increased risk for developing cubital tunnel syndrome because the twisting motion required to throw a slider can damage ligaments in the elbow.

A diagnosis of cubital tunnel syndrome is usually made upon observation alone, although sometimes nerve testing (EMG/NCS) may be needed to determine how much the nerve and muscle are being affected.

Treatment begins with conservative and preventative measures such as rest. Splinting the arm to avoid bending it at the elbow may be helpful. Becoming aware of the actions and positions that cause the pain helps to formulate a plan to avoid those movements.

If symptoms persist, surgery to free the nerve and relieve the pressure can be performed. Surgery may result in simple decompression of the ulnar nerve; move the nerve to the front of the elbow; move the nerve under a layer of fat, under the muscle, or within the muscle; or trim the bump of the inner portion of the elbow under which the ulnar nerve passes.

Therapy may be required following cubital tunnel syndrome surgery. During recovery, your lifting and elbow movement may be restricted. The tingling and numbness may disappear quickly, or it may require several months to dissipate. It may take several months to recover your hand and wrist strength.