Cubital tunnel syndrome

 

Cubital Tunnel Syndrome is due to pressure or stretching of the ulnar nerve around the inner elbow, which can cause numbness/tingling in the ring and little fingers, and can lead to weakness in the hand.  

 

Causes include:

Pressure: leaning on the elbow on a desk or armrest can cause tingling in the hand.

Stretching:  Keeping the elbow bent for a long time can stretch the nerve behind the elbow (eg, whilst sleeping or on the phone).

 

Anatomy:  

The ulnar nerve can flick over a bony prominence causing irritation. Some people are born with an extra muscle or tight muscles, which compress the nerve.

 

Diagnosis:

Is based on history, examination and nerve conduction studies to locate the area of compression (as it is occasionally at the neck level).

 

Treatment:

Activity modification

Splinting the elbow straight whilst sleeping (or wrapping a hand towel round the elbow to stop it bending)

Surgery, especially if the nerve compression is causing muscle weakness in the hand. Recovery is often incomplete following surgery but you will notice some improvement over a 2 – 3 year period. Surgery will prevent worsening of the condition.

 

Postoperative risks and complications:

Swelling and stiffness – keep your hand raised and exercise your fingers to prevent this

Scar – will be firm and lumpy initially, but with regular scar massage will fade and soften with time

Numbness or neuroma around scar due to a small nerve being damaged or trapped in scar tissue

Incomplete return of sensation and strength (depending on severity of compression)

Complex Regional Pain Syndrome (CRPS) – a complication of any upper limb surgery (<5%), which is unpredictable and causes swelling, stiffness and pain. This is treated with different Hand Therapy techniques.

 

More information:

http://www.bssh.ac.uk/patients/conditions/22/cubital_tunnel_syndrome