Cubital Tunnel Syndrome

Cubital tunnel syndrome is the second most common peripheral nerve entrapment condition in the upper limb, after carpal tunnel syndrome. It involves compression or irritation of the ulnar nerve at the elbow.

What is Cubital Tunnel Syndrome?

The ulnar nerve passes around the inside of the elbow through a narrow channel called the cubital tunnel. At this point, the nerve is close to the surface and is easily compressed, either by direct pressure, prolonged elbow bending, or structural changes within the tunnel itself. When the nerve is compressed, it causes the characteristic symptoms of cubital tunnel syndrome.

You may already be familiar with the sensation of hitting your 'funny bone'. This is the ulnar nerve at the elbow, and the tingling that results gives a good indication of the symptoms this condition produces.

Diagnosis

Examination will assess the distribution of symptoms and the function of the ulnar nerve. Nerve conduction studies (NCS) and electromyography (EMG) may be required to confirm the diagnosis and assess the severity of nerve involvement.

Symptoms

  • Tingling and numbness in the ring finger and little finger, particularly when the elbow is bent

  • Aching pain on the inner side of the elbow

  • Weakness of grip and pinch

  • In more advanced cases, wasting of the small muscles of the hand

Treatment Options

Non-Surgical Treatment

Physiotherapy and nerve gliding exercises

Activity modification, avoiding prolonged elbow flexion

Night-time elbow splinting to keep the elbow straight during sleep

Surgical Treatment: Ulnar Nerve Decompression

When non-surgical measures fail or when nerve compression is significant, Mr Adam can offer ulnar nerve decompression surgery.

This involves releasing the tight tissue over the cubital tunnel to relieve pressure on the nerve. In some cases, transposition of the nerve (moving it to a different position around the elbow) may be appropriate.