Cubital Tunnel Syndrome / Ulnar Nerve Entrapment
Cubital tunnel syndrome, also known as ulnar nerve entrapment, is a condition that occurs after the ulnar nerve in the elbow has been overly stretched or compressed. Similarly to its better known relative, carpal tunnel syndrome, this condition is associated with reduced mobility, numbness and pain.
How does cubital tunnel syndrome develop?
The ulnar nerve is one of the arm’s three main nerves. It begins in the neck, and runs down the arm and through the groove on the inner side of the elbow, making it part of the area known as the ‘funny bone’.
As the ulnar nerve lives close to the skin, it has little protective padding, especially at the elbow. So when the ulnar nerve is placed under pressure, it can easily become irritated or even damaged.
There are a number of occurrences that can cause cubital tunnel syndrome to develop. These include:
- Bending your elbow for long periods of time, such as while sleeping.
- A direct blow to the inside of the elbow (hitting your ‘funny bone’).
- Leaning on your elbow for long periods of time, especially on a hard surface.
- Intense physical activity that involves repeated twisting and stretching of the ulnar nerve.
Less commonly, the ulnar nerve can snap back and forth over a bony bump when the elbow moves.
People who have had prior elbow injuries (including dislocation), bone spurs, arthritis, or issues with their elbow joint are at a higher risk of developing cubital tunnel syndrome.
Additionally, those who are required to perform prolonged repetitive activities that require the elbow to be bent or flexed (such as for sport or work), are also more at risk of cubital tunnel syndrome occurring.
What are the symptoms of cubital tunnel syndrome?
Depending on its severity, cubital tunnel syndrome can cause symptoms ranging from mild to debilitating. The most common symptoms occur when the nerve has been mildly irritated, and include:
More severe symptoms can include:
- Weakness affecting the hand, particularly the two outermost fingers
- Decreased ability to grip using the hand
- Muscle wasting and claw-like deformity in the hand
How is cubital tunnel syndrome diagnosed?
Dr James McLean is an Adelaide orthopaedic surgeon who specialises in upper limb orthopaedics. During your consultation, Dr McLean will first learn what he can about your symptoms and medical history before performing a physical examination.
A nerve conduction test may then be performed to determine how well the nerve is working, and identify exactly where the ulnar nerve is compressed. The test does this by measuring the signals that travel in the nerves of your arm and hand. During the test, several places along the ulnar nerve are stimulated, and the time it takes to respond indicates areas where compression may be occurring.
If Dr McLean suspects that bone spurs or arthritis may be compressing the nerve, X-rays may also be required to assess the area.
Treatment options for cubital tunnel syndrome
Wherever possible, conservative methods are applied to manage the condition. These include bracing, wearing a splint, and avoiding activities that put undue pressure on the elbow. Additionally, non-steroidal anti-inflammatory medicines may be prescribed to help reduce swelling around the nerve.
If conservative methods don’t relieve symptoms, or if ulnar nerve compression is severe, surgery may be required to relieve pressure. Dr McLean uses minimally invasive techniques wherever possible to reduce pain and risk of infection, and to promote faster recovery times. The procedure is performed as day surgery, with patients returning home the same day. Most patients recover from the procedure in approximately a week, and are back to normal activities within 2 weeks.