Cubital Tunnel Syndrome

What is cubital tunnel syndrome?

Cubital tunnel syndrome affects the ulnar nerve, also known as the funny bone. This nerve runs all the way from your neck to your fingers, and it is quite easy to cause strain or injury to it. Also known as nerve entrapment syndrome, cubital tunnel syndrome affects the arm and hand, causing pain and weakness, pins and needles or a numb sensation. In more severe cases it can cause pain in your fingers and your hand may cease up.

While there is no obvious reason why cubital tunnel syndrome happens, it is often caused by trauma to the elbow area, and is where the phrase ‘banging your funny bone’ comes from, a sensation you are probably familiar with. It can also occur if you lean on your elbows for a prolonged period of time or can be the result of a repetitive strain injury, or fluid build-up from a previous surgery can cause it to happen.

You may be more prone to developing cubital tunnel syndrome if you suffer from any of the below:

Prior elbow issues and injuries
Swelling or cysts around the elbow area
Arthritis in the elbow

Symptoms may include aching on the inside of the elbow, weakened grip and in some more extreme cases, muscle wastage.

Diagnosis

During your appointment, your consultant will be able to determine nerve compression with a number of physical examinations. Some of the tests they may carry out include:

Tapping the funny bone nerve, causing a shock into the fingers
Elbow, shoulder, wrist and neck examinations to see whether you feel pain or sensations elsewhere
Testing the strength of your hands and fingers by asking you to grip something
Bending your elbow to check the positioning of your nerves

They may also refer you for nerve conduction studies. This is a test where the nerve is stimulated to and the time it takes your nerve to respond is measured. If you are suffering from cubital tunnel syndrome, there may be a delayed amount of time before your nerve recognises that it is being stimulated. Your doctor may also request x-rays to see if the bones in your elbow may be causing the complaint.

Non-surgical treatments

Several non-surgical treatments may be recommended prior to surgery to treat cubital tunnel syndrome. Anti-inflammatories such as ibuprofen can help with the swelling in the initial stages, and should be able to provide some relief.

It may also help to put your elbow in a splint at night. This will help to keep your elbow in a straight position thus alleviating any unnecessary pressure on the ulnar nerve. Your consultant may also be able to suggest some exercises, known as nerve gliding exercises. These can help to stretch the nerve and prevent stiffness:

Elbow and wrist extension – reaching your affected arm out to the side and level with your shoulder with your palm down, you will flex your fingers towards the ceiling slowly and then bend your arm inwards towards your shoulder
Head tilt – reaching your arm out to the side again, face your palm upwards and tilt your head away from your arm
Arm flexion – holding your arms out directly in front of you, try to tilt your fingers towards the floor creating a stretch

Surgical treatment

If your symptoms persist and worsen, you may need surgery to take the pressure off your ulnar nerve. At North West Hand Clinic we can perform a procedure called a cubital tunnel release. This procedure can be performed under both a local and general anaesthetic, we will discuss the best option to suit you prior to surgery.

Cubital tunnel release takes approximately 30-45 minutes. An incision will be made in your elbow and any tissue can be cut to release the compression on the nerve. They may need to move your nerve about slightly to reposition it and ensure that it does not have any more pressure on it.

The surgery is performed as a day case and in most cases, you should be able to go home the next day.

Your recovery

After returning home, you should try to keep your elbow rested. Your surgeon will make a follow up appointment to see you in clinic approximately two weeks following surgery. You are advised not to drive for two to three weeks, your surgeon will confirm following your surgery. You may be referred to a hand therapist to help you with the rehabilitation process. You should be fully recovered after around six weeks.

Whatever your hand or wrist condition is, we can help.

Mr Randeep Mohil provides clinics across Lancashire and Cheshire.

Please call us on 01625 466158 or email info@northwesthandsurgeon.co.uk

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Lancashire Clinics

The Beardwood Hospital, Blackburn
Clinic days: Monday evenings (alternate) and Thursday mornings
Website: The Beardwood Hospital
Ramsay Fulwood Hospital, Preston
Clinic days: Monday and Tuesday evenings (alternate)
Website: Ramsay Fulwood Hall

Ramsay Euxton Hall Hospital, Chorley Clinic days: Tuesday evenings (alternate) Website:Ramsay Euxton Hall

Cheshire Clinic, Northwich Clinic days: Friday morning (alternate) Website: The Cheshire Clinic

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Cubital Tunnel Syndrome

What is cubital tunnel syndrome?

Diagnosis

Non-surgical treatments

Surgical treatment

Your recovery

Whatever your hand or wrist condition is, we can help.

Get in touch