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Cubital Tunnel Syndrome

Cubital Tunnel Syndrome is a condition where one of the main nerves in your arm becomes inflamed. The nerve, called the ulnar nerve, passes through a small opening near the inside of your elbow. If this opening becomes too narrow, it can tighten and trap the nerve. This usually occurs slowly over time. As the pressure worsens, you might notice pain traveling down your arm to your fingers, a “pins and needles sensation” in your fingers, or weak grip. Similar symptoms can also occur if the ulnar nerve is stretched too far or if it is too loose and moving more than normal.

Symptoms

The most common symptoms of cubital tunnel syndrome are:

  • Pain on the inside of your elbow
  • Numbness and tingling from your elbow down your forearm and sometimes into your ring and little fingers (fourth and fifth fingers)
  • Popping or snapping feeling on the inside of your elbow
  • Muscle wasting in your hand, causing weak grip
  • Weakened and painful movements of your wrist or hand

Causes & Risk Factors

In many cases, the exact cause of cubital tunnel syndrome is not known. There are some known risk factors including:

  • Jobs which require you to repetitively bend your elbow, such as hammering, shovelling, or lifting (for example, plumber, joiner, mechanic, agricultural worker, miner)
  • Long term use of machines or tools that bore or punch through other materials (for example, jackhammer)
  • Leaning on your elbows for long periods of time, such as when using a laptop
  • Playing sports where you frequently bend your elbow
  • Keeping your elbows in a bent position for a long time, such as when holding a mobile phone or sleeping
  • Arthritis in your elbow
  • Previous injury to your elbow
  • Other medical conditions which cause nerve problems

Diagnosis

In addition to a complete history and physical examination, your doctor may request one or more of the following tests:

  • Blood tests: to rule out other causes of your symptoms such as diabetes or low vitamin levels
  • X-rays: to check whether bone is pressing on your nerve
  • Nerve conduction studies: usually done by a specialist, these tests show how quickly a signal travels down your nerve. This can help the doctor find the exact location where damage has occurred
  • Electromyography (EMG): usually done by a specialist, this test checks whether the nerves are making the muscles move properly

Complications

If cubital tunnel syndrome is left untreated, it can cause permanent nerve damage in the hand.

Treatment

Your healthcare provider will talk to you about the best option for you. To start, they may advise:

  • Rest
  • Using a splint or elbow pad
  • Anti-inflammatory painkillers such as ibuprofen or aspirin
  • Specific exercises
  • Speaking with a physiotherapist

If these options are not helpful, your doctor may then advise:

  • Steroid injections to decrease inflammation

If your symptoms are severe or the above options do not help, you doctor may recommend a surgery called cubital tunnel release. This is where the surgeon cuts any tight structures around the nerve to relieve the pressure and widen the tunnel. If this alone does not provide enough room for the nerve, the surgeon may then do a medial epicondylectomy. This removes a part of the bone on the inside of your elbow to further widen the tunnel. If your nerve still does not move properly, the surgeon may then decide to perform an ulnar nerve transposition. This creates an entirely new tunnel for your nerve.

Prevention

You can prevent cubital tunnel syndrome by warming up your arm muscles before exercise or strenuous work, stretching afterward, and not overdoing physical activity. You should also not lean onto your elbows for long periods of time.

 
 
 

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