Cubital tunnel syndrome, or ulnar neuropathy, is a condition commonly caused by abnormal pressure on the ulnar nerve near the “funny bone” in the elbow, which could originate from a number of our typical habits and daily activities.
It's a condition that can sometimes be treated nonsurgically. When surgery is required, I'm able to do perform the procedure in the exam room.
Ulnar neuropathy is often caused by frequent and prolonged bending of the elbow – such as when lifting or reaching, using a cellphone or sleeping with a hand tucked under your pillow – which stretches the ulnar nerve. Leaning on your elbows or arms for long periods of time, especially on hard surfaces, puts direct pressure on the nerve and also increases your chance of developing cubital tunnel syndrome.
Sensing the Syndrome
Symptoms of cubital tunnel syndrome may feel similar to the sensation of hitting your funny bone. Early signs include tingling, numbness and muscle weakness in the hands and arms – especially “pins and needles” in the ring and little fingers – which may develop into pain that could extend to the elbow. Late signs show loss of muscle mass between the fingers and in the palm that translates to poor coordination of finger movement. Some of these late findings may not be reversible, so early diagnosis is important.
Patient symptoms and a physical examination can provide a lot of insight and, in many cases, may be all your doctor needs to diagnose cubital tunnel syndrome. Sometimes, a nerve study and a test to measure the health of muscles and nerve cells (electromyography) may be needed to confirm diagnosis, locate the nerve damage and determine the condition’s severity.
Nonsurgical Treatment Options
Most mild cases of cubital tunnel syndrome can be managed with conservative therapies, especially if electromyography indicates that there is minimal pressure on the ulnar nerve. Nonsurgical treatment options include:
- Medications, such as nonsteroidal anti-inflammatory drugs, that reduce swelling of soft tissue
- Corticosteroid injections to relieve inflammation and reduce pressure on the nerve
- Wearing wrist or elbow splints during daily activities or while sleeping
Doctors may refer patients to a physical medicine and rehabilitation specialist. These specialists can teach patients to perform their daily activities with minimal strain on the elbow. They may also train patients through exercises that can help stretch and strengthen forearm muscles over time. A few small changes to your day-to-day activities can greatly reduce or even eliminate symptoms of cubital tunnel syndrome.
When Surgery Is Necessary
Doctors may recommend surgery in more severe cases, such as when the wrist becomes droopy or when patients have difficulty extending their fingers. Surgical treatments may also be an option if symptoms persist after three months of conservative therapy and nonsurgical treatments.
There are different procedures available to treat the condition. While the best method depends on each patient’s situation, any kind of surgery aims to alleviate pressure on the ulnar nerve – much like conservative therapy.
Dr. Yoav Kaufman is a plastic surgeon at Kelsey-Seybold Clinic who specializes in hand surgery. He is accepting new patients at Main Campus and Spring Medical and Diagnostic Center. His clinical interests include hand and upper extremity surgery, reconstructive plastic surgery, aesthetic plastic surgery and breast reconstruction.