An Overview of Cubital Tunnel Syndrome in the Elbow

Cubital tunnel syndrome results from compression of the ulnar nerve around the elbow. If you have ever “bonked your funny bone”, you have irritated your ulnar nerve and know the feeling. The condition may be extremely irritating, and thankfully individuals can often avoid surgery for it.

The ulnar nerve has both a sensory function and a large motor function in the upper extremity. As the ulnar nerve travels down the upper aspect of the arm, it traverses the elbow on the inside portion and goes right behind it.

The ulnar nerve travels through what is known as the cubital tunnel around the elbow. It is prone to compression either from the bones, muscles or tendons in the area at various points. A person may end up with cubital tunnel syndrome from repetitive flexing of the elbow and pressure in the area.

For instance, a person may notice a pins and needles sensation in the distribution of the ulnar nerve after talking on the phone while holding it up to his or her ear for an extended period of time or while leaning on the elbow on a table which can even directly compress the nerve.

Symptoms of cubital tunnel syndrome may include numbness, weakness, or pain in the hand. The individual may also have pain on the inner side of the elbow. It may feel to the person as if the hand is actually falling asleep. Symptoms are common on the ring and pinky finger of the hand as that is where the ulnar nerve provides sensation.

Treatment of cubital tunnel syndrome involves resting the area, and potentially a splint or an elbow pad that prevents flexion of the elbow. The splint is slightly cumbersome, but can simply be worn at night. The nerve may be shifting back and forth in the cubital tunnel experiencing compression at various times, which will not respond typically well to the splint.

Anti-inflammatory medications may help substantially. There’s really not a good injection option for the problem, such as a steroid injection. But oral medications may help a lot. The last resort is surgery to move the ulnar nerve to a better anatomic position and then solidify the position. This surgery is typically very successful. The risks of surgery are no different than the norm and include infection, bleeding, nerve injury, or anesthesia complications.

Cubital tunnel is a very common problem. As mentioned, with proper nonoperative care, surgery is typically avoided.