Cubital tunnel syndrome is a condition caused by increased pressure or stretching of the ulnar nerve, which runs along the inside of the elbow behind the bony bump known as the “funny bone”. It is the second most common upper extremity nerve entrapment after carpal tunnel syndrome.

Common Symptoms

• Numbness and tingling in the ring and small fingers
• Pain in the forearm, elbow, and hand
• Weakness or clumsiness in the hand

Cause & Anatomy

• The ulnar nerve can become compressed or irritated due to:
• Direct trauma or injury to the elbow
• Repetitive elbow flexion/extension movements
• Prolonged elbow flexion (e.g. holding a phone, resting elbow on hard surfaces)
• Anatomical variations like a subluxating ulnar nerve or abnormal muscle
• Arthritis, bone spurs, cysts or tumors around the elbow

The ulnar nerve runs through a bony tunnel (cubital tunnel) on the inside of the elbow. This makes it vulnerable to compression, friction, and traction forces when the elbow is bent.

Diagnosis

• Physical examination to check for symptoms of compression and nerve irritation
• Nerve conduction studies (EMG/NCV) to assess nerve function
• Imaging tests like ultrasound or MRI may be done

Prevention of Cubital Tunnel Syndrome

• Avoiding repetitive elbow bending or direct pressure on the cubital tunnel area
• Taking breaks from activities that aggravate symptoms
• Using elbow pads or wrapping a towel around the elbow to prevent flexion while sleeping

Non-Surgical Treatment

• Activity modification and avoiding aggravating positions
• Night splints to keep the elbow extended
• Oral anti-inflammatory medication
• Nerve gliding exercises

Surgery

• If non-surgical treatment fails, surgery may be recommended to release pressure on the ulnar nerve. Options include:
• Releasing the nerve at the elbow
• Ulnar nerve transposition (moving the nerve to front of the elbow)

Rehabilitation After Surgery

• Wound healing for 1-2 weeks after surgery
• Possibly physical therapy to regain range of motion and strength
• Nerve recovery can take many months. In many cases, the goal is to prevent the symptoms of weakness, clumsiness, and numbness from worsening.

FAQ’s

How is it different from carpal tunnel syndrome?
Cubital tunnel affects the ulnar nerve at the elbow, while carpal tunnel affects the median nerve at the wrist. Cubital tunnel causes symptoms in the ring/small fingers, carpal tunnel affects the thumb/index/middle fingers.

Will I need surgery?
Surgery is considered if non-surgical treatments fail to relieve severe or worsening symptoms like muscle weakness or loss of dexterity.

How long does recovery take after surgery?
Recovery can take many months as nerves heal slowly. Physical therapy helps regain function