• Cubital Tunnel Syndrome

    (Ulnar Nerve Entrapment)

    Definition

    Cubital tunnel syndrome is a set of symptoms caused by abnormal pressure on the ulnar nerve. The ulnar nerve passes through an area on the inside of the elbow, also called the cubital tunnel. Problems with this nerve can cause numbness and weakness in the hand, particularly the pinky and ring fingers.
    Nucleus factsheet image
    Pressure on the ulnar nerve can cause problems in the pinky and ring fingers of the hand.
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Cubital tunnel syndrome is caused by abnormal pressure of the ulnar nerve at the elbow. It may be the result of:
    • Excess mechanical stress on the elbow from long periods of time with the elbow in a bent position or with pressure on the elbow
    • Injury to the elbow, especially direct blow to the inside of the elbow
    • Bleeding, inflammation, or fluid build-up near the nerve, elbow joint
    In some cases, the cause may be unknown.

    Risk Factors

    Factors that may increase your chance of developing cubital tunnel syndrome include:
    • Repetitive motion—common with people who have heavy labor occupations
    • Leaning on or holding the elbow in a bent position for prolonged periods—common with heavy phone users, musicians, baseball players, or bicyclists
    • Joint disorders, such as gout or arthritis
    • Previous elbow injury
    • Previous surgery on or around the ulnar nerve

    Symptoms

    Symptoms may be constant or only appear when the elbow is bent. Symptoms can vary but may include:
    • Numbness or tingling in the pinky and ring fingers
    • Muscle weakness resulting in a poor grip
    • Poor finger coordination
    • Pain in the elbow or forearm
    Long-term problems with this nerve can lead to muscle wasting in the hand.

    Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done. A diagnosis can usually be made based on your symptoms.
    Your doctor may do further tests to assess any potential damage:

    Treatment

    In most cases, cubital tunnel syndrome will go away on its own when excess pressure on the elbow is removed. Activities may need to be limited if they contribute to the syndrome. Your doctor may also recommend:
    • Ice to help relieve inflammation and pain
    • A splint, brace, or padding to keep your elbow straight and relieve pressure
    • Exercises and therapy to help maintain strength, range of motion, and flexibility
    • Medication to relieve pain and swelling
    If an illness or injury is the cause of symptoms, then a specific treatment will be advised for those.

    Surgery

    Surgery may be required in more severe cases or if other treatment methods fail. The goal of surgery is to relieve compression and restore the nerve function and muscle strength. Surgical options include:
    • Cubital tunnel release—increases the size of the tunnel the nerve passes through
    • Ulnar nerve anterior transportation—moves the nerve to a different position
    • Medial epicondylectomy—removes part of the bony ridge that catches the nerve as it moves across the elbow joint

    Prevention

    To help reduce your chance of cubital tunnel syndrome:
    • Avoid repetitive movements
    • Periodically stretch out your arm and elbow
    • Keep your muscles strong with strengthening exercises
    • Use proper technique when playing sports
    • Modify your home or work station to avoid prolonged bending of your elbow

    RESOURCES

    The National Institute for Occupational Safety and Health http://www.cdc.gov/niosh

    Ortho Info—American Academy of Orthopaedic Surgeons http://orthoinfo.org

    CANADIAN RESOURCES

    Canadian Centre for Occupational Health and Safety http://www.ccohs.ca

    When it Hurts to Move—Canadian Orthopaedic Foundation http://whenithurtstomove.org

    References

    Neal SL, Fields KB. Peripheral nerve entrapment and injury in the upper extremity. Am Fam Physician. 2010;81(2):147-155.

    Trehan SK, Parziale JR. Cubital tunnel syndrome: Diagnosis and management. Med Health R I. 2012;95(11):349-352.

    Ulnar nerve entrapment at the elbow (cubital tunnel syndrome). Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00069. Updated September 2015. Accessed September 7, 2017.

    Ulnar nerve entrapment of elbow. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115940/Ulnar-nerve-entrapment-of-elbow. Updated June 1, 2017. Accessed September 7, 2017.

    Revision Information

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