Hand & Wrist: Cubital Tunnel Syndrome


Cubital Tunnel Syndrome, also known as ulnar neuropathy or “cellphone elbow”, is a nerve compression syndrome caused by increased pressure to the ulnar nerve at the inside of the elbow. Basically, it is a pinched nerve at the elbow.

There is a groove near the inside of the elbow where the ulnar nerve travels on its path from the upper arm to the forearm. This nerve is more commonly known as the “funny-bone”. While “banging the funny bone” usually results in temporary symptoms, chronic pressure can affect blood flow to the nerve resulting in numbness, tingling, pain, or weakness in the hand.

Causes of Cubital Tunnel Syndrome

Pressure to the nerve usually occurs from compression, stretch, or friction causing the ring and small fingers to “fall asleep”.  For example, any one or more of the following contribute to symptoms:

  • Leaning on the elbow – such as an arm rest or table – causes pressure and compression to the nerve
  •  Keeping the elbow bent for long periods of time stretches the nerve; for example, sleeping with the elbow bent or holding a phone to your ear
  •  Repetitive bending and straightening of the elbow may cause friction to the nerve

Additional causes of nerve irritation may include:

  • Trauma – such as an elbow dislocation or fracture
  • Anatomy – occasionally the ulnar nerve snaps out of place with elbow motion, which can lead to irritation.
  • Thyroid conditions, rheumatoid arthritis, and diabetes can also be associated with Cubital Tunnel Syndrome.



Signs and symptoms of an Cubital Tunnel Syndrome may include:
  • Tingling, burning, pain, numbness, and/or "pins and needles" feeling in the ring and little fingers
  • Pain at the inside of the elbow, similar to a tooth ache
  • Awakening at night due to numbness or pain
  • Feeling weak or clumsy
  • Decreased strength and mobility
  • Difficulty straightening the ring and little fingers
Splint

Wearing a splint at night prevents the elbow from bending while sleeping.

Activity Modification

Avoid leaning on the elbow, use a headset or blue tooth with your phone, and improving posture may all help to reduce pain and irritation.

Hand Therapy

A session with hand therapy can provide instruction in activity modification, splinting options, and specific home exercise program to address nerve irritation and core strength.

Surgery

If symptoms are severe or do not improve despite non-operative treatment, surgery may be needed to make more room for the nerve and prevent permanent injury to the nerve. Your hand surgeon can help decide the best treatment for you.

 

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Diagram of ulnar nerve at elbow joint, cubital tunnel syndrome, TRIA Orthopaedic Center

Courtesy of American Society for Surgery of the Hand