Cubital tunnel syndrome also known as Ulnar nerve entrapment, occurs when the ulnar nerve in the arm is compressed or irritated. The ulnar nerve is one of the three primary nerves in the arm and can become constricted at multiple points. The most common site of compression is behind the inside of the elbow.

Anatomy of the Ulnar Nerve

The ulnar nerve travels through a tunnel, termed the cubital tunnel, which is located beneath a bone prominence at the elbow’s inside, called the medial epicondyle. This specific spot where the nerve is closest to the skin is often recognized as the “funny bone.” The nerve extends beyond the elbow, navigating under the forearm muscles and into the hand, particularly on the side near the little finger, further passing through Guyon’s canal. The ulnar nerve is responsible for sensation in the little finger and half of the ring finger and regulates many hand muscles.

Causes and Risk Factors

While the exact cause of cubital tunnel syndrome is sometimes uncertain, the ulnar nerve is more susceptible to compression at the elbow due to its narrow passage and minimal soft tissue protection. Common causes include:

• Prolonged elbow bending
• Nerve sliding behind the medial epicondyle
• Consistent pressure on the elbow
• Fluid buildup causing swelling
• Direct trauma to the elbow’s inside

Individuals with a history of elbow fractures, arthritis, prolonged elbow bending activities, and cysts near the elbow are at a heightened risk.

Symptoms

Common symptoms encompass:

• Aching pain inside the elbow
• Numbness and tingling in the ring and little fingers
• Weak grip and coordination issues in severe cases
• Muscle wasting in long-term nerve entrapment

Diagnosis

A doctor will conduct a thorough medical history assessment and physical examination. Tests may include:

• X-rays to detect bone irregularities
• Nerve conduction studies to ascertain nerve functionality and pinpoint compression locations

Treatment Options

Nonsurgical Treatment:
Initial treatment typically involves non-surgical methods, such as:

• Anti-inflammatory medications like ibuprofen
• Bracing or splinting to maintain a straight elbow posture during sleep
• Nerve gliding exercises to improve nerve movement

Surgical Treatment:
In cases where non-surgical treatments are ineffective, or the nerve compression is severe, surgical intervention may be considered. Surgical procedures can include:

• Cubital tunnel release
• Ulnar nerve anterior transposition
• Medial epicondylectomy

Post-surgery, patients may require a splint and might benefit from physical therapy to restore strength and mobility.

Ulnar nerve entrapment at the elbow, or cubital tunnel syndrome, can impact one’s daily life, but with appropriate diagnosis and treatment, many can find relief. Dr. BSV Raju and his team are committed to providing the best care for patients experiencing this condition. If you believe you have symptoms of ulnar nerve entrapment, schedule an appointment today.