Ask a Doctor: Cubital Tunnel Syndrome

Ask a Doctor: Cubital Tunnel Syndrome

Dr. Douglas E. Pittner answers your questions about Cubital Tunnel Syndrome.

My doctor said I have cubital tunnel syndrome.  What does that mean?
The cubital tunnel is the name for a space, like a tunnel, at the inside of the elbow.  It is where your ulnar nerve (the “funny bone” nerve) travels around the elbow and into your forearm.  Sometimes problems develop in this area.  It is possible for this tunnel to be too tight, causing pressure on the ulnar nerve.  The nerve can also be stretched as it travels around the elbow.  Cubital tunnel syndrome refers to the pain, numbness, or weakness that is caused by these problems around the elbow.

Why do my fingers to go numb?
The ulnar nerve travels from your elbow to your hand and provides sensation to your fingers as well as connections to important muscles in your hand.  The nerve acts like an electrical wire that sends signals to and from the hand.  When this nerve is stretched or compressed at the elbow, the electrical signals can be slow.  Your body interprets this as numbness or tingling, usually in the small and ring fingers.  You may experience pain in the elbow or forearm.  Weakness can also develop in the hand muscles which can cause decreased strength with gripping or pinching.

Can I be tested for cubital tunnel syndrome?
Your doctor may test for cubital tunnel syndrome with a nerve conduction study (NCS).  During this office procedure, special equipment is used to test your nerve’s ability to transmit electrical signals.  The test can find areas of pressure and determine if the nerve is functioning properly.

Do I need to have surgery for this problem?
The best treatment for cubital tunnel will depend on how severe the problem is and how long it has been present.  Your doctor can give you guidance regarding your treatment options.  Many times non-operative treatments can be tried first.  These may be as simple as changing routine activities or avoiding leaning on the elbow.  Sometimes pressure on the nerve increases when the elbow is bent for a long time, such as while holding the phone or while sleeping.  Wearing a splint at night, or loosely wrapping a towel around the elbow, may help keep the arm straight and improve the problem.  A hand therapist can suggest exercises or stretches that may help.  However, if the pain or numbness continues, surgery may be recommended to improve the problem or prevent it from getting worse.

How is cubital tunnel treated with surgery?
The goal of surgery for cubital tunnel syndrome is to remove the pressure on the nerve and protect it from further damage.  There are several methods of doing this.  Your doctor can explain the best options for you.  The surgery will release any tight structures surrounding the nerve, and may involve gently moving the nerve to a new location.  Most patients go home on the same day with medication to control any discomfort.

How long does it take to recover after cubital tunnel surgery?
The exact length of time for recovery depends on many things, such as the type of surgery performed and your activity level.  In general, activities such as lifting and carrying will be somewhat restricted after surgery.  Your doctor may place you in a temporary splint to prevent elbow motion during the early healing.  Many people will return to normal everyday activities by 6 weeks after surgery.  Heavy lifting or aggressive activities may take longer.  Sometimes the pain and numbness of cubital tunnel syndrome improves quickly after surgery.  However, in more severe cases, recovery of the nerve may take longer.

The views expressed in this article are those of the author and do not necessarily reflect the official policy or position of the Department of the Navy, DoD, nor the U.S. Government.

CDR Douglas E. Pittner is a military service member.  This work was prepared as part of his official duties. Title 17, USC, §105 provides that ‘Copyright protection under this title is not available for any work of the U.S. Government.’ Title 17, USC, §101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties.

Dr. Pittner is a native of Cleveland, Ohio.  He completed his orthopedic surgery training at The Ohio State University and obtained subspecialty training in hand and upper extremity surgery at the University of Pittsburgh.  Dr. Pittner entered service in the US Navy as an orthopedic surgeon in 2007.  He currently lives in North Carolina with his wife and children and continues to serve as a Navy hand surgeon at Camp Lejeune, NC.  Dr. Pittner participates as a member of the Public Education Committee for the American Society for Surgery of the Hand and contributes as an Associate Editor for the Journal of Hand Surgery.

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