Cubital Tunnel Syndrome
Ulnar Nerve Entrapment
When the elbow's ulnar nerve has been compressed or stretched, cubital tunnel syndrome (or ulnar nerve entrapment) results. Similar to carpal tunnel syndrome, this elbow condition causes pain, numbness and reduced mobility.
What is Cubital Tunnel Syndrome?
Cubital tunnel syndrome can be caused by many factors. There are three main nerves in the arm, one being the ulnar nerve which runs from the neck and through the elbow's inner groove (at the 'funny bone'). The ulna nerve has little padding at the elbow as it is located close to the skin. Thus, it becomes easily damaged or irritated when pressure is applied.
Various occurrences can result in the development of cubital tunnel syndrome, including:
- Prolonged bending of the elbow (i.e., while sleeping)
- Blow to the elbow's inside (the 'funny bone')
- Prolonged leaning on the elbow (specifically on a firm exterior)
- Repetitive stretching or twisting of the ulnar nerve during physical activity
When the elbow moves, the ulnar nerve may also snap from side to side over a bony bump; however, this is less common.
Individuals who have a history of elbow injuries (such as dislocations), arthritis, bone spurs, or other elbow joint problems have a greater risk of cubital tunnel syndrome development. People who must perform repetitive elbow bending or flexing motions (such as in a work or sport setting) also have a higher risk of developing this condition.
Symptoms
There are many symptoms for cubital tunnel syndrome, ranging from mild to debilitating, depending on the severity of the condition. When the nerve undergoes mild irritation, common symptoms include: numb or tingling little or ring finger, or 'pins and needles' sensations in the arm and hand.
Severe symptoms for more complex cases include:
- Reduced hand strength, especially in the two outermost fingers
- Decreased gripping ability in the hands
- Muscle wasting
- Hand deformity (claw-like appearance)
Diagnosis of Cubital Tunnel Syndrome
Nerve function can be assessed through a nerve conduction test. Dr Oscar Brumby-Rendell is an orthopaedic surgeon based in Adelaide. In your consultation, Dr Brumby-Rendell will discuss your medical history and symptoms and conduct a physical examination.
After this, a nerve conduction test may also be conducted to identify nerve function and the location of ulnar nerve compression. This test measures nerve signals in the hand and arm, and the ulnar nerve is stimulated along numerous locations, with response time indicating compression areas.
X-rays may be conducted if Dr Brumby-Rendell thinks the nerve may be compressed by arthritis or bone spurs.
Treatment
Non-Surgical Treatments
Conservative measures are used to treat this condition where possible. Such measures include wearing a splint, bracing, and avoiding movements that create elbow pressure. To reduce swelling around the ulnar nerve, non-steroidal anti-inflammatory medicines may also be prescribed.
Surgical Treatments
Surgery may benefit patients whose symptoms have not changed after implementing conservative measures, or if the compression is severe. Techniques that reduce invasiveness are used by Dr Brumby-Rendell where possible. This reduces infection risks and post-surgery pain and results in faster recovery periods. This surgical procedure is conducted during the day, and patients do not stay at the hospital overnight. Recovery time is generally a week, and patients can recommence everyday activities after approximately 2 weeks.
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