Cubital Tunnel Syndrome is a condition characterized by the compression of the ulnar nerve in a region called the cubital tunnel at the elbow.
The ulnar nerve passes behind the bony prominence called the medial epicondyle at the back of the elbow and through a passage called the cubital tunnel. The cubital tunnel is a narrow passage on the inner side of the elbow, formed by bones, muscles, and ligaments through which the ulnar nerve passes. The roof of the cubital tunnel is covered with a layer of fascia (a sheet-like tissue).
What Are the Symptoms of Cubital Tunnel Syndrome?
In general, the signs and symptoms of Cubital Tunnel Syndrome emerge gradually. If left untreated, Cubital Tunnel Syndrome can cause permanent nerve damage in the hand.
Commonly reported symptoms associated with Cubital Tunnel Syndrome include:
Intermittent numbness, tingling, and pain in the little finger, ring finger, and inner part of the hand. These symptoms are particularly noticeable during the night when the patient unknowingly sleeps with bent elbows, causing them to wake up from pain and numbness. The symptoms are also more frequent with bending the elbow or resting the elbow for extended periods.
Aching pain on the inside of the elbow
Weakness in the hand with reduced grip strength
Decreased sensation and fine motor control in the hand, causing the person to drop objects or have difficulty holding small objects.
Muscle atrophy and permanent nerve damage in the hand if left untreated.
What Causes Cubital Tunnel Syndrome?
Trauma
Repetitive motion
Frequent pressure on the elbow due to sitting posture for a long time
Medical conditions that cause pressure and irritation in the ulnar nerve, such as bone spurs, ganglion cysts, or tumors in the cubital tunnel.
How is cubital tunnel syndrome diagnosed?
Cubital tunnel syndrome is diagnosed based on a detailed history and physical examination. Nerve conduction studies such as EMG (electromyography), X-rays, and MRI imaging may also be required for diagnosis.
What is the role of EMG in cubital tunnel syndrome?
With EMG, we usually get answers to questions such as how well the nerve is working, whether it is compressed, and where the nerve compression is.
How is Cubital Tunnel Syndrome Treated?
If there is no muscle loss or nerve damage, non-surgical options are started to treat symptoms such as pain and numbness.
What are the Non-Surgical Methods for Cubital Tunnel Syndrome?
Avoid frequently bending the elbow.
Avoid putting pressure on the elbow by not leaning on it. Elbow pads can be worn while working at a desk to reduce pressure.
Wearing a brace often works to keep the elbow in a straight position at night. Avoid activities that bring on symptoms.
If conservative treatment options do not eliminate symptoms such as pain, numbness, and tingling, and muscle loss has begun, the only option is surgery.
How is Cubital Tunnel Syndrome Surgery Performed?
The aim of cubital tunnel surgery is to reduce pressure on the ulnar nerve and increase blood flow to speed up the healing of the ulnar nerve by providing more space for the nerve to move freely.
Cubital Tunnel Syndrome Surgery: Anterior Transposition of the Ulnar Nerve
In this surgery, the ulnar nerve is loosened from its tunnel and removed. After being thoroughly loosened, a new tunnel-like bed is created on the front side of the elbow, making sure it doesn't get compressed under the muscle or fat tissue.
What is the process like after ulnar nerve surgery?
After surgery, your wound usually heals within 10-14 days, during which you can shower with waterproof dressing materials. After surgery, there is no limitation on elbow joint movement as long as you have no pain. In the first days after surgery, your elbow movements may be restricted due to pain. However, as the days progress, your elbow movements will return to normal.
Elevating the arm above heart level and moving the fingers are important to prevent swelling.
Applying cold to the surgical area to reduce swelling will both reduce your pain and decrease your need for painkillers. Ice should be applied to the surgery area through a towel for 20 minutes every hour.
