Cubital Tunnel Syndrome
Cubital tunnel syndrome is caused by pressure on the ulnar nerve as it passes behind the elbow and through a tunnel composed of bone on three sides and a tight overlying ligament. It is possible to feel the nerve through the skin in this location. Hitting the “funny bone” actually means banging the ulnar nerve. This nerve supplies feeling to the ring and small finger, and controls some of the important small muscles in the hand. Patients with cubital tunnel syndrome may complain of numbness and tingling in these two fingers, and pain and ache in the elbow that may radiate up or down the arm.
Symptoms are made worse by flexing the elbow as this position squeezes the nerve in the tunnel. Talking on the phone, clutching the strap of a pocket book, or sleeping in a curled up position may heighten symptoms.
Non operative treatment consists of avoidance of the flexed position by changing habits of activities of daily living. A splint that keeps the elbow in extension may be used at night. In those patients that either do not respond to non operative treatment or have already progressed to a stage of nerve deterioration, surgery may be indicated.
There are several different surgical techniques, the most reliable and predictable method moves the nerve from its location in this tunnel, to a new location under the muscles in front of the elbow. A splint that immobilizes the elbow and wrist is worn for ten days after surgery.