A nerve that travels from the neck to the arm and then to the fingers is known as the ulnar nerve. It is located near the ulna bone. It provides sensation to the ring and little fingers and to the forearm. The ulnar nerve extends the entire length of the elbow, forearm, and fingers. There is a small passage called the cubital tunnel through which muscles, ligaments, and ulnar nerve pass inside the elbow. This is the most common area where irritation may occur. The condition is known as cubital tunnel syndrome.
What causes cubital tunnel syndrome?
The cause of cubital tunnel syndrome is mostly idiopathic or unknown. However, many experts believe that excessive pressure, force, or tension created on this nerve due to repetitive movements may cause this condition.
The anatomical structure and positioning of the ulnar nerve with little soft tissue and a narrow space covering it make it susceptible to direct pressure. Therefore, any pressure or compression of this nerve causes numbness in the fingers.
Stretching – The nerve is vulnerable to stretching – especially during sleep.
Cubital tunnel syndrome has different names – such as handlebar palsy, bicycler’s neuropathy, tardy ulnar palsy, ulnar nerve entrapment, or Guyon’s canal syndrome.
The following activities and any previous injury may put some people at a higher risk of developing cubital tunnel syndrome:
- Previous dislocation or fracture
- Swollen elbow joint
- Prolonged or repetitive movements
- Excessive flexing or bending of the elbow joint
- Arthritis or bone spurs of the elbow joint
What are the symptoms of cubital tunnels syndrome?
The ulnar nerve is a funny bone nerve. As this nerve is sparsely protected and close to the surface of the skin, it is more sensitive. If something hits in the inner elbow region, the sensation resembles an electric shock.
The signs and symptoms associated with cubital tunnels syndrome include:
- Stiffness in the fingers
- Problems manipulating things with hands or fingers
- Straightening and bending fingers are difficult
- Reduced grip or weakened grip strength
- Muscle loss at the base of the first finger and thumb
- Weakness in the arm, forearm, and fingers
- Pain in the arm, forearm, or fingers
How is cubital tunnel syndrome diagnosed?
Your orthopedic doctor may take note of the symptoms and perform a physical examination. The doctor will also take into account your complete medical history, and recommend the following tests:
X-ray: This test takes images of the bones and surrounding structures to see whether you have bone spurs or arthritis in your elbow.
Nerve conduction test: This test helps in determining the speed of signals that travel down a nerve. The test may be recommended to know whether any constriction or compression of the nerve is delaying the signals.
Electromyogram (EMG): This test helps in testing the forearm muscles controlled by the ulnar nerve. Both nerve and muscle functions are tested. When the muscles don’t work properly in their usual manner, it is an indication of a problem with the ulnar nerve.
When you see your orthopedic doctor regarding the problem you may have, your doctor will instruct you to avoid certain actions that aggravate your symptoms, such as – leaning on the elbow, driving for a long time, resting your arms on the armrest of a chair for long; holding a book for a long time; typing extensively on a keyboard for long; holding a phone for a long time; and sleeping on the arm by bending the affected elbow.
In addition, your doctor will recommend the following home-based relieving methods:
- Using Pain relieving NSAIDs and anti-inflammatory medications and other OTC drugs
- Ensuring proper workstation ergonomics – the chair should not be kept lower than the tabletop
- Using an elbow pad that provides protection during the day
- Doing a thorough warm-up before exercise
- Resting the elbow and the arm whenever possible
- Avoiding sports equipment or clothing that compresses the elbow
- Wearing an elbow pad during the day provides protection
- wearing an elbow splint at night to prevent the elbow from bending
- Wrapping the impacted arm loosely with paddings, such as cloth, towel, or pillow
If you don’t get any relief from the nagging symptoms and the symptoms last longer than six weeks, your doctor may recommend surgery. Orthopedic doctors recommend surgery if your symptoms become extreme and chronic and if you experience weakness or muscle loss in your hand due to cubital tunnel syndrome.