Ulnar Nerve - Cubital Tunnel Syndrome
Cubital tunnel syndrome describes a condition where the ulnar nerve, which passes through the cubital tunnel on the inside of the elbow, becomes inflamed or compressed. The ulnar nerve lies directly next to the bump of bone on the inner portion of the elbow, commonly called the “funny bone”. The cause of ulnar neuropathy is often unknown, but may occur after a fracture, dislocation, or repeated minor traumas. The condition can also be a complication of diseases such as diabetes or arthritis.
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Symptoms — including numbness, tingling, pain in the elbow, forearm, hand, and/or ring and little fingers — are felt when there is pressure on the nerve. Sitting with the elbow on an arm rest, or repetitive elbow bending and straightening can create enough pressure to cause symptoms. Some patients notice weakness while pinching, clumsiness, and/or a tendency to drop things. In severe cases, sensation may be lost and the muscles in the hand may lose bulk and strength.
Treatment begins with modification of activities that may be contributing to the symptoms. Elbow pads may be suggested to cushion the nerve and keep the elbow extended. Non-steroidal anti-inflammatory medications, tricyclic antidepressants, or anticonvulsants may be prescribed.
Ulnar nerve decompression surgery may be recommended for people that have progressive symptoms or weakness that does not respond to conservative treatment. A small incision is made on the underside of the elbow, and the nerve and the cubital tunnel are examined for abnormalities. Tissue that is compressing the nerve is removed and the elbow is flexed and extended to ensure that the nerve moves freely. If the motion of the nerve over the bone is constrained (subluxation), the ulnar nerve will be moved under the muscle to prevent ongoing irritation. The incision will be closed with absorbable stitches.