February 13, 2018

Cubital tunnel syndrome, also known as ulnar nerve entrapment, is the second most common type of nerve entrapment treated in an orthopaedic center after carpal tunnel syndrome. Those who suffer from cubital tunnel syndrome may experience pain along the inside of the elbow or in the hand. Tingling and numbness, like that of carpal tunnel syndrome, are experienced in the ring and little finger.

Cubital tunnel syndrome is caused by irritation or compression of the ulnar nerve, which travels from the shoulder to the hand. The ulnar nerve can become irritated when the arm is bent. This is because the nerve is the most vulnerable when it passes through the cubital tunnel in the elbow. In some cases, the ligaments surrounding the nerve may compress and cause painful symptoms.

How is cubital tunnel syndrome diagnosed?
A hand doctor may perform a variety of tests at an orthopaedic clinic to diagnose and to gauge the extent of the cubital tunnel syndrome. Common tests performed by an orthopaedic doctor to diagnosis nerve entrapment include:

  • Physical exam
    During a physical examination of your hand, your hand doctor will check for swelling, tenderness, and muscle strength. Your doctor may also tap on the elbow to see what sensations you feel.
  • X-rays
    To determine if hand therapy or orthopaedic surgery is necessary, your doctor may perform an ultrasound to identify anything that may be obstructing the ulnar nerve. Obstructions may be arthritis, a fracture, a cyst, or tumor.
  • Electrophysiological tests
    Electromyography uses small pulses of electricity to study the function of the ulnar nerve. These tests are also used to determine if you're experiencing any other nerve dysfunctions.

How is cubital tunnel syndrome treated?
Cubital tunnel syndrome, if minor, may be treated using hand therapy and changing everyday patterns of hand activity. A splint or brace may also be used to keep the elbow or wrist in a straight position. This helps to reduce pressure on the ulnar nerve.

Physical therapy treatments for pain management include strengthening exercises and stretching. Corticosteroid injections may be recommended to reduce swelling of the ligaments around the ulnar nerve.

However, if your cubital tunnel syndrome fails to improve over a series of months you may need outpatient orthopaedic surgery to relieve pressure on the ulnar nerve. These surgeries are often covered by Medicare, which approved payments for up to 3.04 million orthotic procedures in 2016.

There are three types of surgery to decompress the ulnar nerve including cubital tunnel release, ulnar nerve transposition, and medial epicondylectomy. Cubital tunnel release enlarges the cubital tunnel whereas ulnar nerve transposition relocates the ulnar nerve. A medial epicondylectomy removes a part of the bone in the elbow to prevent the ulnar nerve from moving and becoming irritated.

Many Americans suffer from nerve entrapment in the wrist. If you or a loved one is suffering from cubital tunnel syndrome or other hand impairments, contact the hand therapy experts at Bluegrass Orthopaedics today.