From the Guidelines
Cubital tunnel syndrome is a condition characterized by the compression or irritation of the ulnar nerve as it passes through the cubital tunnel at the elbow, leading to numbness, tingling, and pain in the ring and little fingers, as discussed in the context of chronic elbow pain 1. The cubital tunnel syndrome is often associated with other causes of chronic elbow pain, including epicondylalgia, biceps tendinopathy, osteochondral injuries, collateral ligament tears, and osteoarthritis. Key features of cubital tunnel syndrome include:
- Numbness or tingling in the ring and little fingers
- Pain in the elbow or hand
- Weakness or clumsiness in the hand Management of cubital tunnel syndrome typically involves conservative measures, such as:
- Avoiding direct pressure on the elbow
- Using an elbow splint at night to prevent flexion
- Taking anti-inflammatory medications for pain relief
- Physical therapy exercises to improve nerve gliding and strengthen surrounding muscles If symptoms persist or worsen, surgical options may be considered, including ulnar nerve decompression or transposition, as mentioned in the context of chronic elbow pain management 1. It is essential to note that early intervention is crucial to prevent permanent nerve damage and muscle weakness in the hand. The diagnosis of cubital tunnel syndrome often involves imaging studies, such as radiographs and MRI, as well as electromyography to assess nerve symptoms, as discussed in the assessment of chronic elbow pain 1.
From the Research
Definition and Causes of Cubital Tunnel Syndrome
- Cubital tunnel syndrome (CuTS) is a compression of the ulnar nerve as it courses through the cubital tunnel near the elbow, also known as the "funny bone" 2.
- It is the second most common peripheral nerve compression syndrome 3 and the second most common compression neuropathy in the upper extremity 4.
- Causes of CuTS include repetitive pressure, stretching, flexion, or trauma of the elbow joint, as well as chronic ulnar nerve compression 2.
Symptoms and Diagnosis of Cubital Tunnel Syndrome
- Symptoms of CuTS include numbness, tingling, or pain in the ring and small fingers, as well as hand weakness and atrophy 2, 4.
- Diagnosis can be made through physical exam using Tinel's sign, flexion-compression tests, and palpating the ulnar nerve for thickening and local tenderness 2.
- Ultrasound and nerve conduction studies may also be used in combination with physical exam for diagnosis 3, 2.
Treatment Options for Cubital Tunnel Syndrome
- Conservative treatment includes elbow splints, braces, and night-gliding exercises, and is often pursued before surgical treatment 2, 5.
- Surgical treatment options include open and endoscopic in-situ decompression, medial epicondylectomy, and anterior transposition of the ulnar nerve 3, 2, 6, 4.
- The choice of surgical treatment depends on multiple factors, including the severity of symptoms and the presence of nerve compression or damage 4.