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Starting from your neck to your hand, there is a nerve known as the ulnar. It helps you to control muscles and feel sensations in your forearm, fingers, and hands. Cubital tunnel syndrome happens when that nerve gets irritated or compressed. A compressed ulnar can cause different uncomfortable and severe symptoms that, if they are left untreated, will lead to muscle weakness and atrophy.

Cubital Tunnel Syndrome

Cubital tunnel syndrome is also known as ulnar entrapment, which happens when your ulnar nerve gets irritated or compressed at the inside of your elbow.

Nerves are bundles of string-like fiber that send and receive messages between your brain and your body via electrical and chemical changes in the cell. There are three primary nerves in your arm: the median, the ulnar, and the radial. The ulnar goes from your neck to your arm.

You may suffer from cubital tunnel syndrome if your ulnar nerve is compressed or irritated at the elbow. The nerve may also be affected higher on your arm or wrist.

What does the ulnar nerve do?

Did you know that a funny bone is not a bone? It’s a nerve. That unique, almost electric sensation you feel when you hit your funny bone is the compression of your ulnar nerve.

The ulnar goes through a tunnel of tissues, which is called a cubital tunnel. It travels under a bony bump on the inside of the elbow, known as a medial epicondyle. The space is narrow, and there’s only a little tissue protecting it—that spot where your ulnar nerve is most vulnerable. After the medical epicondyle, the ulnar nerve continues under the muscles on the inside of your forearm and into your hand on the other side, which has a little finger. When it enters in your hand, it goes through another tunnel called Guyon’s Canal.

Causes of Cubital Tunnel Syndrome

Your orthopedic doctor might not be able to narrow down the exact cause of your cubital tunnel syndrome. Possible causes may include:

1. Anatomy

Over time, the soft tissues of your ulnar nerve might get thicker, or there might be extra muscle. Both of these issues can stop your nerve from working and cause cubital tunnel syndrome.

2. Pressure

A seemingly simple use of your elbow, suppose leaning it on an armrest, can press on the ulnar nerve. When the nerve gets compressed, you may also feel your arm, hand, ring, finger, and pinky finger fall asleep.

3. Snapping 

Your ulnar nerve might not stay in its position. It might snap over the medial epicondyle when you move your hand. Snapping it repeatedly irritates the nerve.

4. Stretching

If you bend your elbow for a long duration, like when you sleep, you may overstretch the nerve. Too much stretching can also result in cubital tunnel syndrome.

Symptoms of Cubital Tunnel Syndrome

Contact your orthopedic doctor if you have the following symptoms for more than six weeks. You could get muscle wasting in your hand if you wait too long to get treatment for the compressed nerve. But if you do get your treatment on time, your symptoms should improve or go away.

Symptoms of cubital tunnel syndrome include:

  • Difficulty in moving your fingers when they are numb.
  • Numbness in your arm and fingers that comes and goes.
  • Pain on the inside of your elbow.
  • Tingling in your hands.

Inner elbow pain and numbness in your hand are the most common symptoms. This mostly happens when your elbow is bent. Your elbow might be bent. Your elbow might be bent when you:

  • Drive 
  • Hold a phone
  • Sleep

Non-surgical Treatment For Cubital Tunnel Syndrome

There are both surgical and non-surgical treatments for cubital tunnel syndrome. Orthopaedic surgeons prefer noninvasive treatments first and usually start with nonsurgical treatments. They include:

1. Bracing or splitting

Wearing a padded brace or splint when you sleep may help you to keep your elbow straight.

2. Exercise

Nerve gliding exercises will help your ulnar nerve to slide more easily through the cubital tunnel syndrome. These exercises will also prevent stiffness in your arm and wrist. One activity that you should definitely try is holding your arm in front of you with your elbow straight, then curling your wrist and fingers toward your body. Check with your orthopedic doctor to see if nerve gliding exercises suit you.

3. Hand Therapy

A hand therapist might help you to learn ways to avoid putting pressure on your ulnar nerve.

4. Nonsteroidal Anti-Inflammatory Drugs

Medications like Ibuprofen might help. They will help you to reduce the swelling around your nerve and lessen your pain from cubital tunnel syndrome.

Surgical Treatments For Cubital Tunnel Syndrome

If nonsurgical treatments don’t improve your cubital tunnel syndrome, your nerve is very compressed, or the compression has caused muscle weakness, your orthopaedic surgeons might recommend surgery. Or if you are visiting a physician, he’ll definitely send you to an orthopaedic surgeon. There are some types of surgeries that help you with cubital tunnel syndrome. They include:

1. Cubital tunnel release

The roof of your cubital tunnel is a ligament. This surgery cuts and divides your ligament, making the tunnel bigger and decreasing pressure on your ulnar nerve. New tissue will grow where your ligaments get cut.

2. Ulnar nerve anterior transposition

In this surgery, the surgeon moves your ulnar nerve from behind the medial epicondyle to the front. The treatment stops the nerve from getting caught on your bone.

3. Medial epicondylectomy

This surgery removes a part of the medial epicondyle to release your nerve.

These procedures are generally outpatient, but you might have to stay one night at the hospital. You’ll likely need to wear a splint on your arm for about two or three weeks. Physical therapy is essential to regain your motion and strength.

Surgery is not a guaranteed permanent treatment for cubital tunnel syndrome.

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