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(Ulnar Nerve Entrapment)

Definition

Cubital tunnel syndrome is a set of symptoms caused by abnormal pressure on the ulnar nerve. The nerve passes through the cubital tunnel on the inside of the elbow. Problems with this nerve can cause a weak hand grip and numbness in the ring and small finger.

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Pressure on the ulnar nerve can cause problems in the hand and fingers.
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Causes

This problem is caused by pressure of the ulnar nerve at the elbow. The cause it not always known. In some people, it may be from:

  • Stress on the elbow from long periods of time with the elbow in a bent position or with pressure on the elbow
  • Injury to the elbow, such as a direct blow
  • Bleeding, swelling, or fluid build-up at the elbow

Risk Factors

Things that can raise the chance of this problem are:

  • Repetitive motion, such as with hard labor
  • Leaning on or holding the elbow in a bent position for long time, such as with heavy phone users, musicians, baseball players, or cyclists
  • Joint disorders, such as gout or arthritis
  • A past elbow injury
  • A past surgery on or around the ulnar nerve

Symptoms

Symptoms may happen all the time or only when the elbow is bent. They may be:

  • Numbness or tingling in the small and ring fingers
  • A weak grip
  • Poor finger coordination
  • Pain in the elbow or forearm

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done. A diagnosis can usually be made based on your symptoms.

It may be confirmed with these tests:

Treatment

This problem often goes away on its own. Activities that are causing the problem may need to be stopped. Other steps may be:

  • A splint, brace, or padding to keep the elbow straight and ease pressure
  • Exercises and therapy to help with strength, range of motion, and flexibility

Surgery

Some people may need surgery when other methods do not help. The goal of surgery is to ease compression and bring back nerve function and muscle strength. Choices are:

  • Cubital tunnel release—increases the size of the tunnel the nerve passes through
  • Ulnar nerve anterior transportation—moves the nerve to another place
  • Medial epicondylectomy—removes part of the bony ridge that catches the nerve as it moves across the elbow joint

Prevention

There are no guidelines to prevent this problem.

RESOURCES

The National Institute for Occupational Safety and Health  http://www.cdc.gov/niosh 

Ortho Info—American Academy of Orthopaedic Surgeons  http://orthoinfo.org 

CANADIAN RESOURCES

Canadian Centre for Occupational Health and Safety  http://www.ccohs.ca 

When it Hurts to Move—Canadian Orthopaedic Foundation  http://whenithurtstomove.org 

References

Miller TT, Reinus WR. Nerve entrapment syndromes of the elbow, forearm, and wrist. AJR Am J Roentgenol 2010 Sep;195(3):585.

Osei DA, Groves AP, et al. Cubital Tunnel Syndrome: Incidence and Demographics in a National Administrative Database. Neurosurg. 2017; 80:417-420.

Trehan SK, Parziale JR. Cubital tunnel syndrome: Diagnosis and management. Med Health R I. 2012;95(11):349-352.

Ulnar nerve entrapment at the elbow (cubital tunnel syndrome). Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00069. Updated September 2015. Accessed December 3, 2019.

Ulnar nerve entrapment of elbow. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/ulnar-nerve-entrapment-of-elbow  . Updated June 1, 2017. Accessed December 3, 2019.

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