Cubital Tunnel Syndrome
Cubital tunnel syndrome is a condition characterised by an acute or chronic compression of the ulnar nerve at the elbow. The ulnar nerve runs down the back of the elbow behind the funny bone (also known as the medial epicondyle) and through a passage called the cubital tunnel. Located on the inside of the elbow, the cubital tunnel is a narrow passageway that is formed by bone, muscle and ligaments, with the ulnar nerve passing through its centre. This nerve ends at the ring and little fingers. When you bend your elbow under normal conditions, the ulnar nerve is stretched and catches on the medial epicondyle. Since it causes pain or loss of sensation, cubital tunnel syndrome treatment is recommended.
Repetitive bending and extension of your elbows may aggravate the symptoms of cubital tunnel syndrome. This is because flexion of the elbow stretches the ulnar nerve and repetitive bending causes irritation since the nerve has to constantly stretch and slide back and forth behind the funny bone. The ulnar nerve can be compressed by anatomical anomalies such as bone spurs and fibrous bands. Compression of the ulnar nerve may also occur along the wrist which is usually due to external pressure being applied by lumps such as benign growth or cyst on the wrist.
Signs And Symptoms
Cubital tunnel syndrome presents itself as intermittent numbness, tingling and pain to the ring and little fingers, as well as the inner aspect of the hand. These symptoms tend to occur more frequently at night, when weight is applied to the elbow, or when the elbow is bent. Over time, this numbness may cause weakness in the hand, resulting in diminished grip strength. This causes some patients to have a tendency in dropping objects easily or experience difficulty in handling small objects such as chopsticks.
Aside from the complete overall evaluation of the upper extremity, doctors will sometimes send patients for a nerve conduction study and electromyography to see how much of the nerve and muscles are affected, an integral aspect for the cubital tunnel syndrome treatment in Singapore. These nerve tests also help to check and rule out other conditions such as a pinched nerve in the neck.
The main goal of every cubital tunnel syndrome treatment is to provide the patient with relief from the pain and numbing sensation. Doctors often recommend conservative treatment options to treat the symptoms initially unless muscle weakness or wasting is present. The first-line treatment is usually to avoid actions that can exacerbate the condition such as frequently bending the elbow or applying pressure on it. Patients are also advised to wear a splint at night while sleeping to keep the elbow in a straight position. Some patients are also prescribed non-steroidal anti-inflammatory drugs (NSAIDs) for pain management.
However, if there is severe muscle wasting or weakness, or if the condition does not improve with conservative cubital tunnel syndrome treatment, then your hand surgeon may recommend a surgical option. Surgery for cubital syndrome aims to reduce the pressure on the ulnar nerve by providing more space for it to move freely, which in turn, increases blood flow to promote healing within the area. Surgery consists of freeing the nerve in the tunnel where it passes as the elbow by releasing the sites of compression and in some cases, a new tunnel is created before repositioning the ulnar nerve. Occasionally, the medial epicondyle is excised to create more space for the affected nerve.
The numbness and tingling sensation may not completely resolve even after surgery, especially in severe cases, but it usually improves gradually over time. It is advisable not to wait too long before seeking professional help as cases of severe cubital tunnel syndrome are associated with poorer surgical outcomes.
Every case is different, hence it is best to consult a hand surgeon to determine the cubital tunnel syndrome treatment method that is most suitable for you. Reach out to us today if you are suffering from cubital tunnel syndrome and let us help you.