What is cubital tunnel syndrome?
Cubital tunnel syndrome is a pinched ulnar nerve. It’s also called ulnar nerve entrapment. The ulnar nerve is a major nerve in the arm, running down the ulna bone close to the surface of the skin. If it gets trapped, it’s usually at the elbow. But the ulnar nerve can also become entrapped at the wrist.
If it sounds like carpal tunnel syndrome to you, you’re in the right ballpark. After carpal tunnel, cubital tunnel syndrome is the most common nerve entrapment. Both are pinched nerves with similar symptoms. The biggest difference is the specific nerve and the area it’s trapped.
Part of the problem is where the nerve lives. Instead of being buried near bones and muscles, it’s close to the surface of the skin. This is why it’s easy for it to get pinched.1 If you’ve ever hit your funny bone then you’ve had the misfortune of finding that out. Banging your “funny bone” briefly pinched your ulnar nerve.
Cubital tunnel syndrome usually doesn’t cause significant problems, but it can be extremely uncomfortable. It often resolves on its own. But when it doesn’t resolve, it can lead to more pain and even disability.
Have you noticed any of these ulnar nerve entrapment symptoms?
It can be hard to separate nerve pain from muscle, joint, or ligament pain. But if you have a cluster of these symptoms, it may point to cubital tunnel syndrome.2
1. You feel like you’ve hit your funny bone or tweaked your wrist…but the discomfort won’t go away.
Hitting your elbow or pinching your wrist usually fades away after a few minutes. But with ulnar nerve entrapment that numbness, tingling, and pain keep persisting after you injured it. The pain may also show up in your wrist, without hurting your elbow at all.
2. Your grip is worse than it was.
Your ulnar nerve runs down your fingers. When those nerves aren’t working at full speed, you may find yourself dropping things you pick up. A weak grip can make using handles and knobs more difficult as well.
3. You’re having trouble bending and straightening your fingers.
This makes it hard to manipulate things with your fingers. Simple every-day tasks like buttoning a button or dialing a phone take more effort. You might also have pain that’s worse in the pinky and ring finger. This might keep you “guarding” your fingers. That is, you can physically open and close them, but it’s more painful than it ought to be, so you stay away from those movements.
4. Your pain is worse when you bend your elbow
Flexion of your elbow stretches the ulnar nerve. A trapped nerve can spike your pain if you bend the elbow. You might find yourself straightening your arms more when you use your phone, drive, eat, and use a computer.
What Could Have Caused My Trapped Elbow Nerve?
Nerve entrapment is often fixed by removing the offender. So what can lead to cubital tunnel syndrome?3
- Fractured and dislocated elbow. Broken elbows are a common work and sports injury, increasing the risk of a trapped ulnar nerve.
- Arthritis. The bone malformation and the swelling of arthritis can painfully catch and pinch the ulnar nerve.
- Swelling at the joint. This can be caused by anything from rheumatoid arthritis to injuries to the elbow.
- Bone spurs. A notch of bone leaves less room for a nerve to rest and stretch freely.
- Prolonged elbow flexion. For many of us, our elbows are flexed much of the day. Working on a computer, using a smartphone, and driving keeps our elbows bent. And holding a phone to your ear for a long time significantly flexes the elbow. Some people also sleep with bent elbows.
- Putting pressure on the nerve. Leaning on elbows frequently can be too forceful on the ulnar nerve. Resting your arm across the edge of something like a window or table can also act as a tourniquet on the nerve
What Are Some Ulnar Nerve Entrapment Treatments?
Most people make a full recovery if their cubital tunnel syndrome is treated. If it’s caught the problem can usually be reversed entirely.
If the entrapment is from keeping the elbow constantly flexed, it may be a very fast and easy fix. For example, a headset can keep you from needing to hold the phone to your ear. Adjusting your computer chair may relieve the pressure on your forearms. Be mindful of when you’re unconsciously bending your elbow, like in bed or against the table.
Exercises can have an excellent outcome. Most exercises involve gently flexing and extending the elbow and the wrist. There may be a tingling sensation briefly after the exercise, but it should fade.
Anti-inflammatories, like ibuprofen, can be cheap and straightforward fixes if the nerve entrapment is from swelling.
Your doctor may also prescribe a brace. This can help you recover temporarily, and give you an idea of when you’re unconsciously bending. It looks similar to a knee brace but goes on your elbow.
These are conservative treatments. If your nerve is damaged, your disability from the pain is significant, or if you’ve lost muscle strength or control from the entrapment, you may need surgery.
Surgery For Ulnar Nerve Entrapment
This procedure is also called surgical nerve decompression, or cubital tunnel release. The surgery is usually short and outpatient.4 It’s often quick and minimally invasive. It uses a small incision and a short recovery time.
For those dealing with more severe entrapment, the nerve can even be moved to the front of the elbow. This surgery is called an ulnar nerve transposition.
Need a Surgical Consult For Treating Your Ulnar Nerve Entrapment?
If your wrist and elbow pain is not getting better with conservative treatments, it’s time to take the next step. If your ulnar nerve is compressed for a long time or is seriously compressed, you can experience muscle wasting. This can’t be reversed, so it’s important to get a treatment plan ASAP. Let the Nevada Nerve Surgeon team answer your questions at 702-505-8655.[Your doctor is the best person to talk to about your health concerns. This article shouldn’t be used to diagnose yourself or give yourself a treatment plan.]