Patient's Guides to Injuries and Conditions

A Patient’s Guide to Cubital Tunnel Syndrome

The following information is from the American Society of Hand Therapists and is available as a handout from their website: http://www.asht.org.

What is cubital tunnel syndrome?

This image from www.floridaortho.com shows the major nerves of the arm. The ulnar nerve is shown in green on the right.

The ulnar nerve is one of the primary nerves in the arm that travels from the neck, along the arm, through the elbow to the fingers. When this nerve is irritated or stretched at the elbow level, a condition called cubital tunnel syndrome can develop. Cubital tunnel syndrome gets its name from the tunnel in which the nerve travels. When people say they hit their “funny bone,” it is actually the ulnar nerve.

Illustration from www.urmc.rochester.edu showing the ulnar nerve passing through the cubital tunnel at the elbow.

What causes cubital tunnel syndrome?

Cubital tunnel syndrome has several possible causes. The nerve can stretch when the elbow is bent for long periods of time with activities such as sleeping or holding a phone to the ear. The anatomy can be another cause, as the nerve can shift over the bony part of the inside of the elbow during motion. Direct pressure on the elbow, frequent bending, or intense physical activity of the elbow can also irritate the nerve.

Magnetic resonance neurography (MRN) image from neurography.com showing irritation in the ulnar nerve passing through the cubital tunnel.

What are the symptoms of cubital tunnel syndrome?

Pain, numbness, tingling, and weakness in the hand are all symptoms of cubital tunnel syndrome. Numbness, or loss of sensation, is usually felt in the small and ring fingers. This numbness may gradually turn into pain. Putting pressure on the elbow or bumping it can cause an “electric shock” sensation to the fingers. Other symptoms can include “clumsiness” in the hand, or a claw-like deformity of the ring and small fingers.

What is the treatment for cubital tunnel syndrome?

For nonsurgical treatment, a physician will provide a referral to a hand therapist for education and intervention to help relieve the symptoms. If the symptoms do not improve, the physician my recommend a surgery. Surgery involves relieving the pressure on the nerve. Hand therapy is usually recommended following surgery.

An example of a brace used to treat cubital tunnel syndrome from opchealth.com.au.

What can a hand therapist do for me?

The hand therapist will help determine which activities aggravate the symptoms, and instruct in modifying these activities. Treatment may include exercises for the arm and hand, taping, fitting for a padded elbow sleeve, as well as a custom-made orthosis for night use. If surgery is performed, therapy will assist in restoring normal ranges of motion and function of the arm and hand.