Cubital Tunnel Syndrome

What is cubital tunnel syndrome?

Cubital tunnel syndrome is compression of a nerve that extends from your neck to your hand (ulnar nerve). The ulnar nerve runs along the inside of the elbow and is responsible for sensation in the ring finger and small finger, as well as fine motor skills such as gripping objects and typing. Cubital tunnel syndrome is also called ulnar nerve entrapment or ulnar nerve compression.

Cubital tunnel syndrome is the second most common type of nerve compression outside the brain and spinal cord. Still, it’s rare.

Anyone can get cubital tunnel syndrome, but it’s most common in people who repeatedly bend their elbows, such as during computer work or baseball pitching. Most people get better without surgery. When nonsurgical treatments don’t help, an orthopedic surgeon may recommend surgery to relieve the pressure on the ulnar nerve.

At Mass General Brigham Orthopedics, you’ll have access to a dedicated team of hand and arm orthopedic specialists who are committed to helping you manage hand and wrist arthritis. You’ll benefit from a collaborative approach that brings together fellowship-trained orthopedic surgeons, experienced rheumatologists, and skilled rehabilitation specialists. Together, they tailor a treatment plan to help you stay active and control your symptoms.

Call 857-282-3300 to schedule a consultation or find a hand specialist.

Cubital tunnel syndrome symptoms

Cubital tunnel syndrome causes pain that feels similar to hitting your “funny bone.” That’s because your “funny bone” is actually your ulnar nerve. Usually, the pain is more severe when your elbow is bent.

You may also experience:

• Numbness or tingling in your hand or fingers
• Trouble moving your fingers because it feels like they’ve “fallen asleep”
• Weak grip, especially if cubital tunnel syndrome goes untreated

See a healthcare provider if you have symptoms for four weeks or longer. Early treatment helps lessen symptoms and prevent nerve damage.

Causes of cubital tunnel syndrome

Cubital tunnel syndrome may develop because of:

• Elbow injuries: Dislocating or fracturing your elbow can compress the ulnar nerve.
• Nerve pressure: Constantly leaning on your elbow may squeeze the ulnar nerve over time.
• Nerve stretching: When the elbow bends, your ulnar nerve stretches around a bony bump on the inside of your elbow. Bending your elbow repetitively or keeping it bent for long periods can overstretch the ulnar nerve, leading to irritation and compression.
• Underlying conditions: People with arthritis or bony growths (bone spurs) in their elbows may be more likely to develop cubital tunnel syndrome.

Diagnosing cubital tunnel syndrome

Diagnosing cubital tunnel syndrome usually starts with a conversation about your symptoms. Your provider may ask:

• Do you have numbness or tingling in your fingers or hands?
• Do you feel “funny bone” pain in your elbow?
• Have you ever injured your elbow?
• How long have you had these symptoms?
• What worsens or relieves the symptoms?

An orthopedic specialist examines your shoulder, neck, elbow, hand, and wrist. They may move your arm into different positions or tap your elbow to check for pain. They may also order tests, such as:

• Nerve conduction studies: These tests measure nerve function. Your provider sends an electrical current down your arm. If the current slows, it can point to an area of nerve compression.
• Electromyogram (EMG): This test checks how nerves and muscles work together. Your provider inserts small electrodes into your muscles to measure the muscle’s electrical signals. If your forearm muscles don’t function properly, it may point to ulnar nerve compression.
• X-rays: An X-ray may check for signs of arthritis or bone spurs.

If you’re experiencing symptoms of cubital tunnel syndrome, call 857-282-3300 to schedule a consultation or find a hand specialist.

Treating cubital tunnel syndrome

Most people start with nonsurgical treatments for cubital tunnel syndrome. Orthopedic surgeons usually only discuss operating if you have significant muscle weakness or wasting (shrinking).

Nonsurgical cubital tunnel syndrome treatment

Your provider may recommend:

• Braces or splints: You wear a padded splint or brace to keep your elbow straight, which reduces pressure on the ulnar nerve. Some people only need to wear these while sleeping.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Medicines such as ibuprofen reduce inflammation and swelling. This may lessen pain associated with ulnar nerve entrapment.
• Nerve gliding exercises: Specific cubital tunnel syndrome exercises may help the ulnar nerve slide more easily when you move. For example, you may hold your arm straight, palm face-up, and curl your fingers toward your body. Then extend your fingers away from you. This can help lessen stiffness in the elbow and wrist.

Cubital tunnel syndrome surgery

An orthopedic surgeon may recommend surgery to relieve pressure on the ulnar nerve. These surgeries are typically outpatient procedures, meaning you return home the same day. An orthopedic surgeon may offer:

• Cubital tunnel release: The surgeon cuts and divides the ligament at the top of your cubital tunnel, the passage where your ulnar nerve goes through your elbow. Cutting this ligament creates more space for your ulnar nerve. Eventually, new tissue grows where the ligament was cut.
• Ulnar nerve transposition: Your surgeon moves your ulnar nerve from behind your medial epicondyle (bony spot on the inner side of your elbow) to in front of it. Moving the nerve prevents it from getting caught on this bony spot and overstretching.

Frequently asked questions