Nerve Conditions · Elbow
Cubital Tunnel
Syndrome
Cubital tunnel syndrome is a compressive neuropathy that occurs at the elbow. The ulnar nerve is irritated, often creating numbness and tingling in the small and ring fingers, and muscle weakness of the hand may occur in severe cases.
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Overview
What Is Cubital Tunnel Syndrome?
Cubital tunnel syndrome is a compressive neuropathy that occurs at the elbow. The ulnar nerve — the nerve that runs along the inner side of the elbow — becomes irritated, often creating numbness and tingling in the small and ring fingers. Muscle weakness of the hand may occur in severe cases.
Many people first notice the sensation of having hit their “funny bone,” which is the ulnar nerve at the elbow. When that numbness lingers or recurs rather than passing quickly, it may be a sign of compression at the cubital tunnel.
Nerve Instability
Occasionally, cubital tunnel may be associated with instability of the nerve. In this circumstance, the ulnar nerve may rub over the inner prominence (medial epicondyle) of the elbow during movement from a straight to bent position or vice versa. This snapping or rubbing can further irritate the nerve and is an important finding during evaluation.
Common Symptoms
- Numbness and tingling in the small and ring fingers
- A sensation similar to hitting the “funny bone” that lingers or recurs
- Muscle weakness of the hand in severe cases
- A snapping or rubbing sensation as the elbow bends and straightens
- Discomfort with prolonged elbow bending, such as holding a phone
- Difficulty with grip or fine tasks as the condition progresses
When to Seek Evaluation
Numbness in the ring and small fingers that persists, recurs, or is accompanied by weakness or clumsiness is worth evaluating. An examination can help determine whether the ulnar nerve is compressed at the elbow and whether there is associated instability.
Request an AppointmentTreatment Options
Non-Surgical Treatment
Many patients improve with conservative treatment. Non-surgical options include activity modification and splinting, both aimed at keeping pressure off the ulnar nerve at the elbow.
Avoiding Flexed Elbow Posture
Avoiding flexed positioning of the elbow helps prevent placing pressure on the ulnar nerve and may improve symptoms. Because the nerve is stretched when the elbow stays bent, reducing that posture is a central part of non-surgical care.
Night Bracing
Wearing a cubital tunnel brace at night or placing a pillow around the elbow may also help avoid flexed posture of the elbow and improve symptoms associated with ulnar nerve irritation. This is especially useful for people who sleep with the elbow tightly bent.
Avoiding Pressure on the Medial Elbow
Activity modification should also include avoidance of pressure to the medial elbow, such as when leaning on an armrest. Wearing an elbow pad during the day to cushion the medial elbow may potentially assist with symptoms.
Non-operative treatment also carries risks and benefits which should be discussed with your treating physician.
Surgical Treatment
Cubital Tunnel Release
Surgical treatment options include cubital tunnel release with or without transposition of the ulnar nerve. Whether transposition is needed depends on the findings during evaluation — including the presence of nerve instability or other anatomic factors.
As with carpal tunnel release, variation in anatomy may be encountered, such as the presence of an accessory muscle. Understanding these possible variations is part of surgical planning.
Release of compressive structures and ligaments overlying the ulnar nerve may improve symptoms. Outcomes after surgery vary, and risks and benefits should be discussed in detail with your treating physician.
Discussing Risks & Benefits
Every treatment — surgical or non-surgical — carries its own risks and potential benefits. The right choice depends on your symptoms, examination findings, severity and goals. Dr. Amin reviews these with you in detail so you can make an informed decision about your care.
Surgical Considerations
- Cubital tunnel release, with or without ulnar nerve transposition
- Anatomic variation such as an accessory muscle
- Release of compressive structures and ligaments overlying the nerve
- Presence of nerve instability may influence the approach
Considering Cubital Tunnel Release?
An evaluation can confirm the diagnosis, assess for nerve instability and help determine whether surgery or continued non-surgical care is the better path for you.
Request an AppointmentCommon Questions
Cubital Tunnel Syndrome FAQs
What are the symptoms of cubital tunnel syndrome?+
Cubital tunnel syndrome typically causes numbness and tingling in the small and ring fingers because of irritation of the ulnar nerve at the elbow. Muscle weakness of the hand may occur in severe cases. Some people notice a sensation like hitting the “funny bone” that lingers or recurs.
Can cubital tunnel syndrome be treated without surgery?+
Yes. Non-surgical treatment options include activity modification and splinting. Avoiding flexed positioning of the elbow helps prevent pressure on the ulnar nerve and may improve symptoms. A cubital tunnel brace at night, or a pillow around the elbow, may help avoid flexed posture. Avoiding pressure to the medial elbow — such as leaning on an armrest — and wearing an elbow pad during the day may also assist with symptoms.
What does cubital tunnel release surgery involve?+
Surgical treatment options include cubital tunnel release with or without transposition of the ulnar nerve. As with carpal tunnel release, variation in anatomy may be encountered, such as the presence of an accessory muscle. Release of compressive structures and ligaments overlying the ulnar nerve may improve symptoms.
What is ulnar nerve instability?+
Occasionally, cubital tunnel may be associated with instability of the nerve. In this circumstance, the ulnar nerve may rub over the inner prominence (medial epicondyle) of the elbow during movement from a straight to bent position or vice versa. This finding is assessed during evaluation and may influence treatment planning.
Not sure which nerve condition is causing your symptoms? Read Cubital Tunnel vs. Carpal Tunnel or learn about carpal tunnel syndrome.
Precision Hand and Orthopedic Surgery
Numbness in Your Ring & Small Fingers?
If numbness, tingling or weakness in your hand is affecting your grip or daily activities, an evaluation with Tanay Amin, MD, FAAOS can help determine whether cubital tunnel syndrome is the cause and what treatment is right for you.
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Disclaimer: This information is not intended to convey, substitute or supplant any medical advice. In order to establish a treating relationship, please schedule and complete your visits with a licensed physician.
Copyright 12/9/2021 Tanay Amin, MD. Do not copy, distribute, or publish this article. Please contact Precision Hand and Orthopedic Surgery PLLC with regards to any inquiries or corrections.