Cubital Tunnel Syndrome: Ulnar Nerve Compression at the Elbow
The ulnar nerve is one of the three main nerves that travels down the arm into the hand. It can become compressed or irritated, which causes pain or numbness in the hand and arm. Most commonly, this compression occurs at the level of the elbow, as the nerve runs in a tight space next to the bony bump (epicondyle) on the inside (medial aspect) of the arm. This tight space as is known as the cubital tunnel. When the elbow bends, the nerve stretches around the medial epicondyle, and the space inside the cubital tunnel decreases. This can cause nerve irritation. Repeated pressure on the inside of the arm may cause similar symptoms as well.
Patients with cubital tunnel syndrome describe pain or numbness on the inside of arm and hand. The ring finger and small finger may feel as if they've "fallen asleep". Typically these symptoms may be worse in the morning, as many patient sleep with bent elbows at night.
Initially, treatment for cubital tunnel syndrome focuses on avoiding activities that irritate the nerve. Elbow pads or braces are used to prevent the elbow from bending during sleep at night. Anti-inflammatory medications may be used to help control the pain. If symptoms persist or become more severe, a nerve conduction study may be used to evaluate the status of the nerve, and the location of nerve compression. Surgical intervention is reserved for patients who fail non-operative treatment, and involves release of the cubital tunnel to improve the space available for the nerve. The nerve may also be moved in front (anterior) of the medial epicondyle to prevent the nerve from being irritated with elbow range of motion.