Cubital tunnel syndrome, or ulnar nerve impingement, is a condition in which too much pressure is placed on the ulnar nerve at the elbow.This is the nerve you irritate when you hit your “funny bone”. The ulnar nerve is a nerve that supplies sensation to your small and ring fingers. It also activates the muscles within your hand. The ulnar nerve becomes compressed as it crosses on the inside of the elbow. The ulnar nerve becomes compressed by ligaments, muscles, and sometimes even blood vessels. Sometimes the nerve is also noted to sublux or dislocate over the bone in the elbow. This can often give a “popping” sensation and can cause pain.
WHAT ARE THE SYMPTOMS OF CUBITAL TUNNEL SYNDROME?
Unlike carpal tunnel syndrome, which affects the thumb and first 3 fingers, in cubital tunnel syndrome people often complain of numbness and tingling in the ring and small fingers. Often the numbness and tingling occur at times when the elbow is resting on a hard surface or during activities that require elbow flexion. As the ulnar nerve also innervates muscles to the hand, one might also note a decrease in grip strength.
HOW IS CUBITAL TUNNEL SYNDROME DIAGNOSED?
In our practice cubital tunnel syndrome is most often diagnosed by history and physical exam. On occasion, a nerve conduction test will be ordered to confirm the diagnosis. However, as this test is uncomfortable and inaccurate we try to avoid this testing.
WHAT IS THE TREATMENT FOR CUBITAL TUNNEL SYNDROME?
In most cases, the initial treatment is nonoperative. A trial of elbow pads and activity modification is tried at first. However, often these modalities fail and surgery is required.
WHAT DOES CUBITAL TUNNEL SURGERY INVOLVE?
The simplest operation to treat cubital tunnel is a cubital tunnel release. The ulnar nerve is identified at the elbow and all constricting structures are identified and released over the course of the nerve. If the nerve is noted to sublux or dislocate over the elbow with elbow flexion then move extensive surgery is required. In this case the nerve is freed and relocated in front of the elbow.
WHERE IS THE SURGERY PERFORMED?
Cubital Tunnel surgery is performed as an outpatient in either a hospital or surgery center. For those with high deductible insurance or without insurance, ulnar nerve release can be performed safely and comfortably in an office surgery suite.
WHAT ARE THE MAIN RISKS OF THE SURGERY?
• Swelling, stiffness, and pain
• Nerve Damage
• Injury to the elbow joint or forearm muscles
• Residual numbness in fingers
WHAT IS THE RECOVERY TIME AFTER CUBITAL TUNNEL RELEASE?
This is dependent on the type of work you perform and whether the nerve needed to be relocated. Many patients with office jobs only require a few days. However, patients who perform heavy labor may require 4-6 weeks to recover. You can drive within a few days when you are off of narcotics.