Cubital Tunnel Syndrome

Cubital tunnel syndrome is a condition caused by compression or irritation of the ulnar nerve as it passes through the cubital tunnel on the inner side of the elbow. This nerve is responsible for sensation in the ring and little fingers and for controlling some hand muscles. Prolonged pressure or repetitive bending of the elbow can lead to pain, tingling, numbness, and weakness in the arm and hand. It is the second most common nerve entrapment in the arm after carpal tunnel syndrome.

Diagnosis of Cubital Tunnel Syndrome

Cubital tunnel syndrome is diagnosed with:

Medical history review (symptom onset, repetitive activities, or injuries).
Physical exam to test sensation, grip strength, and ulnar nerve function.
Provocative tests:
- Tinel’s sign (tapping over the ulnar nerve at the elbow).
- Elbow flexion test (holding the elbow bent reproduces symptoms).
Nerve conduction studies (NCS) or EMG to measure nerve function.
Imaging (ultrasound or MRI) may be used if another elbow condition is suspected.

Treatment for Cubital Tunnel Syndrome

Physical therapy helps manage symptoms, improve mobility, and reduce nerve compression. Treatment may include:

Activity modification to avoid prolonged elbow flexion or direct pressure on the elbow
Splinting or bracing at night to keep the elbow straight
Nerve gliding exercises to improve ulnar nerve mobility
Stretching exercises for forearm and wrist flexibility
Strengthening exercises for hand, wrist, and forearm muscles
Pain management with modalities like ultrasound or electrical stimulation
Ergonomic adjustments at work or home to reduce nerve stress
In severe cases, surgery to release or reposition the ulnar nerve may be required, with PT critical for recovery afterward.

Symptoms of Cubital Tunnel Syndrome

Signs and symptoms of cubital tunnel syndrome include:

Numbness and tingling in the ring and little fingers
Hand weakness, especially in grip and pinch strength
Pain or aching on the inside of the elbow
Symptoms that worsen with prolonged elbow bending (e.g., talking on the phone, sleeping with arms bent)
Clumsiness or difficulty with fine motor tasks (buttoning clothes, typing)
In advanced cases, visible muscle wasting in the hand

Prevention of Cubital Tunnel Syndrome

To reduce the risk of cubital tunnel syndrome or prevent flare-ups:

Avoid leaning on elbows for long periods
Keep elbows straight during sleep with a soft splint or pillow support
Take frequent breaks during repetitive arm activities
Stretch and strengthen forearm and hand muscles regularly
Address early symptoms of tingling or numbness promptly