Cubital tunnel syndrome is a common nerve entrapment syndrome in the body occurring with an incidence of 24.7 cases per 100,000 persons per year (Dtsch Arztebl Int. 2015 Jan; 112(1-2): 14–26), second only to carpal tunnel syndrome. It occurs when the ulnar nerve becomes injured or irritated on the inside aspect of the elbow (funny bone) through compression, stretching, or other traumatic insult. In this area of the elbow, the nerve is relatively unprotected between the bone and the skin in an anatomical space named the cubital tunnel.
Symptoms of cubital tunnel syndrome can be insidious in nature or more abrupt if it occurs after some traumatic event to the elbow or nerve. Symptoms usually begin with numbness or tingling in the pinky and ring finger and can extend up the forearm. Sleeping on the elbow, leaning the elbow on a chair or desk, or any acute or repetitive injury to the elbow can initiate or make the symptoms worsen. If the condition progresses, a person may have weakness and clumsiness of the hand, muscle wasting in the hand, or have a hand deformity known as “ulnar claw hand”.
Cubital tunnel syndrome is most common in people who have jobs where their elbow is bent most of the day, where they are leaning on their elbow most of the day, or where there could be any repetitive injury to the elbow during the day. Also, recreational activities like playing a musical instrument (guitar) or participating in certain sports (golf or tennis) can increase the risk of acquiring an injury to the ulnar nerve.
The most effective treatment, especially in the earlier stages, is to avoid the cause of the symptoms if possible. Sleeping differently, not leaning on the elbow at work, or avoidance of certain recreational activities may help alleviate the problem. Also, certain elbow braces which decompress the elbow area where the ulnar nerve is located or braces that inhibited bending of the elbow have proven efficacious for this condition (www.thelonniebrace.com L3762). Plus, some find improvement through physical therapy.
However, if the cubital tunnel symptoms progress despite conservative measures, more aggressive treatment options are available. Steroid injections into the cubital tunnel itself or surgery may be possible options. With surgery, the nerve in the region of the elbow is explored and any compressive tissues that may be aggravating the area.
*Surgical Area Exploration During Surgery
Not only can there be the afore mentioned physical ailments from cubital tunnel syndrome, but it can also lead to work loss and disability. Musculoskeletal disorders including cubital tunnel syndrome are one of the most common work-related diseases. Work. 2015;51(4):635-44. It is estimated that cubital tunnel syndrome occurs at an annual incidence 0.8% per person-year in laborers doing repetitive work activities. Scand J Work Environ Health. 2004 Jun;30(3):234-40. Plus, the mean wage replacement and medical benefits paid per case on average $19,100 and $15,200, respectively. Am J Ind Med. 2010 Dec; 53(12):1242-51.
In the end, the best defense against cubital tunnel syndrome is knowledge. Understanding the causes of this condition and treatment options enable cubital tunnel to be treated early and more easily. Avoidance of certain activities and specific bracing of the elbow can help avoid long term weakness, discomfort, and even work loss.
As a physician, I would highly recommend the Lonnie Brace for both cubital tunnel problems or tennis elbow. Its unique design decompresses and speeds up recovery of an injury to the ulnar nerve or elbow. Plus, it has a removable hinge to limit elbow mobility if required. It is also recognized by DME and has an L Code (3762) for billing: http://www.thelonniebrace.com.
