Cubital tunnel syndrome is a clinical condition that results from compression or stretching of the Ulnar nerve when it pass
behind the bony prominence at the medial border of the elbow joint (medial epicondyle). The clinical features of this condition include pain, numbness or tingling sensation of the forearm and the medial border of the hand, the ring and small fingers. In severe cases, weakness of the small muscles of the hand with hand grip weakness and wasting of the muscles, best manifested at the first web space between the thumb and the index finger. In chronic severe condition, it may lead to hand deformity called ulnar claw hand. Diagnosis of the disease is usually clinical, confirmed by Neurophysiological studies and imaging in form of U/S and MRI scan.
Management, conservative treatment is the first option in mild and moderate condition. The first treatment is to avoid actions that cause symptoms. Wrapping a pillow or towel loosely around the elbow or wearing a splint at night to keep the elbow from bending can help. Avoiding leaning or resting the elbow on the “funny bone” can also help. A hand therapist can help you find ways to avoid pressure on the nerve.
In moderate and severe cases, especially when there are significant symptoms that the patient can’t cope with, wasting of the small muscles of the hand or severe changes of the nerve function reflected by neurophysiological studies, surgery option should be consider as a preventive measure of further damage of the nerve and preserve the function. This can involve releasing the nerve, or even moving the nerve to the front of the elbow, and/or removing a part of the bone. The surgery called Cubital tunnel decompression or Ulnar nerve decompression at the elbow joint
Physiotherapy is sometimes needed after surgery, and the time it takes to recover can vary. Numbness and tingling may improve quickly or slowly. It may take many months for recovery after surgery. Cubital tunnel symptoms may not totally go away after surgery, especially if symptoms are severe.