CUBITAL TUNNEL SYNDROME
 
Cubital Tunnel Syndrome
What is it?
The ulnar nerve is one of the three main nerves in your arm. It travels from your neck down into your hand, and can be compressed in several places along the way, such as beneath the collarbone (thoracic outlet syndrome) or at the wrist (Guyon's Canal). The most common place for compression of the nerve though is behind the inside part of the elbow. This is referred to as the funny bone as it buzzes and tingles if accidentally knocked.  

Ulnar nerve compression at the elbow is called Cubital tunnel syndrome. As the name suggests, the nerve passes through a tunnel just before it travels down the arm to the hand. In the hand it provides sensation to the little and ring finger and also give power to the muscles within the hand.

Most cases arise without an obvious cause, but the tunnel can be narrowed by arthritis of the elbow joint or by an old injury. 
Cubital Tunnel Syndrome
What are the symptoms?
Pain, numbness, tingling and weakness in the hand are all symptoms of cubital tunnel syndrome. Numbness, or loss of sensation, is usually felt in the small and ring fingers. This numbness may gradually turn into pain. 

Putting pressure on the elbow or bumping it can cause an “electric shock” sensation to the fingers. Other symptoms can include “clumsiness” in the hand, or a claw-like deformity of the ring and small fingers.

Numbness or tingling of the little and ring fingers are usually the earliest symptom. It is frequently intermittent, but may later become constant. Often the symptoms can be provoked by leaning on the elbow or holding the elbow in a bent position (e.g. on the telephone). Sleeping with the elbow habitually bent can also aggravate the symptoms.

In the later stages, the numbness is constant and the hand becomes weak. There may be visible loss of muscle bulk in severe cases, particularly noticeable on the back of the hand between the thumb and first finger, with loss of strength and dexterity.

Investigations may include x-rays of the elbow and nerve conduction studies.
Cubital Tunnel Syndrome
What causes it?
Cubital tunnel syndrome has several possible causes. The nerve can stretch when the elbow is bent for long periods of time with activities such as sleeping or holding a phone to the ear.

The anatomy can be another cause, as the nerve can shift over the bony part of the inside of the elbow during motion. Direct pressure on the elbow, frequent bending or intense physical activity of the elbow can also irritate the nerve.
Cubital Tunnel Syndrome
What is the treatment?
For nonsurgical treatment, a hospital doctor will provide a referral to a hand therapist for education and intervention to help relieve the symptoms. If the symptoms do not improve, the doctor may recommend a surgery. Surgery involves relieving the pressure on the nerve. Hand therapy is recommended following surgery. 

If you attend your GP with the symptoms of cubital tunnel syndrome the GP will refer you to a hospital consultant.
Cubital Tunnel Syndrome
What can Hand Kinetics do?
The hand therapist will help determine which activities aggravate the symptoms, and instruct in modifying these activities. 
Treatment may include exercises for the arm and hand, taping, fitting for a padded elbow sleeve, as well as a custom made splint for night use.

If surgery is performed, therapy will assist in restoring normal range of motion and function of the arm and hand.


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