Cubital Tunnel Syndrome: Tests, Treatments & Surgery

There is no one true cause for developing cubital tunnel syndrome. However, some patients are at higher risk for developing compression of the ulnar nerve at the elbow.

There is no one true cause for developing cubital tunnel syndrome. However, some patients are at higher risk for developing compression of the ulnar nerve at the elbow.

Hitting or bruising your ulnar nerve at the elbow, such as falling onto your elbow, can cause similar symptoms to cubital tunnel syndrome. However, these symptoms typically resolve on their own and do not commonly need surgical intervention.

During the exam your doctor may ask you what elbow or hand positions make your symptoms worse. They may also check which fingers become numb in your hand. The physician may lightly tap on your nerve at the elbow to see if you get any electrical shocks or numbness in the small and ring fingers.

The physician will also test your hand strength and look for any muscle wasting in your hand. They will also check if your ulnar nerve moves out of position at the elbow. Additionally, the physician will check for any other spots of compression, such as your neck and wrist.

If your doctor suspects cubital tunnel syndrome, they may order an x-ray to evaluate your elbow anatomy to ensure no bony structures are compressing the nerve. They may also recommend an Electromyography (EMG) and Nerve Conduction Velocity (NCV) study to determine the severity of compression across the elbow, as well as to rule out other causes of nerve compression. The test is conducted by an EMG/NCV specialist such as a neurologist or physical medicine and rehabilitation physician.

Here at Seaview Orthopaedics, your EMG and NCV tests may be conducted by pain management specialist Dr. Adam Meyers. The tests measure electrical activity of muscles and the speed of electrical signals traveling along the nerve across specific sites in the arm, including elbow and wrist. During the EMG, a small needle is inserted into specific muscles to measure and record electrical impulses within selected muscle fibers.

Cubital tunnel surgery involves releasing the tight ligaments surrounding the ulnar nerve at the elbow, which gets rid of the pressure on the nerve. This procedure improves blood flow allowing the nerve to heal. An incision is made on the inside of your elbow to visualize and protect the nerve while the tight structures are being released.

If your nerve is unstable, or moves around the elbow instead of staying within its groove, your surgeon may have to move it to a more secure location to prevent symptoms from recurring. Depending on the type of surgery you have, the physician may also place you in a splint for a few weeks after the procedure to protect and rest the elbow.

You may experience soreness in your elbow for about 3 months after surgery.

The surgery is performed at a surgical center where you can go home the same day. Pain experienced after the procedure is typically managed by alternating Tylenol and anti-inflammatory medications.

Very rarely will a stronger type of medication be necessary for managing pain after your procedure.

A follow-up visit will be scheduled 10-14 days after surgery to have your sutures removed and the incision site checked by your physician. Physical or hand therapy is not necessary after cubital tunnel surgery. However, if your elbow becomes stiff and you are unable to straighten, bend, or rotate your elbow and forearm completely, the physician may recommend physical or occupational therapy to help improve your range of motion.

After your first follow up appointment, you may begin slowly easing into your normal daily activities according to your comfort levels. After 6-8 weeks, you may resume activities that require gripping, pulling and pinching. It can take up to 3 or more months to regain full strength depending on the severity of your cubital tunnel syndrome.

Following your procedure, daily numbness and tingling can take several months to a year to improve depending on the extent of the nerve compression. Nerves tend to recover slowly, so you may notice improvement even a year removed from surgery. It should be noted that in severe cases daily numbness and tingling, as well as grip and pinch strength, may not completely recover.