Cubital tunnel syndrome, also called ulnar neuritis, is a nerve disorder involving compression or stretching of the ulnar nerve at the elbow and forearm.
It can cause pain, tingling, numbness, hand weakness, and loss of feeling in the ring and little fingers. Because the ulnar nerve has little tissue protecting it at the elbow, it is also vulnerable to injury from a direct blow.
What Is Cubital Tunnel Syndrome?
Cubital tunnel syndrome occurs when the ulnar nerve is compressed, stretched, or irritated at the elbow, arm, or forearm.
The condition may be caused by pressure from swollen, inflamed, or scarred tissues, stretching of the nerve from loose elbow ligaments, a direct blow to the nerve, or repetitive elbow bending.
Ulnar nerve irritation can also reduce hand and wrist function and may interfere with sports that require a strong grip or repetitive throwing.
Causes and Risk Factors
Causes may include:
- Pressure on the ulnar nerve at the elbow, arm, or forearm from swollen, inflamed, or scarred ligament tissues or surrounding muscles
- Stretching of the nerve due to loose elbow ligaments
- A direct blow to the nerve at the elbow
- Repetitive elbow bending
Risk factors include:
- Sports or occupations that require repetitive and strenuous throwing motions, such as baseball and javelin throwing
- Contact sports such as football, soccer, and rugby
- Other injuries to the inner elbow, including medial epicondylitis and loose inner elbow ligaments
- Poor physical conditioning, including strength and flexibility
- Inadequate warm-up before activity
- Diabetes mellitus
- Hypothyroidism
Symptoms
Common signs and symptoms include:
- Tingling, numbness, or burning along the inner forearm or in the ring and little fingers
- Sharp pain that may shoot from the elbow to the wrist and hand
- Hand weakness, clumsiness, or heaviness
- Reduced fine hand function
- Weak grip or pinch
- Increased pain with forced full elbow bending
- Tenderness or aching on the inner elbow
- Reduced performance in sports requiring a strong grip
- Reduced control with throwing, including pitching
Treatment
Initial treatment may include:
- Rest from the activity causing symptoms
- Medication and ice to reduce inflammation
- Avoiding leaning on the elbow
- An elbow pad
- Elbow splinting, usually at night, to help prevent full bending of the elbow
- Stretching and strengthening exercises for the forearm and elbow
Referral to a physical therapist or athletic trainer may also be recommended.
Nonsteroidal anti-inflammatory medications such as aspirin or ibuprofen, or other pain relievers such as acetaminophen, may be recommended as directed by a physician.
If conservative treatment is not successful, surgery may be necessary to reduce compression of the ulnar nerve.
For athletes, assessment of proper throwing mechanics is important before returning to competition.
Recovery and Outcomes
Cubital tunnel syndrome usually improves with appropriate treatment and may sometimes resolve on its own.
Surgery is usually necessary only when muscle wasting or nerve changes have developed.
Potential complications include:
- Permanent numbness and weakness of the ring and little fingers
- Weak grip
- Permanent paralysis of some hand and finger muscles
- Surgical risks including infection, bleeding, nerve injury, recurrent or continued symptoms, and elbow stiffness
When to See Dr. Chudik
If numbness, tingling, weakness, grip difficulty, inner elbow pain, or other symptoms persist or worsen, schedule an evaluation with Dr. Chudik.
Call 630-324-0402, request an appointment online, or email contactus@chudikmd.com.