The cubital tunnel is a passage around the elbow through which an important nerve called the ulnar nerve runs. This nerve provides the sensation to the little finger and half of the ring finger. It also supplies power to some of the strong muscles that bend your wrist and some fingers.
The cubital tunnel is around an inch long and is made up of bones and ligaments on the inside of the elbow. The walls are bone, with the roof and floor being made of strong ligaments.
The ulnar nerve can be compressed as it enters and exits the cubital tunnel as well as inside the cubital tunnel itself. This compression leads to the symptoms of cubital tunnel syndrome.
What are the symptoms of cubital tunnel syndrome?
These can be variable, however more common symptoms that may strongly suggest the presence of cubital tunnel syndrome are numbness, pins and needles and weakness in gripping with the ring and little fingers. Struggling with fine activities such as tying shoelaces or doing up buttons can also be seen. Symptoms at night which wake you from sleep are common, as well as symptoms from long distance driving. More severe or longstanding cubital tunnel syndrome can lead to weakness and wasting of the muscles in between the hand bones and the base of the little finger.
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How do you diagnose cubital tunnel syndrome?
The diagnosis is normally made clinically following a medical history and examination. In some cases you may require some nerve tests called neurophysiology or nerve conduction studies, which look at how well the nerve is transmitting information to confirm the diagnosis.
How do you treat cubital tunnel syndrome?
As with any condition there are non operative and operative options for treatment.
Non operative treatments include activity avoidance or restriction and the use of splints. This of course is treating the symptoms rather than the cause and there are limits to the effectiveness and duration of non-operative treatment.
The operative option is to perform a cubital tunnel release. In this operation the ligament that forms the roof of the cubital tunnel is divided to relieve the pressure on the ulnar nerve as well as other structures that may compress the nerve around the cubital tunnel.
The operation is done as a day case procedure under a general anaesthetic and takes around 30 minutes to perform.