Cubital Tunnel Syndrome

What Is Cubital Tunnel Syndrome?

If you have ever hit your “funny bone,” you have felt the telltale tingling sensation in your ring and little fingers created by an insult to your ulnar nerve. If you have inflammation in the cubital tunnel, you may feel a similar numbness, tingling, and pain in the ring and little fingers because the swelling causes pressure on the ulnar nerve. 

On its way from the upper arm to the forearm, the ulnar nerve passes through the cubital tunnel, which is located on the inside of the elbow. The ulnar nerve is directly connected to the little finger, and the adjacent half of the ring finger, supplying the palm side of these fingers, including both front and back of the tips.  

At the Yale Hand and Microsurgery Program, we offer surgical and non-surgical treatment for cubital tunnel syndrome. Because damage to the cubital tunnel is related to repetitive tasks, we take a comprehensive approach to problems developed in the workplace. 

Causes of Cubital Tunnel Syndrome

Cubital tunnel syndrome is caused by increased pressure on the ulnar nerve as it passes through this tunnel. The ulnar nerve normally stretches a few millimeters every time the elbow is flexed. If your work, daily activity, or pastimes require repeated flexion of the elbow, the ulnar nerve can become irritated and inflamed. Other causes include direct pressure on the elbow, trauma, injury, or any activity that requires you to hold your elbow in a bent position for long periods of time. 

The nerve can also move from its original position in the tunnel to a place outside the tunnel, leading to continued irritation and inflammation. 

At the Yale Hand and Microsurgery Program, we will help determine the cause of your cubital tunnel syndrome, so that we can incorporate modifying specific work and daily activities as an important part of your treatment plan. 


Symptoms of Cubital Tunnel Syndrome

Even mild symptoms of cubital tunnel syndrome can be irritating. 

If you have cubital tunnel syndrome, you may experience some of the following symptoms: 

  • Numbness, tingling, and pain in the elbow, forearm, hand, and/or fingers
  • Numbness of the little and half of the ring fingers
  • “Electrical shock” sensations down to the fingers when tapping the bump of bone on the inner portion of the elbow
  • Pain when bending the elbows sharply
  • Weakness of the hand muscles (in more severe cases)

You will probably feel the symptoms when there is pressure on the nerve, such as when you are repetitively bending and straightening your elbow. Symptoms can flare when you hold your elbow in a bent position for a long period of time, as in holding a phone or while sleeping. 

If you think you may have cubital tunnel syndrome, our doctors can diagnose and assess the severity. Some diagnostic tests may include an MRI, radiography, and high-resolution ultrasonography.

This list should be used as a guideline. Not every symptom is included. If you or a loved one has one or more of these symptoms, it does not mean that he or she has cubital tunnel syndrome. If you are concerned that you or a loved one might have cubital tunnel syndrome, please make an appointment with your doctor.


Treatments for Cubital Tunnel Syndrome

It is natural to be concerned that you can only find relief from cubital tunnel syndrome symptoms through surgery. However, not all patients will require surgery.

If your cubital tunnel syndrome is mild, you may be able to treat it by restricting elbow movement, by modifying your work, by protecting your elbow, and with anti-inflammatory medicine. 

If you have weakness of the hand, atrophy of the hand muscles, or permanent numbness, surgery is the recommended treatment of choice. 

At the Yale Hand and Microsurgery Program, we offer you comprehensive care and the latest surgical techniques to treat cubital tunnel syndrome. Treatment is an outpatient surgery in which we release the regions of nerve compression and relocate the ulnar nerve to an area that is better protected and causes less stretch on the nerve when the arm is straightened. 

J. Grant Thomson, MD, FRCS, FACS and Michael Matthew, MD have special interests in hand surgery, wrist surgery, microsurgery, and occupational disorders of the upper extremity.