Cubital Tunnel Syndrome

Cubital tunnel syndrome is a condition where the ulnar nerve becomes compressed or irritated as it passes through a narrow space on the inside of the elbow called the cubital tunnel.

The ulnar nerve runs from the neck, down the arm and into the hand. At the elbow, it lies very close to the surface, right where you feel that sharp, tingling pain when you bump your “funny bone.” When this nerve gets pinched or stretched too often, it can lead to symptoms like forearm pain, numbness or even muscle weakness in the hand.

This condition is also called ulnar nerve entrapment at the elbow and is the second most common nerve compression in the arm (after carpal tunnel syndrome).

What Leads to Cubital Tunnel Syndrome?
The ulnar nerve is particularly vulnerable at the elbow because of its anatomy. When the elbow stays bent for long periods or endures repeated pressure, the nerve can become compressed.

Common causes and risk factors:

• Frequent bending of the elbow (e.g., holding a phone, sleeping with the elbow bent)
• Resting the elbow on hard surfaces for long periods
• Previous elbow injury or arthritis
• Repetitive work that involves flexing the arm
• Muscle or bone abnormalities that put pressure on the nerve
  
  

Some people are simply more prone to it due to natural anatomy, such as having a tight cubital tunnel or a nerve that slips out of place when the elbow bends.

What Does Cubital Tunnel Syndrome Feel Like?
Symptoms of cubital tunnel syndrome usually affect the sensation of the ring and little fingers, which are controlled by the ulnar nerve, and movement of some muscles in the hand and forearm.

Common signs and symptoms:

• Numbness or tingling in the ring and pinky fingers
• Hand pain or discomfort, especially when the elbow is bent
• Weakened grip strength or hand clumsiness
• Muscle wasting in the hand (in severe or long-term cases)
• Symptoms that worsen at night or when resting elbows on a surface
  
  

Many patients report that their arm feels like it’s "falling asleep" or tingling after prolonged elbow bending.

How Is Cubital Tunnel Syndrome Identified?
Diagnosis begins with a physical exam. Your provider may tap the nerve at the elbow (similar to testing your funny bone) or assess sensation and strength in your hand.

To confirm the diagnosis and evaluate the severity, your doctor might order:

• Nerve conduction studies (NCS): Measures how well electrical signals travel through the nerve
• Electromyography (EMG): Checks muscle function and detects nerve damage
• X-rays or ultrasound: To check for bone issues or nerve instability
  
  

These tests help determine how much the ulnar nerve is being compressed and whether permanent damage has occurred.

Non-Surgical Treatments for Cubital Tunnel Syndrome
If caught early, many cases of cubital tunnel syndrome can be managed with simple changes in posture and activity.

Common non-surgical treatments include:

• Night splint or elbow brace to keep the elbow straight during sleep
• Avoiding prolonged elbow bending (like phone use or sleeping with a bent arm)
• Ergonomic adjustments at work to reduce elbow pressure
• Anti-inflammatory medications to reduce swelling and irritation
• Nerve gliding exercises prescribed by a physical or occupational therapist
  
  

Surgical Treatment

When Is Surgery Needed?

If non-surgical treatments don’t work, or if symptoms become more severe, your provider may recommend surgery to relieve pressure on the ulnar nerve.

Common surgical options:

• Ulnar nerve decompression: Releases pressure by opening the cubital tunnel
• Ulnar nerve transposition: Moves the nerve to a safer location in front of the elbow
  
  

Surgery is usually done on an outpatient basis, and recovery includes activity restrictions, bracing, and possibly hand therapy.

How to Avoid Cubital Tunnel Syndrome
While not all cases are preventable, smart habits can help reduce your risk, especially if your job or activities involve frequent elbow use.

Prevention tips:

• Avoid resting elbows on hard surfaces (use padding or armrests)
• Don’t sleep with your elbows tightly bent. Instead try a night brace if needed.
• Stretch and move your arms regularly if working at a desk or driving long hours
• Use a headset instead of holding a phone between your ear and shoulder
• Strengthen surrounding muscles with supervised hand therapy exercises
  
  

Simple changes in posture and hand position can help protect your ulnar nerve from pressure and irritation.

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