Cubital Tunnel Syndrome is caused by compression of the ulnar nerve at the elbow. It causes numbness and/or tingling in the ring and small fingers. These symptoms are usually the worst when you wake up in the morning. It can also happen when you're sitting in your car, in a chair or on the couch resting your elbow on the console or arm rest. It can cause decreased grip strength and coordination, causing you to drop items more often. The sensation of hitting your “funny bone” is caused by impact and therefore trauma to the ulnar nerve (notice next time you hit your funny bone, your ring finger and pinky will go numb)
So why does this happen? The ulnar nerve starts in your neck and travels down into your hand. At the elbow it travels through the “cubital tunnel”. This nerve sits nicely in its groove on the inside of the elbow. When you bend your elbow the nerve has to stretch further over the bony part of your elbow and when you straighten your arm it shortens to its resting length. The nerve can become painful in the morning because we sleep in the fetal position (elbows completely bent, hands tucked under our chin) this causes that nerve to be stretched all night long, leaving it irritated in the morning. Muscles also cross over the ulnar nerve in your forearm. If one of these muscles becomes too tight, it can cause compression of the nerve.
This nerve is very superficial and therefore can become compressed or irritated when you rest your elbow on ANYTHING (think armrests, desks, car doors/consoles or on the table while you hold your head up). The ulnar nerve can also become irritated after using vibraroty tools, prolonged sling wear, or a direct fall onto your elbow.
Prevention or management of cubital tunnel syndrome is all about protecting the ulnar nerve and allowing it to calm down. If you are experiencing the most symptoms at night/ in the morning try wearing a brace to keep your elbow straight (an occupational therapist can also make you a custom splint for the perfect fit) Symptoms when using vibratoy tools? Purchase a pair of anti vibration gloves. Pain when working on the computer all day? Check your ergonomic set up: elbows should be close to your side and less than 90 degrees bent, do not rest your elbows on your desk or chair armrests and focus on your posture.
Additionally, exercises and stretching of the wrist and elbow are important to maintain/improve range of motion and strength as well as to ensure muscle balance and stability. This can improve symptoms and help you to decrease your pain.
Still having pain? Next step would be to schedule a visit with your doctor. They can order tests of the nerve to see how severely damaged/compressed the nerve is by measuring its conduction velocity. If you demonstrate compression of the nerve they can complete surgery to either cut the roof of the cubital tunnel to allow the nerve more space or they can move the nerve and bury it in muscle- this way it is not as close to the surface and as easily irritated the bending of the elbow or direct pressure to the elbow. Occupational therapy is recommended after these surgeries to help get you back to function.
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