In our body, there is a nerve called the ulnar which runs from the neck to the hand. It aids muscle control and feeling in the forearm, hand, and fingers. When that nerve is inflamed or squeezed, cubital tunnel syndrome develops. If left untreated, a depressed ulnar can produce a variety of unpleasant and severe symptoms, including muscular atrophy.
The ulnar runs through the cubital tunnel, a tissue tube that runs beneath the medial epicondyle, and a bony bump on the inside of the elbow. The space is small, and only a thin layer of tissue protects it. The ulnar nerve is especially sensitive in that area. The ulnar nerve makes its way to the hand by passing through the muscles of the forearm to reach the hand on the side of the little finger after passing through the medial epicondyle (pinky). When it reaches the hand, it passes via Guyon’s canal, another tunnel.
We can control some of the larger muscles in the forearm (Ones that help to grip objects), be aware of the little finger and half of the ring finger, and have the ability to control most of the muscles in the hand all thanks to the ulnar nerve. Fine actions like typing on a keyboard or playing a musical instrument are all made possible by the muscles in the hand.
Cubital tunnel syndrome, also known as ulnar nerve entrapment, occurs when the ulnar nerve on the inside of the elbow becomes inflamed or compressed (squeezed).
Nerves are bundles of string-like fibers that use electrical and chemical changes in the cells to transmit and receive messages between the brain and body. The median, ulnar, and radial nerves are the three primary nerves in the arm. The ulnar nerve runs from the neck to the arm and hand.
If the ulnar nerve is constricted or inflamed at the elbow, one may have cubital tunnel syndrome. The nerve may be impacted further up the arm or even at the wrist. The possible causes of depression of the ulnar nerve include the following:
– Anatomy: The soft tissues surrounding the ulnar nerve may thicken over time, or there may be more muscle. Both of these disorders can induce cubital tunnel syndrome by preventing the nerve from functioning properly.
– Pressure: The ulnar nerve can be compressed by seemingly simple actions such as leaning one elbow on an armrest. The arm, hand, ring finger, and pinky finger may fall asleep if the nerve gets pinched.
– Snapping: The ulnar nerve may not stay in place as it should. When one moves it, it may snap across the medial epicondyle. The nerve is irritated by snapping it repeatedly.
– Stretching: If one bends their elbow for an extended period of time, such as while sleeping, they risk overstretching the nerve. Cubital tunnel syndrome can be caused by excessive stretching.
If one experiences the symptoms quoted below for more than six weeks or the symptoms get intense, it’s highly advised to consult a doctor because If one waits too long to treat the compressed nerve, they risk losing muscle mass in their hand. If they do receive therapy, their symptoms will soon improve or disappear.
Cubital tunnel syndrome causes the following symptoms:
– Tingling sensation and numbness in hand and fingers which comes in waves
– When numb, it’s difficult to move the fingers
– Aching of the insides of the elbow.
The most prevalent symptoms are inner elbow pain and numbness and tingling in the hand. When the elbow is bent, these symptoms are most likely to happen which is the case while driving, holding a phone, or sleeping.
The diagnosis of cubital tunnel syndrome involves the following in addition to a thorough medical history and physical examination:
– Nerve conduction test: A test to determine how quickly signals flow down a nerve in order to determine whether the nerve is compressed or constricted.
– Electromyogram (EMG): This test examines nerve and muscle function and can be used to assess the ulnar nerve-controlled forearm muscles. If the muscles aren’t working properly, it could be a symptom of a problem with the nerve.
– X-ray: This procedure examines the bones of the elbow to look for symptoms of arthritis (rheumatoid / osteoarthritis) or bone spurs.
While the treatment of cubital tunnel syndrome is concerned, non-surgical methods are given preference by medical professionals. The most popular non-surgical methods to treat carpal tunnel syndrome include the following:
– Splinting: Braces or splints when worn around the elbow helps to keep it straight and hence prevent the nerve from getting depressed
– Exercise: There are several hands and arm exercises that can help relieve tension from the nerves and muscles and can go a long way in providing relief in the case of cubital tunnel syndrome.
– Hand therapy: A hand therapy by a professional can help one learn ways by which they can prevent unnecessary stressing of the nerve
– NSAIDs: Medications like ibuprofen can help reduce the swelling surrounding the nerve and hence provide relief
If the non-surgical methods fail to provide relief to the condition, or if the nerve is compressed to the point where it is causing muscular atrophy, surgery becomes the need of the hour. The most commonly implied surgical methods are
– Cubital tunnel release: A ligament runs along the top of the cubital tunnel, this ligament is sliced and divided in this procedure, resulting in expansion of the tunnel and relieving pressure on the ulnar nerve. Where the ligament is cut, new tissue will grow.
– Ulnar nerve anterior transposition: During this procedure, the surgeon will relocate the ulnar nerve from the back of the medial epicondyle to the frontal part. Thus the surgery prevents the nerve from becoming entrapped in the bone.
– Medial epicondylectomy: This procedure involves removing a portion of the medial epicondyle to free up the nerve.
These treatments often don’t require hospitalization, but one may need to stay in the hospital for one night. The arm will most likely need to be splinted for two to three weeks. Physical treatment may be required to regain the range of motion and strength.
Although cubital tunnel syndrome cannot be prevented, there are a few things one can do to lower the risk:
– Do not lean on the elbow.
– Avoid exerting pressure on the insides of the arm.
– Keep the seat up.
– Keep the elbow straight while sleeping.
– Avoid anything that requires bending the arm for an extended period of time.
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