Common Nerve Problems in the Elbow -- Cubital Tunnel Syndrome (Q&A)

By: Howard County General Hospital

Hi. My name is Dr. Khurram Pervaiz.

I am a shoulder, elbow and hand specialist with the Orthopedic Associates of Central Maryland and I work at Howard County General Hospital. There are several nerves around the elbow. There is the ulnar nerve, the radial nerve and the median nerve.

The one that's most commonly affected is the ulnar nerve, the nerve that crosses the inside of the elbow. This nerve can travels through a tunnel and when the tunnel gets narrow the condition, also known as cubital tunnel syndrome can give you pain, numbness and tingling from the elbow radiating down into the hand. So the ulnar nerve is the main nerve on the inside of the elbow, also known as the funny bone. So, when one would hit their elbow on something hard and you get a numbness and tingling in your little finger, you've essentially hit the ulnar nerve. This condition can sometimes be confused with carpal tunnel syndrome. In fact the symptoms can overlap.

I frequently see patients with both carpal and cubital tunnel syndrome having a pinched nerve around the wrist as well as around the elbow. This is why it's important for you to be evaluated by an upper limb specialist, somebody that specializes in treatment of such conditions. Frequently, a nerve test also known as an EMG or a nerve conduction study is necessary to assess the severity of the nerve compression around the elbow.

Common Nerve Problems in the Elbow -- Cubital Tunnel Syndrome (Q&A)

Symptoms of cubital tunnel syndrome are nerve compression around the elbow, are frequently pain on the inside of the elbow that radiates down into the little finger and half of the ring finger. It can give you numbness and tingling. A lot of my patients tell me it wakes them up in the middle of the night, bothers them when they're driving. This has also been coined as cellphone elbow because when you hold a cell phone up to your ear and you have your elbow bent for a long period of time people will have numbness and tingling in the little finger. That can be one of the early signs of cubital tunnel syndrome. An EMG or a nerve conduction study is a specialized test frequently done by somebody that specializes in nerve conduction studies..the arm um..

Physicians that train in something like this can be physical medicine and rehab specialists or neurologists. Cubital tunnel syndrome in the early stages can be treated with rest, a night splint that keeps your elbow straight at night and then through behavioral modification... Basically avoiding too much elbow flexion during the day, although, that can sometimes be difficult because almost all of us during day to day activities at work or at home require a bent elbow.

Surgery for cubital tunnel syndrome is indicated when pain, numbness and tingling is not relieved with medical management and or if the nerve study were to show you have severe cubital tunnel syndrome especially if the nerves are so irritated or diseased that you were starting to get muscle weakness or muscle atrophy in the hand. I do see patients in my practice who have such severe weakness in the hand that they are starting to drop things In a case like that surgery is usually the first step. Surgery for cubital tunnel syndrome through an incision on the inside of the elbow and through that incision the nerve is decompressed. The goal of the surgery is to take pressure off the nerve. Sometimes, the nerve has to be moved to the front of the elbow to avoid the nerve from getting kinked.

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