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Cubital Tunnel Syndrome

This is used to describe a combination of symptoms and signs that result from the compression of the ulnar nerve in the cubital tunnel. This tunnel is the space located behind the ‘funny bone’ of the elbow.

What may I notice or complain of?

You may complain of tingling, pins and needles and or numbness in the tips of the little and ring fingers as well as the inner (ulnar) side of the hand. There may be associated pain that runs up and down the inner side of the forearm. The symptoms can be brought on by normal activities such as driving, combing hair or holding the phone or activities that involve bending the elbow. Nocturnal or night symptoms can occur and disturb your sleep. Severe and long standing compression lead to wasting of the muscles of the hand.
How is it treated?

Initially non surgical methods are used to help relieve symptoms. These include splinting to be worn at nights (including wrapping a bath towel around the elbow at night to reduce bending when asleep) and anti inflammatory drugs.

Surgery to relieve compression is recommended after a failed non surgical treatment and usually in the presence of confirmed compression on nerve conduction studies.

Anaesthesia
This is usually performed under general anaesthesia.

What to expect post operatively?
A bulky dressing is placed over the area with the fingers free.

The patient can reduce the dressings in 5 days and place a simple plaster over the area.

Hand therapy is very useful and will continue for a variable period of time.

Usually there are no stitches to remove as they fall off themselves after a week.

What are some of the problems that may arise?
As with any surgery there are risks.

Infection can occur as with any surgery and is usually treated with antibiotics.

Collection of blood under the skin (haematoma) can occur especially in patients on aspirin or warfarin. It can usually be drained without much difficulty.

The scars may be tender or sensitive. Massage with cream does help and it settles with time.

Resolution of symptoms is often incomplete. The main aim of surgery is to prevent further deterioration.

When can I go back to work?
This depends on your occupation. Most patients in administrative or office posts may be able to go back earlier (2weeks) while people in heavy manual jobs may take much longer (6 weeks or more). Patients are however able to resume earlier if they can temporarily re-arrange their duties at work to be more supervisory during the convalescence.

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