Tingling Fingers or a Numb Hand? It May Be Ulnar Nerve Entrapment

You’ve certainly felt it — that painfully electric, tingling sensation in your elbow and arm after you hit your funny bone. This feeling is caused by a temporary triggering of a nerve response, but for some of us, the sensation is chronic and is often accompanied by other enduring symptoms.

These persistent pains may be the result of a condition called ulnar nerve entrapment, or cubital tunnel syndrome, and they can occur due to repetitive stress, injury, or even as a result of your favorite pastime. They are certainly more serious than the discomfort caused by the occasional bump to the elbow, yet they’re still highly treatable.

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Nerve Compression Syndrome

Cubital tunnel syndrome is a type of nerve compression syndrome that occurs when the ulnar nerve becomes irritated, compressed, or inflamed. The ulnar nerve runs from your neck through a tight tunnel of muscle, ligaments, and bone in the elbow — the cubital tunnel — and eventually ends in your fingers. When this nerve becomes consistently reactive, it is called cubital tunnel syndrome or ulnar nerve entrapment. 

The ulnar nerve functions to help you move your forearm, hand, and fingers. It lies close to the surface of the skin and sends your brain sensory information regarding pain, touch, and temperature. According to the National Institute of Health’s National Center for Biotechnology Information, ulnar nerve neuropathy is second only to carpal tunnel syndrome as the most common neuropathy of the arm. Like carpal tunnel syndrome, cubital tunnel syndrome has many potential causes, most of which are orthopedic. 

Cubital Tunnel Syndrome Causes

Cubital tunnel syndrome may result from our everyday activities, whether work or play. Frequent reaching, pulling, or lifting during sports like tennis, golf, baseball, and weightlifting can cause this syndrome. It may occur due to repetitive motions performed at work, such as hammering or typing, or consistent pressure on the wrists, as in bicycling. Even sleeping with your arms always bent can bring on cubital tunnel syndrome. 

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Cubital tunnel syndrome has many potential causes:

  • Extended time spent with elbow bent
  • Excessive leaning on the elbows, especially on hard surfaces
  • Direct blow to the elbow
  • Prior injury to the elbow, such as a fracture or dislocation
  • Arthritis in elbow or neck
  • Repeated pressure on wrists
  • Bone spurs or cysts
  • Elbow instability (when the cubital tunnel is too loose and the nerve moves more than it should)
  • Nerve swelling or inflammation caused by other medical conditions 

Cubital Tunnel Syndrome Symptoms 

Regardless of the cause, many patients with cubital tunnel syndrome will experience a similar range of symptoms, such as:

  • “Pins and needles” feeling in forearm and hand, especially when elbow is bent
  • Reduced sensation or loss of sensation (numbness) in ring finger and/or pinky finger 
  • Aching or tenderness on the inside of the elbow 
  • Popping or snapping feeling on the inside of the elbow
  • Hand or wrist pain
  • Weak grip/frequently dropping things due to loss of muscular strength
  • Difficulty with fine motor tasks such as writing with a pen or buttoning a shirt
  • Sensitivity to cold 

Cubital Tunnel Syndrome Treatment

Symptoms of cubital tunnel syndrome may start out mild and worsen over time. Many patients benefit from non-surgical interventions, such as rest and pain-relieving, anti-inflammatory medications.

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In prolonged or severe cases, surgery may be necessary. It is important to see a doctor and undergo any necessary cubital tunnel syndrome tests to determine your best treatment options. 

Non-Surgical Treatment of Cubital Tunnel Syndrome

  • Take a break from and/or stop performing any activity that aggravates the condition
  • Avoid leaning on your elbows, or use an elbow pad when you rest them on a hard surface
  • Perform occupational therapy to strengthen the ligaments and tendons in the hands and elbows
  • Wear a splint or elbow brace to keep your arm straight and reduce irritation
  • Try cubital tunnel syndrome exercises to keep your arms flexible and strong
  • Talk to your doctor about pain relieving, anti-inflammatory medicines (such as ibuprofen or high-dose aspirin)

Surgical Treatment of Cubital Tunnel Syndrome

In prolonged cases or if you’re experiencing severe pain, surgical treatment may be necessary. 

Nerve decompression surgery is used to release the tight cubital tunnel at the area of nerve compression, commonly the elbow and occasionally the wrist. In cases where the nerve is unstable and tends not to stay in its normal location, nerve transposition may be recommended. This procedure is implemented to move the nerve out of the tunnel and secure it in a safer location.

Cubital tunnel syndrome has a variety of symptoms, many potential causes, and is highly treatable. Mechanical issues such as repetitive movements from a sport or job, prior injury, or even improper posture when working or sleeping can cause the pain and irritation of this syndrome.

It’s important to determine what’s causing your pain so you can correct the underlying issue. While it may be possible to treat the condition at home, you should talk to an orthopedic elbow specialist to receive a proper treatment plan tailored to the duration and severity of your symptoms.

If you’re experiencing numbness or tingling in your hands, fingers, or arms, and would like to talk to an orthopedic surgeon about your symptoms, please feel free to contact us.

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