Huw David

Elbow - Cubital Tunnel Syndrome

We have all suffered the misfortune to catch our funny bone and experienced an electric shock in the arm. The funny bone is in fact the Ulnar Nerve and is prone to being caught as it passes behind the elbow joint. However unpleasant catching the nerve may be, the sensation passes within a few moments. Compression of the nerve as it passes behind the elbow through the Cubital Tunnel leads to recurrent or persistent symptoms that may require surgery. The ulnar nerve provides sensation to part of the hand, typically all of the little finger and usually part of the ring finger. Compression of the nerve will initially give rise to pins and needles in these digits leading to numbness if the compression becomes severe. The nerve becomes inflamed or “irritable” and symptoms are likely to develop quickly when pressure is applied to the joint as when resting on the point of the elbow or when the arm is bent for long periods and thus sleep disturbance is common. The nerve also has an important role in supplying a number of muscles in the hand and individuals suffering with cubital tunnel syndrome may also experience a general loss of strength in the hand. Symptoms occasionally develop because the nerve is unstable and flicks in and out of its’ normal position on movement of the joint. Ulnar nerve symptoms are also commonly encountered in arthritis of the joint.

Establishing the correct diagnosis is not a complex matter, but it is important to distinguish between compression of the nerve at the elbow rather than elsewhere in the arm, as for example at the wrist and a nerve test (EMG) may be indicated. It is also important to ensure that symptoms in the hand are not due to Carpal Tunnel Syndrome, a very common condition resulting from compression of a neighbouring nerve at the wrist.

Treatment usually involves surgery to release the nerve and occasionally move it to the front of the elbow and so out of harms way. Surgery is usually performed on a day case basis.