Ulnar nerve entrapment (Cubital tunnel syndrome)

What is it?

The ulnar nerve is a nerve that runs from your neck and passes down the arm in a groove on the inside of the elbow. When you hit your elbow (funny bone) and get tingling into your little and ring finger it is the ulnar nerve at its tunnel that you are hitting.

The ulnar nerve helps you to grip and pinch things and it also gives you feeling in your little and ring fingers.

The groove that the nerve sits in is made up from bone and there is a ligament that holds the nerve in place by crossing from one bone to another.  When the elbow is bent it stretches the nerve and can push the nerve against the bone.

If this happens too often, or the tunnel is too tight, the nerve may be irritated and result in pins and needles and/or numbness and/or weakness in the little and ring fingers of the hand.

These symptoms are often worse on the telephone, resting the head on the hands and curling the arm under your body when sleeping at night.

How can you help yourself?

Every time the elbow is bent the nerve is tightened and the blood supply to the nerve is reduced. There are a few hints below that can help you stop putting pressure on this nerve

  • Avoid crossing your arms over your chest
  • When talking on the phone watch how much the elbow is bent, if you use the phone regularly a hands free or cradle attachment would be best
  • Alter your sleeping position so the elbow is straight
  • Elbow splints to keep the elbow straight
  • Adjust your desk position so your elbows are not bent past 30 degrees
  • Avoid resting on elbows on the table

How can physiotherapy help?

Physiotherapy can help by getting the nerve moving/gliding along its path to try and prevent it from being caught up within the tunnel. Your physiotherapist can also help you to analyze your working environment, sport and lifestyle to give you helpful information to ease the pressure on the nerve.

Surgery

Surgery may be offered to release the pressure on the nerve. This is performed through a wound at the back of the elbow. The nerve is carefully identified and the tight tunnel released. This is usually day case surgery, often with a general anaesthetic. After surgery the wound may be sensitive for several weeks. Nerve recovery can be slow, but often pins and needles in the hand may start to settle in 1 to 2 weeks.