Patient with doctor assessing elbow

Ulnar Nerve/Cubital Tunnel Syndrome Treatment

Certain nerves are particularly prone to becoming compressed due to the way the surrounding bones are structured. The ulnar nerve is one of these. It runs over one of the elbow bones very close to the surface of the skin.

People often refer to this area as “the funny bone” because of the strange sensation you get if you hit the bumpy part of your elbow. The feeling is not actually caused by a bone at all but by the ulnar nerve which travels down the inside of the arm to the hand. When you move many of the muscles in your hand, it is your ulnar nerve that you use to do it. It carries sensations to your ring finger and little finger, part of your palm and the back of your hand.

What is cubital tunnel syndrome?

The narrow space inside the elbow joint that the ulnar nerve passes through is caused the cubital tunnel. It runs across the elbow joint and comprises the bones of your elbow and your forearm muscles. Cubital tunnel syndrome develops when the nerve becomes compressed or irritated. Read our blog Ulnar Nerve/Cubital Tunnel Syndrome Symptoms for an explanation of the condition, its causes and the symptoms to look out for.


Diagnosis of Cubital Tunnel Syndrome

It is important to get a proper diagnosis as, left untreated, severe cases of cubital tunnel syndrome can cause permanent loss of sensation in the hand or weakness and reduction in the size of muscles in the hand and base of the little finger. We offer nerve conduction tests and electromyography tests to assess for nerve damage, plus ultrasound or MRI scans to check for injuries or structural abnormalities


Treatment Cubital Tunnel Syndrome

In mild cases, you can normally treat cubital tunnel syndrome by being mindful of the position of your elbow, and of the activities that result in symptoms. Avoiding having the elbow bent for long periods, such as when using a mobile phone, is important.  At night, many side-sleepers find hugging a pillow to be helpful. Splints which prevent bending the elbow are also available.  Taking painkillers or anti-inflammatories, doing exercises recommended by a physiotherapist, or, in rare cases, having painkilling injections can be helpful.

In some cases, however, you may need surgery to relieve the most severe symptoms.


What is nerve decompression surgery?

Nerve decompression surgery can be used to relieve pressure on nerves that have become trapped or compressed. The aim is to open up narrow spaces to give the nerves more room, or to remove whatever is pressing on the nerve. This type of surgery has good success rates however recovery depends on how severe the condition is and how much of the ulnar nerve is affected. As with all surgery, there is a small risk of infection, scar sensitivity or worsening of symptoms.


What to expect in cubital tunnel decompression

Cubital tunnel decompression surgery is normally performed under general anaesthetic, because the surgery is delicate and the length of the scar needed for complete decompression needed is variable and dependent on the findings during the the operation. An incision is made on the inner side of the elbow so the surgeon can access the ligament and muscle that forms the roof of the cubital tunnel. This ligament and muscle will be carefully opened up to reduce pressure on the nerve.

Sometimes when we access the ulnar nerve we discover that it is moving incorrectly over the bone when the elbow is bent. If this is the case we will move the nerve to a more secure position nearer the front of the elbow in a procedure known as transposition.

You will need to wear a bandage and sling for a few days after surgery. We normally use dissolving stitches so you will not need to have them removed. You will need to keep the wound covered and we will check how well it is healing after around two weeks. A few days after surgery, you will be able to remove the sling and begin gentle exercises to strengthen the area and improve flexibility.

 


What is neurolysis?

Sometimes a nerve may be unable to move properly due to the formation of scar tissue. This normally occurs if you have been involved in an accident or had previous surgery. If this is the case, we can perform a microsurgical procedure called neurolysis to release scar tissue so the nerve can move more smoothly.

If you have symptoms associated with cubital tunnel syndrome (pain in the arm, hands and/or fingers, tingling and numbness on the affected side or a weakened grip) talk to us about getting a diagnosis. If you have already been diagnosed with cubital tunnel syndrome, we can advise on the different treatment options, including surgery.


Orthopaedic Consultant & Surgeon | London

Thames Shoulder & Elbow are able to provide advice and support to anyone experiencing symptoms affecting the upper limbs (shoulder, upper arm, elbow, forearm and wrist).

Telephone: 020 376 15987

Email: admin@thamesshoulderandelbow.co.uk

Our Locations

Hospital of St John and St Elizabeth, St John’s Wood – Directions
BMI The Syon Clinic, Brentford – Directions
HCA Chiswick Health Centre, Chiswick – Directions
West Middlesex University Hospital, Chelsea and Westminster Foundation Trust, Isleworth – Directions