Cubital tunnel syndrome is similar to carpal tunnel syndrome insomuch that it is another nerve trapped in a tight tunnel that occurs naturally in the body.
The nerve this time is the ulna nerve and this time it’s trapped further up the arm around the elbow. This gives different symptoms to carpal tunnel. Often people complain of numbness of the little finger, decreased grip strength and also a decrease in dexterity of the hand.
When the elbow’s flexed it decreases the space for the ulna nerve by 60%. This decreases the ability of the blood supply to get the nerve which causes the symptoms.
A really common precipitant of this is office work where the elbow’s flexed a lot of the time to be allow typing on a computer and then the forearm is lent on particularly on the edge of the desk which presses the nerve even harder.
The mainstay of treatment is to avoid the irritants which cause symptoms to be worsened. This can also be helped with a night splint where the elbow is held in a slightly bent position to avoid it getting extremely flexed over the course of an evening. These are often poorly tolerated and need to be worn for a couple of months to know whether they’re working or not.
Unfortunately steroid injections to the cubital tunnel don’t work.
Surgical release of the nerve around the elbow can be performed either open or endoscopically. Recovery of the nerve is surprisingly slow as it has a long way to regenerate from the point of the elbow to the tip of the little finger. This can take two years and there has been some recent evidence that improvements can continue to happen for up to 5 years.