Treatment Options for Cubital Tunnel Syndrome

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Cubital tunnel syndrome may not be as common or widely known as carpal tunnel syndrome, but the symptoms associated with it can be just as troublesome. Cubital tunnel syndrome is caused by compression on the ulnar nerve as it crosses the inside of the elbow. Symptoms include a vague feeling of pain in the elbow or forearm and numbness/tingling in the small and ring fingers. Symptoms are often worse at night and with activities such as driving, typing, and talking on the phone. Treatment options include the following:

Conservative Treatments

Cubital tunnel syndrome is often made worse when the elbow is held in flexion (as when holding a phone to the ear, for example). The first step in treatment is therefore to avoid prolonged periods of elbow flexion. We often sleep with our elbows bent, so an elbow brace worn at night can be effective at curbing nighttime symptoms and can make the nerve less irritable during the day. Using a Bluetooth earpiece and making ergonomic adjustments to your computer workstation may also help to keep your elbows relaxed. Over-the-counter anti-inflammatory medications can be helpful as well, but should not be taken indefinitely.

Surgical Treatments

If conservative treatments are not effective enough, there are two surgical options for cubital tunnel syndrome:

  • Cubital Tunnel Release: In this procedure, an incision is made in the fascia overlying the nerve at the elbow, in order to relieve pressure on the nerve. The incision is relatively short (about 2 inches), and the recovery is usually fairly quick. About 90% of patients will experience relief with this procedure, which is usually recommended as the first step in the surgical treatment of cubital tunnel syndrome.
  • Ulnar Nerve Transposition: Some patients (about 10%) still have symptoms after cubital tunnel release and require a more extensive procedure. In ulnar nerve transposition, the nerve is moved to the front of the elbow and is buried under a cushion of muscle in the forearm. This requires a longer incision (about 4 inches), and recovery takes longer due to the more extensive dissection.

Ultimately, the vast majority of patients report significant, long-term improvement of their symptoms following surgical treatment for cubital tunnel syndrome.