Peripheral nerve conditions

Ulnar nerve syndrome, otherwise known as cubital tunnel syndrome, is a medical condition in which pressure impacts the ulnar nerve. This nerve runs from the top of the shoulder to the hand and provides the hand with movement and sensation.

Compression most commonly occurs inside the elbow where the ulnar nerve passes through the cubital tunnel under the medial epicondyle bone.

It is sometimes difficult to know why this syndrome occurs, but because the passage that the ulnar nerve travels through is very slim with little tissue, it can easily happen. It may happen after bending or leaning on an elbow for prolonged periods, or if fluid builds up in the area after an elbow injury.

What are symptoms of ulnar nerve syndrome?

Symptoms of ulnar nerve syndrome include:

• numbness and tingling in the ring and little fingers
• a weakened grip
• difficult coordinating your fingers

How is ulnar nerve syndrome treated?

Once the ulnar nerve is compressed for an extended period, hand muscles may waste irreversibly. It is important to see a neurosurgeon to assess and provide treatment before this occurs. A neurosurgeon can diagnose this syndrome by analysing a person’s medical history, doing physical examinations and ordering tests.

A neurosurgeon will likely start by advising nonsurgical treatment. Ulnar nerve compression can be treated by not bending your elbow for long amounts of time, including when you sleep, and not leaning on your elbow. Other nonsurgical treatment may include splints and anti-inflammatory medicine.

If the condition does not improve or it is severe, a neurosurgeon can provide surgery known as a ulnar nerve decompression or a cubital tunnel release. This creates more room for the ulnar nerve.

Images by Injury Map under a Creative Commons license.

Sources

1. Palmer, B. A., & Hughes, T. B. (2010). Cubital tunnel syndrome. The Journal of hand surgery, 35(1), 153-163.
2. Coppieters MW, Bartholomeeusen KE, Stappaerts KH: Incorporating nerve-gliding techniques in the conservative treatment of cubital tunnel syndrome. Journal of manipulative and physiological therapeutics 27:560-568, 2004.
3. Mowlavi, A., Andrews, K., Lille, S., Verhulst, S., Zook, E. G., & Milner, S. (2000). The management of cubital tunnel syndrome: a meta-analysis of clinical studies. Plastic and reconstructive surgery, 106(2), 327-334.
4. Queensland Health, The ulnar nerve.