But what about cubital tunnel syndrome? Probably never heard of it, huh?
This other “syndrome” needs a better publicist, as it can be a serious, painful condition that affects the elbow, arm, and ring and pinkie fingers. It is caused when the ulnar nerve that passes through the cubital tunnel becomes compressed.
At Texas Neurosurgery, we treat cubital tunnel syndrome with various conservative methods. If these don’t alleviate the problem, we perform ulnar release surgery.
What is the ulnar nerve?
The median nerve, the radial nerve, and the ulnar nerve. Those are the main nerves in the arm. The ulnar nerve runs from your neck down into your hand. There are several spots where it can become constricted. Two main points are at the wrist and under the collarbone, but the most common spot is behind the inside part of the elbow. There the nerve travels through the cubital tunnel.
The cubital tunnel is made up of tissue and it runs under a bump in the bone at the inside of the elbow, called the medial epicondyle. The spot where the nerve runs under the medial epicondyle is commonly referred to as the funny bone. At this spot, the nerve is relatively close to the skin, so bumping this area causes a shock-like feeling, hitting your “funny bone.”
After it passes the elbow, the ulnar nerve travels under muscles on the inside of your forearm and into your hand on the outer side of the palm (away from the thumb).
What does the ulnar nerve control?
Unlike the median nerve involved with carpal tunnel syndrome, which controls the thumb, index, middle, and inside half of the ring finger, the ulnar nerve controls the pinky and the outer half of the ring finger. It also controls most of the muscles in the hand that control fine movements. The ulnar nerve enables us to make a strong grip, as it controls some of the bigger muscles, as well.
What causes the compression?
The ulnar nerve is susceptible to compression at the elbow where it travels through a narrow space with little soft tissue to protect it. In many cases, there isn’t a direct cause/effect for cubital tunnel syndrome, but these are common causes of compression in the ulnar nerve at the elbow:
- When our arm is bent at the elbow, it forces the ulnar nerve to stretch around the boney ridge of the medial epicondyle. If it is bent for long periods of time, this stretching can irritate the nerve, resulting in numbness in the fingers. This can happen when your arm is bent when you’re sleeping.
- The nerve can slide out from behind the medial epicondyle when the elbow is bent. Repetition of this causes irritation.
- Leaning on your elbow for long periods of time puts pressure on the nerve.
- Fluid buildup in the elbow can cause compression.
Everyone has occasional tingling and numbness in his or her pinky and ring finger associated with the ulnar nerve. But you should pay attention to this because if this continues it can lead to muscle wasting that is irreversible.
We use a variety of conservative treatments for cubital tunnel syndrome. If these don’t prove effective, and you still have nerve problems, we may need to perform a cubital tunnel release surgery.