Cubital Tunnel Syndrome
Cubital tunnel syndrome is a condition involving compression or stretching of the ulnar nerve (area of the lower arm, near the elbow), which causes numbness in the ring finger and little finger, pain in the lower arm that may be accompanied by weakness in the hand. The ulnar nerve runs along the inner side of the elbow.
Cubital Tunnel Syndrome Symptoms
Most people with cubital tunnel syndrome experience the following symptoms:
- Pain, tingling, and weakness in the lower arm and some fingers.
- Weakness of muscle strength.
- Waking up at night due to pain or tingling in the hands or fingers, especially the ring and index fingers.
- Difficulty bending and straightening the elbow.
- Difficulty moving hands or fingers.
- Loss of muscle strength in the hands and fingers.
Risk Factors for Cubital Tunnel Syndrome
Some risk factors for cubital tunnel syndrome include:
- Head injury involving the upper limb area.
- Age over 40 years.
- Activities involving certain movements such as throwing.
- Jobs that require prolonged elbow bending, such as telephone operators.
- Resting the elbow area on a hard surface for long periods of time.
- Having a cyst near the elbow joint.
- History of elbow dislocation and fracture.
- Obesity.
Causes of Cubital Tunnel Syndrome
There are several causes of this ulnar nerve disorder. Some of them include:
- Pressure. Nerves have little cushioning over them. Direct pressure (such as resting your arm on an armrest) can put constant pressure on the nerve, depriving the arm and hand below it of the nerve that supplies it.
- Stretching. Keeping your elbow bent for a long time can stretch the nerves behind your elbow. This often happens when we sleep, where sometimes the elbow is in a bent position for a long time.
- Anatomical location. Sometimes the ulnar nerve is out of place. Repetitive movements at the elbow can irritate the nerve. Sometimes the soft tissue around the nerve is thicker or there is extra muscle above the nerve, which can interfere with the nerve’s function.
Diagnosis of Cubital Tunnel Syndrome
Diagnosis can be made by looking at the patient’s history and physical examination, followed by supporting examinations.
Supporting examinations that can be carried out include:
- USG. The examination is performed to see the position of the ulnar nerve in the elbow area.
- MRI. Looks at structural changes in the ulnar nerve and its surroundings.
- X-Ray. The examination is done to see the condition of the elbow bone and check the condition of the joints.
- Nerve Conduction Test. This test measures how fast signals travel down a nerve to find nerve compression or narrowing.
- Electromyogram (EMG). This test is performed to confirm nerve and muscle function by testing the forearm muscles controlled by the ulnar nerve. If the muscles do not work according to their function, this indicates a problem.
Complications of Cubital Tunnel Syndrome
When left untreated, cubital tunnel syndrome can cause muscle weakness and loss of pain, and sensory loss in the hand and forearm.
Cubital Tunnel Syndrome Treatment
The most effective treatment for cubital tunnel syndrome is to stop activities that trigger symptoms.
For most cases of cubital tunnel syndrome, doctors prescribe a splint or protective elbow pad to wear overnight, namely:
- Elbow protectors. Hard elbow protectors can be used to keep the elbow in a fixed position, along with activity patterns to soften the elbow area.
- Surgery. Performed if symptoms worsen and persist for more than 6 months. If the symptoms get worse and do not respond to various types of treatment, then the option of surgery becomes important.
In addition, treatment is also carried out to reduce symptoms, such as:
- Administration of anti-inflammatory drugs, such as ibuprofen and naproxen.
- Steroid injections to reduce swelling and pain.
Cubital Tunnel Syndrome Prevention
Prevention can be done in the following ways:
- Limit activities that may make the condition worse, such as playing tennis or golf.
- Do not lean on your elbows while driving or sitting.
- Keep your arms straight while resting.
- Use a splint while sleeping to prevent the arm from becoming bent.
- Prevent injury to the elbow area.
- Avoid resting your elbows for too long, especially on hard areas.
- Do warm-ups or light movements before doing activities that involve intense elbow use.
If you are experiencing pain or difficulty moving that is affecting your daily activities, you should get checked out right away.