Your elbow is a hinged joint made up of 3 bones: your upper arm bone (humerus) and the two bones in your forearm (ulna and radius). Muscles, ligaments, and tendons hold the elbow joint together, to form the joint capsule- a fluid filled sac that surrounds and lubricates the joint.
The muscles in your forearm cross the elbow and attach to the humerus. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle, while the bump on the inside of your arm is called the medial epicondyle.
The important ligaments of the elbow consist of the medial collateral ligament (on the inside of the elbow) and the lateral collateral ligament (on the outside of the elbow). These ligaments work together to stabilise the elbow, holding the humerus, radius and ulna tightly together. Another ligament called the annular ligament holds the radial head tightly against the ulna.
The tendons in your elbow attach muscle to bone. The biceps tendon attaches the biceps muscle on the front of your arm, and the triceps tendon attaches the triceps muscle to the back of your arm.
The arm consists of nerves that travel down and move across the elbow. There are three main nerves: the radial nerve, the ulnar nerve and the medial nerve. These nerves are responsible for controlling your muscles and sensations, such as touch, pain and temperature.
Cubital Tunnel Syndrome
WHAT IS CUBITAL TUNNEL SYNDROME?
Cubital tunnel syndrome (also known as ulnar nerve entrapment) is a condition that occurs when the ulnar nerve, which passes through the cubital tunnel on the inside of the elbow becomes compressed, swollen or irritated. The ulnar nerve is a nerve that crosses the elbow, and starts in the side of your neck and ends in your fingers.
WHAT ARE THE SYMPTOMS OF CUBITAL TUNNEL SYNDROME?
Numbness and tingling in the hand and fingers (ring and little finger), especially with a bent elbow are common symptoms of cubital tunnel syndrome. Other symptoms include:
- Numbness and tingling in the hand and fingers (ring and little finger) at night
- Hand pain
- Weak grip and clumsiness due to muscle wasting in the affected arm and hand
- Aching pain on the inside of the elbow
- Deformity in the hand
WHAT ARE THE CAUSES AND RISK FACTORS OF CUBITAL TUNNEL SYNDROME?
Some causes of cubital tunnel syndrome are:
- Repetitive bending of elbows such as lifting objects, pulling or reaching for something
- Frequent leaning on the elbow
- Direct impact to the inside of the elbow
- Injury to the elbow
- Bone spurs/arthritis of the elbow
- Previous injury to the elbow
WHAT IS THE DIAGNOSIS OF CUBITAL TUNNEL SYNDROME?
A history of the injury and a physical examination of the elbow and arm will be conducted by the Doctor. He will do some physical tests, such as checking on the muscle strength in your hands and fingers, and tapping the ulnar nerve at the elbow.
Imaging tests will be taken, such as an x-ray for other causes of ulnar nerve compression (bone spurs, arthritis). A nerve conduction test will also be taken to locate the point of nerve compression and an electromyogram (EMG) to measure your nerve and muscle function.
WHAT ARE THE TREATMENT OPTIONS FOR CUBITAL TUNNEL SYNDROME?
Treatment for cubital tunnel syndrome consists of both nonsurgical and surgical options. The first line of treatment is always nonsurgical treatment. These methods include:
- Resting the elbow
- Medication such as nonsteroidal anti-inflammatory drugs (NSAIDs) (ibuprofen) to reduce swelling and inflammation of the nerve
- Nerve gliding exercises
- Elbow pad to be worn during the day to protect the elbow
- Bracing to be worn during the night to keep your elbow in place and to let it heal
Should nonsurgical treatments fail to alleviate your symptoms and the nerve compression has caused severe muscle weakness, surgery may be recommended.
HOW CAN I PREVENT CUBITAL TUNNEL SYNDROME?
Some habits we can adopt to reduce the risk of getting cubital tunnel syndrome are:
- Keeping active and keep your arms flexible and strong.
- Avoid resting on your elbows, especially on a hard surface.
- Always remember to do warm up exercises before exercising or using your arms for sports activities