QUESTION: A 43 year old lady is complaining of pins and needles and numbness in her ring finger and little finger when she is talking on the phone/reading and when she is at work using a computer. It also wakes her at night. She is starting to lose dexterity and coordination in her hand.
What is it?
Cubital Tunnel Syndrome is the compression of the ulnar nerve as it passes through the cubital tunnel at the elbow. It is often referred to as the ‘funny bone’. The ulnar nerve supplies sensation to the ulnar border of the forearm/hand, the little finger and half of the ring finger. Compression of the nerve can cause symptoms such as numbness, pins and needles, tingling, and pain.
Cubital Tunnel Syndrome can be worse at night/during activities where the elbow is in a flexed posture for prolonged periods of time. Other things that may aggravate symptoms include leaning on the elbow/forearm and repetitive elbow movement.
Weakness, loss of coordination and dexterity can occur as the ulnar nerve innervates the small muscles of the hand. In severe cases, muscle wasting can be seen in the hand and a ‘clawing’ deformity of the ring and little fingers can occur.
Clinical Examinations
Your therapist can assess you for Cubital Tunnel Syndrome. Sometimes nerve conduction testing is useful, your hand therapist can advise you whether this is required.
Treatment
Most people with Cubital Tunnel Syndrome will respond well to an elbow splint, and instruction in various self-management strategies along with exercises.
A hand therapist will provide you with:
- Advice about appropriate activity modifications and workstation ergonomics
- Ulnar nerve gliding exercises to reduce nerve irritability
- A thermoplastic or soft splint to limit elbow flexion and provide protection and support.
- This may need to be worn full time or just at night time when sleeping
- Graded strengthening exercises when appropriate
Surgical Treatment
Surgical review may be required depending on your response to conservative treatments after hand therapy. Your therapist will be happy to discuss with you and your GP whether referral to a hand surgeon is appropriate.
If you have any questions regarding Cubital Tunnel Syndrome or any other conditions, or to book an appointment, feel free to contact us here. We’d be more than happy to help.
Thermoplastic Splint
Soft Elbow Splint