We’ve all tweaked our funny bone. It’s not exactly a great feeling, is it?
When this happens, that painful sensation running up to your hand is an irritated ulnar nerve. This nerve starts in your neck and goes all the way to the ends of your fingers. While the pain from a bumped “funny bone” usually passes quickly, in other situations the ulnar nerve can become damaged, causing continued pain and impaired hand function — a condition called cubital tunnel syndrome.
Giles Becker, MD, an orthopedic hand surgeon with Banner – University Medicine in Arizona, talked with us about cubital tunnel syndrome. The condition often gets confused with other nerve and elbow problems, like carpal tunnel syndrome. Dr. Becker explained how to tell the difference and discussed potential treatment options.
What is cubital tunnel syndrome, exactly?
On the inner side of your elbow, your ulnar nerve passes through your arm’s cubital tunnel. This tunnel is made of bone, ligament and muscle. When this portion of the ulnar nerve gets inflamed or swollen, that’s when the pain happens. Sustained nerve pressure or damage here can show up as cubital tunnel syndrome, which you’ll feel as tingling, pain, numbness and/or weakness in your ring and pinky fingers.
Most people with cubital tunnel syndrome, Dr. Becker said, don’t have any identifiable cause, but he added that symptoms may show up more often in people with the following:
- Recurrent elbow swelling
- Arthritic elbow bone spurs
- A more “unstable” ulnar nerve (the nerve will pop around the side of the elbow when it’s bent and straightened)
- Occupations that require resting or bending the elbow for extended periods (ex: truck drivers)
- Frequent, recurring hobbies/activities with prolonged elbow bending
Diabetes is also known to increase the likelihood of ulnar nerve problems — and all nerve problems, really — since diabetes makes the nerves more vulnerable to compression.
So, it’s not carpal tunnel syndrome?
Here’s the difference: cubital tunnel syndrome is an ulnar nerve problem, while carpal tunnel syndrome deals with the median nerve. And that’s a difference you can feel. With carpal tunnel, for example, you’ll feel it in your larger fingers (thumb, index, middle and ring). And with cubital tunnel syndrome, that sensation is specific to your pinky and ring fingers.
In Dr. Becker’s experience, many patients often think they have carpal tunnel when they don’t. This often happens because of an initial misdiagnosis.
Another common mistake is thinking that any elbow pain equals cubital tunnel syndrome.
“Pain around the elbow is rarely cubital tunnel syndrome,” Dr. Becker said, adding that elbow pain more commonly indicates arthritis or tennis/golfer’s elbow.
In any case, Dr. Becker said you can get an accurate diagnosis through a nerve conduction study. In this study, the electrical activity of your forearm nerves is measured to see if there’s any deficit. Currently, other common diagnostic tests include the scratch collapse test, magnetic resonance imaging and ultrasound evaluation.
What’s the best treatment?
For mild cases, Dr. Becker recommends padded armrests, elbow splints and, if possible, decreased general activity in the area that’s affected. For more severe cases — and where it’s not just about hand numbness, but decreased strength — Dr. Becker said surgery may be required to restore function.
If you’re experiencing hand and elbow issues, getting a proper diagnosis is the first step toward recovery. To schedule an appointment with a Banner Health specialist, visit bannerhealth.com.
Are you interested in learning more about elbow, hand and nerve problems? If so, check out these articles written with help from Banner health experts.