The cubital tunnel is located at the inside of the elbow, where our ulnar nerve travels. Anatomically, the cubital tunnel is surrounded by the three borders: the medial epicondyle, the olecranon, and the fascia that connects the two. When the tunnel is irritated, it puts pressure on the ulnar nerve, causing cubital tunnel syndrome.
The three main causes of cubital tunnel syndrome are compression of the ulnar nerve at the elbow region; excessive stretching of the ulnar nerve because of repetitive elbow flexion and extension from the nature of occupation or sports; direct injuries to the elbow such as fracture, dislocation, or swelling. The chief complaint of cubital tunnel syndrome is often numbness and shooting pain on the medial side of the forearm as well as the little finger and medial half of the ring finger.
Cubital tunnel syndrome is the second most common nerve disease of the arm, followed by the well-known carpal tunnel syndrome. Cubital tunnel syndrome usually has a slow onset, but it can progressively get worse. In more serious cases, there could be loss of sensation or affected motor functions on the affected areas.
Special tests such as the positive of the Tinel’s sign at the elbow and the Froment’s sign can confirm the diagnosis. It is likely to be cubital tunnel syndrome if the symptoms are reproduced by sustained elbow flexion or compression of the ulnar nerve.
Non-Surgical Physiotherapy Treatment
Generally, a common physiotherapy approach will treat the presented symptoms as well as eliminate the root cause of the problem. Activity modification will likely be the first step. Patients are advised to minimize repetitive end range flexion of the elbow joint and minimize putting direct pressure on the ulnar nerve at the elbow. Education on not to sleep with a bent elbow and a possible night-time splint to keep the elbow at neutral. Forearm stretches, forearm strengthening (if there is muscle weakness), and ulnar nerve glides are all great exercises to perform.
Lastly, for individuals who have failed conservative treatment for 6 months would likely require surgical intervention such as decompression of the ulnar nerve at the cubital tunnel.
Related topics: Brachial plexus, thoracic outlet syndrome, anterior interosseous nerve syndrome, pronator teres syndrome, medial epicondylitis.
Reference: Chauhan, M., Anand, P., & Das, J. M. (2020). Cubital Tunnel Syndrome. StatPearls [Internet].