Cubital Tunnel Syndrome
I fell last year and hurt my left elbow. Although I did not break any bone I'm still having pain in my forearm. I've also noticed the feeling in the little and ring finger of my left hand is distorted. My GP says I might have something called cubital tunnel syndrome. Can you explain what exactly this is?
Cubital tunnel syndrome, also known as ulnar nerve palsy, is caused by compression of the ulnar nerve at the elbow. The ulnar nerve is one of several nerves that supply the arm, hand and fingers. It passes close to the surface of the skin at the elbow and is easily damaged by trauma, repetitive leaning or repetitive bending of the elbow.
This results in a distortion of the signals transmitted up and down the nerve itself. People with this type of injury typically complain of pain in the forearm which can be either sharp or aching in nature. They may also experience decreased sensation or pins and needles in the small finger.
Over time, weakness in the small and ring fingers can develop.
Severe cubital tunnel syndrome can lead to muscle wasting and can cause a claw-like deformity of the hand.
I've noticed that the pain is worse at night. Why is this?
When the elbow is flexed it causes compression of the nerve.
As you note, symptoms can be worse at night when the elbow has been flexed during sleep. Symptoms can also increase when you use repetitive elbow movements, for example, when changing gears in the car or using a garden shears or while playing sports.
Who should I see to help the problem?
Your GP may refer you to a consultant neurologist for nerve conduction studies which will confirm the extent of the damage to the ulnar nerve. From a practical point of view, your symptoms may be helped by limiting intense use of your elbow.
Avoid leaning on your elbow during day-to-day activities. You may find that using a small pillow at night under your arm to prevent elbow flexion helps.
A physiotherapist will be able to treat the condition with specific exercises while an occupational therapist will be able to recommend splints for both your elbow and fingers to prevent deformities developing. In severe cases of nerve compression, surgery may be needed to release the pressure.