Cubital Tunnel Syndrome
Cubital tunnel syndrome is a pinched nerve at the elbow commonly known as the “funny bone”. This might be caused by trauma or repetitive use of the elbow and may be caused by continuous use of the elbow in a flexed position. This causes the nerve to become stretched and irritated as opposed to when the arm is extended and the nerve is in a relaxed position. The diagnosis can be confirmed with electrodiagnostic testing including nerve conduction velocity and the electromyogram. Nerve conduction velocity studies, the speed of the nerve across the elbow, will be slowed when there is nerve compression and electromyogram studies, the innervation of the muscles, might be affected by the pinched nerve.
For this problem there are three modes of treatment; no treatment, conservative, and surgical. Unfortunately with conservative treatment, only splinting with the arm in an extended position has been found to be helpful. Cortisone injection, physical therapy, anti-inflammatory medications, or beneficial. Night time splinting is achieved with a custom made long arm splint that the patient will wear at night time and as often as possible during the day. Unfortunately it is cumbersome to keep the arm out straight all the time and therefore this is usually used only at night. If the patient has persistent complaints despite conservative treatment surgery would be recommended. There are three types of procedures, one is to cut the medial epicondyle which is the bone pinching the nerve or the other two operations are to actually move the nerve out of the cubital tunnel either above or below the muscles of the forearm. This can be performed as an outpatient procedure with an axillary block where only the arm is put to sleep and it has a high success rate.
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