Most patients present with the complaint of numbness and tingling of the fourth and fifth fingers. They may notice that it is worse at nighttime or after having their elbow in a bent position for a period of time.
For patients with more longstanding compression they may notice weakness with grasping objects, dropping things, or wasting of the muscles. If the issue developed after a trauma or surgery there may be more profound symptoms such as motor deficits. It is very important to have this issue assessed as soon as possible because the longer the nerve is compressed the more damage that can occur and at times it is irreversible.
Our doctors will take their time to listen to your history and better understand your symptoms and the onset. They will take a careful examination of not only your elbows, but your neck, arms, and hands to ensure they have a complete picture of your issue. Cubital tunnel syndrome can often be diagnosed through physical examination alone, but they may order other tests to help establish a diagnosis. Initial treatment usually involves activity modification, night splinting and NSAIDs in more acute cases. If conservative management fails, surgical decompression and transposition of the ulnar nerve may be considered.
A cubital tunnel release with or without ulnar nerve transposition is the surgical treatment for cubital tunnel syndrome. This procedure is done under anesthesia and in a sterile setting at a hospital or surgery center. The surgery involves an incision over the inside of the elbow. The patient’s symptoms of numbness, tingling and sometimes weakness are a result of excessive pressure on the ulnar nerve.
The surgery involves decompressing the ulnar nerve from a tight tunnel of tissue. Sometimes an ulnar nerve transposition may also be done to move the nerve into a less vulnerable position. This prevents that nerve from potentially snapping over the medial epicondyle with elbow motion. The incision is closed with stitches and the elbow is generally placed in a soft dressing after surgery.
Recovery is usually two to three weeks to allow the incision to fully heal. At that point, you can begin to return to activities as tolerated. If the nerve compression was severe, the recovery of sensation may take several months to a year and may never return fully.
Physical therapy may be a part of recovery after surgery. Generally, motion is encouraged right away, but therapy may be helpful for patients that are hesitant to move on their own or have motor deficits. If your doctor decides therapy is right for you specific instructions will be given to the therapist with goals and restrictions.
Cubital tunnel syndrome can be a serious condition and may progress if not addressed. It can lead to pain, weakness, and dysfunction for the arm and hand. Our goal at TOC is for you to return to the things you love! This may take time and patience, but we want your nerve to recover and your sensation and function to return.
We understand that every patient is unique and we will develop your treatment plans accordingly. We want to understand your goals and help you reach them. Please contact our office with any elbow or ulnar nerve issues you may have and receive superior care from our doctors and staff.
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