Cubital Tunnel Syndrome (CuTS), also known as ulnar nerve entrapment, is a common condition that affects the ulnar nerve as it passes through the cubital tunnel, a narrow passageway on the inner side of the elbow. You can find your cubital tunnel by touching your ‘funny bone’! What is commonly associated as hitting your funny bone, is actually hitting your ulnar nerve; which, is why it sends a shock!
Aside from aggravating the ulnar nerve by bumping it, it can also cause problems when it becomes compressed. Similar to carpal tunnel syndrome; overuse, injury, or strain can all cause for the nerve to slightly inflame get pinched in the small tunnels they run.
Anatomy of the Ulnar Nerve
The ulnar nerve, a major nerve in the arm, originates from the brachial plexus and travels down the arm, passing through various structures, including the cubital tunnel. At the cubital tunnel, the ulnar nerve is vulnerable to compression due to its superficial positioning and limited protective structures. This compression can result in symptoms such as numbness, tingling, and weakness in the hand and fingers.
Pathology at the Cubital Tunnel:
CuTS occurs when the ulnar nerve becomes compressed or irritated at the cubital tunnel, leading to symptoms that may include pain, numbness, and weakness in the hand, particularly the ring and little fingers. Prolonged pressure or repetitive bending of the elbow can contribute to the development of CuTS, affecting both the quality of life and the ability to perform everyday activities.
What can you do?
Activity Modification:
Modifying daily activities is a crucial aspect of managing CuTS and preventing symptom exacerbation. Individuals with CuTS should avoid prolonged periods of elbow flexion, repetitive bending motions, and activities that exert pressure on the ulnar nerve- try not to bump your funny bone! Ergonomic adjustments in workstations, regular breaks during activities, and maintaining a neutral wrist and elbow position can significantly contribute to symptom relief.
Ulnar Nerve Glides:
Hand therapy plays a vital role in CuTS management, and ulnar nerve gliding exercises are often incorporated to improve nerve mobility. These exercises involve gentle movements designed to mobilize the ulnar nerve along its pathway, reducing tension and promoting optimal nerve function. Incorporating ulnar nerve glides into a daily routine can aid in maintaining nerve mobility and alleviating symptoms.
For an ulnar nerve glide, begin with your arm out and palm side facing up. Tilt your head in the opposite direction. Slowly, rotate the palm of your hand outward and bend your wrist so that the fingers are pointing towards you. Tilt your head towards your gliding hand, and place that hand over your ear with your elbow still facing forward. Repeat this is a slow motion, gliding and getting a good stretch at each end. (See below!)
Sleep Hygiene and Towel Splinting:
Sleep hygiene is a crucial, yet often overlooked, aspect of CuTS management. During sleep, individuals may unconsciously flex their elbows, compressing the ulnar nerve. Simple adjustments, such as sleeping with a straight arm or using a brace to prevent excessive flexion, can significantly reduce nighttime symptoms. Improved sleep hygiene not only enhances overall sleep quality but also contributes to better CuTS symptom management.
One of the most common ways to aid in straighter elbows at night is towel splinting! Our therapists may recommend this to you at your visit. Basically, you can take an old towel (one that you don’t mind getting tape on) roll it up and place it supportively around your elbow; tape it with some duct tape to secure. This is a great option for keeping your elbows straight at night without having to purchase a splint.
Recap!
Cubital Tunnel Syndrome can significantly impact one’s daily life, but with a comprehensive understanding of ulnar nerve anatomy, pathology, and effective management strategies, individuals can take proactive steps towards symptom relief. Activity modification, ulnar nerve glides, and attention to sleep hygiene are integral components of a holistic approach to CuTS management, empowering individuals to regain control over their hand and arm function. Seeking professional advice and incorporating these strategies into daily life can lead to improved well-being and a more comfortable, active lifestyle.
As always, if you are having symptoms, we recommend talking to a healthcare professional. If you have questions about activities you can be doing at home, whether or not you have cubital tunnel syndrome, or other any other upper extremity concerns, call us to get scheduled for a consultation or evaluation!
