Everyone over a certain age knows the peculiar pain of a “funny bone” injury when you hit the inside of your elbow in a particular spot and experience a weird, tingling pain, almost like a shock. Used in the nickname “funny bone,” “funny” means odd, not laughable. Though funny bone injuries (that actually result from hitting the ulnar nerve rather than a bone) are inconsequential, similar ongoing sensations may signal an unpleasant condition known as cubital tunnel syndrome.
What is cubital tunnel syndrome?
The cubital tunnel is a tunnel of muscle, ligament, and bone through which the ulnar nerve passes from the neck to the hand. The ulnar nerve is named after the ulna, one of the two bones of the lower arm. At the elbow, this nerve passes quite close to the skin, under a bump of bone (the medial epicondyle) at the inside of the elbow. If you accidentally bang the spot at which the nerve is close to the surface, you feel the strange “funny bone” sensation.
Sometimes, however, the ulnar nerve is trapped (known as nerve entrapment) in the cubital tunnel, a tunnel of muscle, ligament, and bone, resulting in pain accompanied by inflammation and swelling at the inside of the elbow. This is known as cubital tunnel syndrome. Although the vast majority of cases of cubital tunnel syndrome can be successfully treated by a knowledgeable physiatrist by nonsurgical methods, left untreated the condition can cause permanent nerve damage in the hand.
What causes cubital tunnel syndrome?
Cubital tunnel syndrome occurs when the ulnar nerve is compressed, typically as a result of the patient bending the elbow for long periods, thus stretching the ulnar nerve. Often, the condition results from:
- Habitually leaning your head on your hand
- Frequent flexion of the elbow or pressure applied to the inner bone of the elbow joint
- Repetitive motions involving pulling, reaching, or lifting
- Arthritis, bone spurs, or another medical disorder
- Traumatic injury like a fracture or dislocation of the elbow
In many cases, the cause of cubital tunnel syndrome remains unknown..
How do I know if I might have cubital tunnel syndrome?
The symptoms of this problem are distinctive and include:
- On and off numbness/tingling in the hand and fingers, especially when the elbow is bent
- Weak grip and clumsiness due to muscle weakness in the affected arm and hand
- Difficulty coordinating fingers to type on a computer or play a musical instrument
- Pain in the pinky or ring finger and inside of the hand
- Numbness and tingling at night
- Hand pain and aching on the inside of the elbow
You should suspect cubital tunnel syndrome if your symptoms worsen while talking into a handheld device, driving, sleeping, hiking with a walking stick, or skiing with poles.
How can the doctors at Long Island Spine Rehabilitation Medicine help?
We are focused on careful diagnosis of cubital tunnel syndrome and treatment that is as noninvasive as possible to relieve your pain and facilitate movement.
Diagnostic Tests
In addition to performing a physical exam and taking a medical history, we may use any of the following to make a correct diagnosis:
- X-rays
- Nerve conduction test
- Electromyogram (EMG)
- MRI scans
Treatment Options
Focused as we are on reducing or eliminating your pain and improving your ability to move easily, we may suggest some or all of the following:
- Avoiding activities that are worsening your discomfort
- Wearing a splint or foam elbow brace at night to limit movement, reducing irritation
- Using an elbow pad to shield your elbow from contacting hard surfaces and to reduce more extremes of flexion
- Undergoing customized physical therapy to restore range of motion
- Having us administer ultrasound-guided injections of steroid and analgesic to reduce pain and inflammation
- Having either PEMF (pulsed electromagnetic field therapy) to reduce soreness and/or PRP (platelet-rich plasma therapy) to accelerate healing
If your “funny bone” is making you grimace instead of laugh, make an appointment with one of our skilled physiatrists. We will find out whether you have cubital tunnel syndrome or some other musculoskeletal problem. Whatever is giving you pain, we are dedicated to making you feel better in the gentlest, least invasive way possible.