Cubital Tunnel Syndrome
Comprehensive treatment for ulnar nerve compression at the elbow
2nd
Most common nerve entrapment
85%
Success rate with early treatment
6-12 weeks
Conservative treatment duration
Cubital tunnel syndrome occurs when the ulnar nerve is compressed as it passes through the cubital tunnel at the elbow. This nerve controls sensation in the ring and little fingers and some hand muscles. Compression can cause numbness, tingling, and weakness.
Common Symptoms
- • Numbness in ring and little fingers
- • Tingling that worsens with elbow flexion
- • Weakness in grip strength
- • Difficulty with fine motor tasks
- • Pain along inner elbow and forearm
- • Muscle wasting in severe cases
Nerve Distribution
- • Sensory: Ring and little fingers
- • Motor: Hand intrinsic muscles
- • Flexor carpi ulnaris
- • Deep flexor muscles
Severity Classifications
Intermittent symptoms with minimal nerve damage
Symptoms
- • Occasional numbness in ring and little fingers
- • Mild tingling at night
- • No muscle weakness
- • Symptoms resolve with position change
Treatment
Conservative management, activity modification
Prognosis
Excellent with conservative treatment
Persistent symptoms with some nerve dysfunction
Symptoms
- • Constant numbness in ulnar distribution
- • Weakness in grip strength
- • Difficulty with fine motor tasks
- • Symptoms worsen with elbow flexion
Treatment
Splinting, nerve gliding exercises, possible injection
Prognosis
Good with early intervention
Advanced nerve damage with muscle atrophy
Symptoms
- • Severe numbness and weakness
- • Muscle wasting in hand
- • Claw hand deformity
- • Significant functional impairment
Treatment
Surgical decompression often required
Prognosis
Variable, may have permanent deficits
Treatment Approaches
Duration: 6-12 weeks
Goals: Reduce nerve compression and inflammation
Interventions
- • Activity modification and ergonomic changes
- • Elbow splinting at night
- • Nerve gliding exercises
- • Anti-inflammatory medications
- • Corticosteroid injections
Duration: Recovery 3-6 months
Goals: Relieve nerve compression permanently
Interventions
- • Ulnar nerve decompression
- • Medial epicondylectomy
- • Anterior transposition of nerve
- • Post-operative rehabilitation
Therapeutic Exercise Program
Frequency: 3-4 times daily
Ulnar Nerve Glide
Extend arm, bend wrist up, then flex elbow while straightening wrist
10 repetitions, hold 5 seconds
Elbow Flexion/Extension
Slowly bend and straighten elbow with palm facing up
10-15 repetitions
Wrist Circles
Gentle circular motions of the wrist
10 circles each direction
Frequency: 2-3 times per week
Grip Strengthening
Squeeze therapy putty or stress ball
2-3 sets of 10-15 repetitions
Finger Abduction
Spread fingers apart against resistance
2-3 sets of 10 repetitions
Pinch Strengthening
Pinch objects between thumb and fingers
2-3 sets of 10 repetitions
Frequency: Daily activities
Workstation Setup
Adjust desk height and arm support
Continuous during work
Phone Use
Use headset or speaker instead of cradling phone
During all phone calls
Sleep Position
Avoid sleeping with elbow bent under pillow
Nightly
Risk Factors
- • Prolonged elbow flexion
- • Repetitive arm movements
- • Leaning on elbows
- • Vibrating tools
- • Diabetes
- • Previous elbow injury
- • Arthritis
- • Bone spurs
- • Tight cubital tunnel
- • Subluxating nerve
- • Muscle variants
- • Previous surgery
Ergonomic Modifications
- • Avoid prolonged elbow flexion
- • Use padded armrests
- • Take frequent breaks
- • Proper workstation setup
- • Use headsets for phone calls
Activity Modifications
- • Sleep with straight arms
- • Avoid leaning on elbows
- • Gentle nerve gliding exercises
- • Maintain good posture
- • Regular stretching routine
Early Intervention
- • Persistent numbness in fingers
- • Weakness in grip strength
- • Difficulty with fine motor tasks
- • Symptoms interfering with work
Urgent Care
- • Severe muscle weakness
- • Visible muscle wasting
- • Claw hand deformity
- • Complete loss of sensation
Bracing & Support
- • Elbow splints
- • Night braces
- • Compression sleeves
- • Ergonomic supports
Exercise Equipment
- • Therapy putty
- • Grip strengtheners
- • Resistance bands
- • Finger exercisers
Ergonomic Aids
- • Padded armrests
- • Ergonomic keyboards
- • Phone headsets
- • Adjustable desks
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