Hand

The cubital tunnel is a tunnel of muscle, ligament, and bone on the inside of the elbow.

The ulnar nerve passes through the cubital tunnel. In this cubital tunnel, the overlying fibrous tissues keep the ulnar nerve from flopping around or moving from that inner elbow space. 

In cubital tunnel syndrome, there is an injury to the ulnar nerve. It can become irritated, inflamed, and swollen.

Like carpal tunnel syndrome, this tunnel space gets tighter for reasons we don’t understand. In cubital tunnel syndrome, this tightness can pop the nerve out of its groove.  

Cubital tunnel syndrome can present as numbness, tingling, and pain in the hand and/or ring and little finger. It may also feel like a zinging pain that shoots up the arm or the sensation of hitting your funny bone. These symptoms may be worse when the elbow is bent.

Some patients might first experience cubital tunnel syndrome symptoms only at night. Soon, these same patients may notice this discomfort throughout the day. It is common for cubital tunnel pain to come and go, and it often gets worse over time, leading patients to seek effective cubital tunnel pain relief.

Because the ulnar nerve has motor and sensory functions that are important for hand functionality, patients may experience hand weakness. People may feel like their hand goes numb when they talk on the phone or have difficulty with daily tasks like brushing their hair or driving a car.

In severe cases of cubital tunnel syndrome, you may see muscle loss develop on top of the hand and the first web space. This muscle loss can make it hard to pinch well, so you may have difficulty turning the key on the door or similar movements.

At Plastic + Hand, we start this process by listening. We ask patients about their symptoms and what is bothering them in their hands. 

A physical exam is essential for proper cubital tunnel syndrome diagnosis. This exam is often paired with nerve tests (i.e., Electromyography (EMG) or Nerve Conduction Study (NCS) to determine the appropriate cubital tunnel syndrome treatment. 

Cubital tunnel syndrome can be progressive. 

There are some conservative measures to treat it, like nighttime splinting. Splinting prevents your elbow from flexing, which can cause compression and tension on the ulnar nerve. But sleeping with your arm in a straight line can be an uncomfortable solution and get old quickly.

Conservative options for cubital tunnel syndrome may not work for many people. If that’s the case, cubital tunnel release surgery can be a curative solution for many people. 

Many people seek cubital tunnel relief through splinting, but it may not be sustainable.

Nerve compression reduces blood flow.

If you have long-term nerve compression, you can have slow-building nerve damage that builds up over time. This damage can lead to sensory deficits, potentially causing motor issues, weakness, and clumsiness with your hand.

If you leave your ongoing nerve damage untreated, you may have severe weakness or muscle loss in your hand or might not feel anything in your fingers. Unfortunately, if the damage is severe, your body may not be able to recover that damage.  

Cubital tunnel release corrects cubital tunnel syndrome, and we perform it in the comfort of our accredited outpatient Plastic + Hand Surgery Center located on-site here in Portland, Maine.

There are two surgical options to treat cubital tunnel syndrome:

Cubital tunnel release

This cubital tunnel release surgery may be appropriate for patients with milder symptoms. 

During cubital tunnel release surgery, your surgeon will make an incision over the cubital tunnel to release the pressure or open the roof of the cubital tunnel. If that pressure is gone, we hope that the blood flow returns to the nerve and it can repair itself.

Ulnar nerve transposition 

Some patients need this surgical option, especially if they have a more severe cubital tunnel diagnosis or the nerve is popping in and out of the groove. 

In ulnar nerve transposition, your surgeon will move the ulnar nerve to an appropriate position. This repositioning effectively lengthens the nerve, so it now travels a shorter distance to get to the hand without tension.

Cubital tunnel surgery recovery

Depending on the severity of your cubital tunnel syndrome and the procedure that is best for you, your surgeon will discuss your specific recovery timeline and post-op details.

If patients cannot get cubital tunnel release surgery immediately, the Plastic + Hand surgeon may recommend conservative options like splinting to ease the symptoms. You will discuss your options directly with the surgeon in your initial consultation. 

Yes. While some insurance companies might have specific requirements, this is a straightforward coverage process. 

You’ll first discuss your cubital tunnel release surgery with your Plastic + Hand surgeon. During your initial consultation, your surgeon will evaluate your medical history, your hand symptoms, and discuss the most appropriate hand procedure for your diagnosis.  

After this personalized consultation, our scheduling and pre-authorization team will work with you and your insurance company to ensure the procedure is covered and scheduled in a timely manner.

After cubital tunnel release surgery, most patients have successfully treated their cubital tunnel syndrome.

The final results of cubital tunnel release surgery are the resolution of numbness and tingling sensations and the gradual return of strength to the hand.

At the Maine Hand Center at Plastic + Hand, we have fully qualified occupational therapists to help you recover and rehabilitate as we get you back to your life.