ing. Your therapist may also use iontophoresis Cubital Tunnel treatment in acute cases S y n d r o m e to reduce the irritation around the nerve. When symptoms are severe or do not im- What is Cubital Tunnel prove, surgery may be needed. Many sur- Syndrome? geons recommend shifting Cubital tunnel syndrome is a condi- the nerve to the front of the tion brought on by increased pres- elbow, the nerve may be sure on the ulnar placed under a layer of fat, nerve at the el- under the muscle, or within bow. There is a the muscle. Some surgeons bump of bone on may recommend trimming the bony bump. the inner portion Following surgery, the recovery will depend of the elbow on the type of surgery that was performed. (medial epi- Restrictions on lifting, writing &/or com- condyle) under which the ulnar posite forearm movement may be recom- nerve passes. This site is commonly mended. Therapy is necessary, early inter- called the “funny bone”. At this site, vention is the key to prevent scarring of the the ulnar nerve lies directly next to nerve to the surgery site or under the muscle the bone and is susceptible to pres- its placed. The numbness & tingling may sure. When the pressure on the nerve improve quickly or slowly, & it may take Cubital Tunnel becomes great enough to disturb the several months for the strength in the hand way the nerve works, then numb- and wrist to improve. Cubital tunnel symp- Syndrome ness, tingling, and pain may be felt toms may not completely resolve after sur- in the elbow, forearm, hand, and/or gery, especially in severe cases. fingers. Causes Pressure on the ulnar nerve at the elbow can develop in several Specializing in Shoulder ways. The nerve is positioned right 499 Blossom Hill Rd, Elbow Wrist & Hand San Jose, Ca 95123 Therapy next to the bone and has very little Phone: 408-268-8536 Fax: 408-268-8727 padding over it, so pressure on this 2242 Camden Ave, Ste 201 408-268-8536 San Jose, CA 95124 Tel: 408-884-8361 Fax: 408-884-8359

Www.HandsOnCareTherapy.com thicker, or there may be myography (EMG) and/or nerve variations of the muscle conduction study (NCS) may be structure over the nerve at done to confirm the diagnosis of Cubital Tunnel the elbow that cause pres- cubital tunnel syndrome and stage sure on the nerve. Cubital its severity. This test also checks for can put pressure on the nerve. For tunnel syndrome occurs other possible nerve problems, such example, if you lean your arm when the pressure on the as a pinched nerve in the neck, against a table on the inner part of nerve is significant enough, which may cause similar symptoms. the elbow, your arm may fall asleep and sustained enough, to disturb the way the and be painful from sustained pres- ulnar nerve works. Treatment sure on the ulnar nerve. If this oc- Symptoms may sometimes be re- Signs and symptoms curs repetitively, the numbness and lieved without surgery and with pain may be more persistent. In Cubital tunnel syndrome symptoms usually therapy, particularly if the EMG/ some patients, the ulnar nerve at the include pain, numbness, and/or tingling. The NCS testing shows that the pres- numbness or tingling most often occurs in sure on the nerve is mini- the ring and little fingers. The symptoms are mal. Changing the patterns of el- usually felt when there is pressure on the bow use may significantly reduce nerve, such as sitting with the elbow on an the pressure on the nerve. Avoid- arm rest, or with repetitive elbow bending ing putting your elbow on hard and straightening. Some patients may notice surfaces helps along with keeping weakness while pinching, occasional clumsi- elbow clicks back and forth over the the elbow straight at night with a ness, and/or a tendency to drop things. In bony bump (medial epicondyle) as custom splint. Therapy to improve severe cases, sensation may be lost and the the elbow is bent and straightened. nerve glide, with myofascial tech- muscles in the hand may lose bulk and If this occurs repetitively, the nerve niques, taping the elbow during strength. may be significantly irritated. the day to pre- vent stretching Additionally, pressure on the ulnar Diagnosis the nerve with nerve can occur from holding the el- Your physician will assess the pattern and excessive flexion. bow in a bent position for a long time, distribution of your symptoms, and examine Ergonomic as- which stretches the nerve across the for muscle weakness, irritability of the nerve sessment may also be needed to medial epicondyle. Such sustained to tapping and/or bending of the elbow, and correct stretching the nerve due to bending of the elbow may tend to oc- changes in sensation. Other medical condi- high workstation or resting the cur during sleep. Sometimes the con- tions may need to be evaluated such as thy- elbow on the arm rest when typ- nective tissue over the nerve becomes roid disease or diabetes. A test called electro-