Condition guide
Do your little finger and half of your ring finger go numb or tingle, especially when you wake up or after a long phone call? Cubital tunnel syndrome happens when the ulnar nerve, which runs along the inner side of the elbow, is squeezed or irritated. For most people, simple steps such as not keeping the elbow bent for long periods and keeping it straight at night settle the symptoms.
You can wrap a folded hand towel around your elbow and tape it without making it too tight, or buy an elbow splint from a pharmacy. Improvement can take several weeks.
Avoid leaning on or pressing on the inner side of your elbow. An elbow pad over the nerve may help.
Use a headset for phone calls and keep your keyboard close to the edge of the desk. Take regular breaks, change your hand position and loosen your grip on the things you hold.
Knowing which positions bring on symptoms, and changing them, is the most important early treatment. Most people get better with simple advice; surgery is rarely needed.
Exercises at home
You may feel mild discomfort during the exercises, but it should fade shortly afterwards. If your symptoms get worse, do fewer repetitions, or stop and speak to a specialist.
Hold your arm out to the side with your palm facing down. Bend your wrist back so your fingers point to the ceiling and hold for 10 seconds. Then bend your elbow to bring your hand towards your head and hold for 10 seconds. Straighten your elbow and wrist to return to the start. You may feel a slight pull towards your little finger, but it should not hurt.
Start with 3 repetitions, up to 3 times a day; as it gets easier, build up to 5 and then to a maximum of 10Sit or stand tall with your shoulders relaxed. Slowly roll your shoulders up, back and down in a circular movement.
10 repetitions, 5 times a dayIn carpal tunnel syndrome, the median nerve is squeezed at the wrist, and numbness mainly affects the thumb, index and middle fingers. In cubital tunnel syndrome, the ulnar nerve at the elbow is affected; the numbness is in the little finger and the half of the ring finger nearest to it.
Keeping the elbow straighter at night reduces the stretch on the nerve. One NHS leaflet recommends wearing the splint or towel wrap every night for 6–8 weeks, and continuing for up to 12 weeks if symptoms are still improving. However, in a small study of 51 people with mild to moderate symptoms, written information alone was as effective at improving work activities and reducing night pain as adding a splint or nerve gliding; the evidence is of low quality.
In a study of 55 people, a steroid injection made no difference compared with placebo at 3 months: 28% had a good outcome with the injection and 30% with placebo.
Surgery may be considered if symptoms are severe, or if they progress despite a splint, advice and exercises. The main aim of surgery is to stop weakness and muscle wasting from getting worse. In studies, releasing the tissue over the nerve and moving the nerve gave similar results (about 70% vs 75% improved at 6–12 months); wound infections were more common when the nerve was moved.
According to one NHS leaflet, you can usually return to light work after 1–2 weeks and to heavy work after about 3–6 weeks; avoid heavy lifting and tight gripping for the first 4 weeks. Numbness often improves but this can be slow; strength also takes time to recover and may not recover fully.
For numbness in the thumb and first fingers, see the carpal tunnel syndrome guide; for tendon-related pain on the inner side of the elbow, see the golfer’s elbow guide.
Sources
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