What Is Cubital Tunnel Syndrome?
Cubital tunnel syndrome or ulnar nerve entrapment is a painful and often progressive nerve condition caused by compression or irritation of the ulnar nerve as it passes through the cubital tunnel—a narrow passageway on the inside of the elbow. Commonly referred to as the “funny bone” nerve, the ulnar nerve runs from the neck down to the hand and plays a key role in controlling movement and sensation in the forearm and hand, especially the ring and little fingers.
When this nerve becomes compressed at the elbow, it can lead to a range of uncomfortable symptoms and may interfere with daily tasks, particularly those that require grip strength, dexterity, or prolonged elbow bending.
Cubital Tunnel Syndrome Causes
Cubital tunnel syndrome develops when there is increased pressure or prolonged stretching of the ulnar nerve at the elbow. Several factors can contribute to this compression, including:
- Frequent Elbow Bending: Repetitive activities that require flexing the elbow—such as talking on the phone, lifting objects—can stretch and irritate the ulnar nerve.
- Prolonged Elbow Pressure: Leaning on the elbow for extended periods, such as during driving or resting on hard surfaces, can increase direct pressure on the nerve.
- Anatomical Variations: A naturally tight cubital tunnel, or a thickened ligament over the nerve can make some individuals more prone to compression.
- Previous Injuries: Fractures, dislocations, or arthritis in the elbow can alter the anatomy and lead to nerve entrapment.
- Occupational Strain: Certain occupations or hobbies that involve vibratory tools can contribute to risk of developing this condition.
Identifying and addressing the underlying causes of cubital tunnel syndrome early can help prevent long-term nerve damage and restore comfortable, functional hand use.
What Are the Symptoms of Cubital Tunnel Syndrome?
The symptoms of cubital tunnel syndrome may begin subtly and worsen over time, especially without treatment. Common signs include:
- Numbness and tingling in the ring finger and little finger—this may be intermittent at first and worsen with activities that keep the elbow bent.
- Hand weakness, especially noticeable when gripping objects or performing precise movements.
- Clumsiness or a tendency to drop things, often caused by decreased hand coordination.
- Pain or aching along the inside of the elbow, particularly after prolonged elbow flexion (e.g., holding a phone or sleeping with the arm bent).
- In more advanced cases, muscle wasting in the hand may occur due to long-term ulnar nerve compression.
Early recognition of these symptoms is key to preventing permanent nerve damage and maintaining full hand function.
How Is Cubital Tunnel Syndrome Diagnosed?
A prompt and accurate diagnosis is essential for effective management of cubital tunnel syndrome. At Academy Orthopedics, we use a combination of clinical evaluation and diagnostic testing to confirm the presence and severity of the condition.
Medical History & Symptom Review
Your physician will begin by discussing your symptoms in detail, such as when they began, what activities make them worse, and how they are affecting your daily life. You may be asked about any prior injuries, repetitive motions, or prolonged elbow positioning that could be contributing to nerve irritation.
Physical Examination
A thorough physical exam helps evaluate nerve function and rule out other conditions. Your provider may:
- Gently tap over the ulnar nerve at the elbow (known as Tinel’s sign) to see if it reproduces tingling in the ring and little fingers.
- Perform a flexion test, where the elbow is held in a bent position to provoke symptoms.
- Assess for muscle weakness, grip strength, and any atrophy in the hand or fingers.
Nerve Conduction Studies (NCS) and Electromyography (EMG)
If clinical findings suggest cubital tunnel syndrome, nerve conduction studies and EMG tests are often ordered to confirm the diagnosis and assess the extent of nerve damage. These tests measure how efficiently electrical signals travel through the ulnar nerve and whether there is any associated muscle dysfunction.
Imaging (if needed)
Although not always necessary, X-rays or ultrasound imaging may be recommended in certain cases to evaluate bone structure, rule out arthritis or bone spurs, or visualize nerve compression more clearly. MRI may be considered when other conditions affecting the cervical spine or brachial plexus need to be ruled out.
Early diagnosis allows for timely treatment and better outcomes. At Academy Orthopedics, we are committed to using the most accurate diagnostic tools and patient-centered evaluations to guide your personalized care plan.
Conservative Treatment Options for Cubital Tunnel Syndrome
At Academy Orthopedics, we believe in beginning with the least invasive approach whenever possible. Many cases of cubital tunnel syndrome respond well to conservative, non-surgical management, especially in the early stages. These strategies may include:
- Nighttime elbow immobilization: Wearing a soft splint while sleeping helps keep the elbow in a straight position, reducing pressure on the ulnar nerve.
- Rest and activity modification: Avoiding prolonged elbow flexion (like holding a phone or leaning on your elbow) can prevent further irritation.
- Anti-inflammatory medications: Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce swelling and ease nerve compression.
- Stretching and nerve gliding exercises: These are guided movements designed to gently mobilize the ulnar nerve and prevent it from becoming stuck in the cubital tunnel.
If your symptoms are mild to moderate, consistent use of these therapies over several weeks to months may result in meaningful improvement.
When Is Surgery Needed?
If your symptoms continue to progress despite conservative treatment—or if nerve function is significantly impaired—surgical intervention may be recommended to prevent permanent damage.
Cubital Tunnel Release Surgery
Cubital tunnel release is a commonly performed procedure that aims to relieve pressure on the ulnar nerve and restore function. During this surgery, a small incision is made along the inside of the elbow to release the tight structures compressing the nerve within the cubital tunnel. This allows the nerve to move more freely and reduces ongoing irritation.
In some cases, your surgeon may also recommend a procedure called ulnar nerve transposition, where the nerve is repositioned to lie in front of the elbow rather than behind it. This is particularly helpful for patients experiencing nerve subluxation, or a snapping/popping sensation at the elbow, which may cause additional irritation or damage.
At Academy Orthopedics, our fellowship-trained hand and upper extremity surgeons will work closely with you to determine the most appropriate surgical approach based on the severity of your condition, your anatomy, and your daily activity needs. Most patients experience excellent relief from symptoms following surgery and can return to normal function with minimal downtime.
Don’t Let Nerve Pain Disrupt Your Life—Schedule Your Appointment Today
If you’re experiencing numbness, tingling, or weakness in your hand or fingers, don’t wait for the symptoms to worsen. Early evaluation and treatment are key to preventing long-term nerve damage and restoring normal function. At Academy Orthopedics, we treat you like family, offering individualized care with a focus on lasting relief and recovery.
With convenient locations in Cumming, Buford, and Duluth, GA, our compassionate, physician-led team is committed to helping you get back to what you love—comfortably, confidently, and without pain.
Contact us or schedule an appointment today to take the first step toward healing and reclaiming your quality of life.e subluxation, or snapping of the ulnar nerve.