What is Cubital Tunnel Syndrome?

Cubital Tunnel Syndrome is the alternate of most common compression neuropathy in the upper extremity after carpal tunnel syndrome. Cubital tunnel syndrome is a peripheral nerve compression syndrome, It's an irritating or injury of the ulnar nerve in the Cubital tunnel at the elbow. We is also known as Ulnar nerve entrapment.

Causes

  • Traction, ischemia or pressure of ulnar nerve which passes through the Cubital tunnel at medial side of the elbow.
  • Someone more likely to develop Cubital tunnel syndrome if he/ she –
  • Repeatedly lean on elbow, especially on a hard surface.
  • Sometimes the result will be abnormal of bone growth in the elbow or from intense physical activity that increases pressure on the ulnar nerve.
  • Cubital tunnel syndrome is risk of baseball pitcher twisting motion needed to throw a slider which can damage delicate ligaments

Sign and Symptoms

  • Medial elbow pain or aching in forearm
  • Hand pain
  • Numbness and tingling sensation present in 4 th and 5 th digits, Hypothenar eminence and ulnar side of dorsum of the hand.
  • Non-painful popping or snapping during passive and active flexion and extension of the elbow also reported by patient.
  • Abduction of the 5 th digit due to weakness of the 3 rd palmar Interosseous muscle may be present. i.e. Wartenberg sign.

Some severe symptoms include-

  • Weakness affecting the ring and little fingers ( atrophy of intrinsic muscles of hand)
  • Decreased pinching ability of the thumb and little finger
  • Decreased overall hand grip
  • Muscle wasting in the hand
  • Claw-like deformity of the hand

Diagnostic Procedure

  • High-resolution neuro-ultrasonography.
  • Magnetic resonance neurography (MRN)
  • X-Rays
  • Electrophysiological Studies

Physical Examination test

  • Elbow Flexion Test
  • Tinel Sign

Physiotherapy Management

Goals of treatment

  1. To control and decrease paranesthesia and pain.
  2. To increase strength of muscle
  3. To improve range of motion
  4. Activity Modification.

Rest and splinting – To control pain and Paresthesia

Icing – To reduce swelling and can be combined with gently applied range of motion exercise.

Joint mobilization – To increasing range of the motion.

Strengthening exercises – To strengthen 4 th and 5 th digits.

Activity Modification- To eliminate pain provoking activities.

Nerve gliding exercises- To stretch the ulnar nerve and encourage movement through the cubital tunnel.

  1. Elbow Flexion and Wrist Extension
  2. Head Tilt
  3. Arm Flexion in front of the Body
  4. A-OK