Cubital Tunnel Syndrome (Ulnar Nerve Compression)

Cubital Tunnel Syndrome (Ulnar Nerve Compression) – Restoring Strength and Sensation in the Arm and Hand

Overview

Cubital tunnel syndrome is a condition caused by compression or irritation of the ulnar nerve as it passes through a narrow space inside the elbow called the cubital tunnel. This nerve controls feeling in the ring and little fingers and helps coordinate several hand muscles.

When pressure builds in this tunnel—often from repetitive bending, leaning, or prolonged elbow flexion—it can cause numbness, tingling, weakness, and pain radiating down the forearm and into the hand.

At Dr. Burke Orthopedics, patients across Pearland, Houston, Friendswood, and Southeast Texas receive comprehensive, evidence-based treatment for cubital tunnel syndrome. Dr. Robert L. Burke, a board-certified orthopedic surgeon, focuses on restoring normal nerve function and helping patients return to daily life without discomfort.

Understanding Cubital Tunnel Syndrome

The ulnar nerve travels from the neck, through the inner elbow (the “funny bone” region), and down into the hand. It runs through a small channel—the cubital tunnel—where bones, muscles, and ligaments surround it.

When the elbow remains bent for long periods or is subjected to pressure, this space can narrow, stretching or irritating the nerve. Over time, this leads to neuropathy, where signals between the brain and hand muscles are disrupted.

Common Causes and Risk Factors

Common causes include:

Repetitive elbow flexion: Holding a phone, typing, or driving with bent elbows.
Prolonged pressure: Resting elbows on hard surfaces for extended periods.
Direct injury: Falls, fractures, or repetitive strain from throwing sports.
Arthritis or bone spurs: Can narrow the cubital tunnel.
Postural issues: Shoulder or neck alignment that increases nerve tension.

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Risk Factors:

Occupations requiring prolonged elbow bending (drivers, computer users, assembly workers).
Previous elbow fractures or dislocations.
Diabetes or metabolic disorders affecting nerve health.
Repetitive upper-limb sports like baseball or weightlifting.

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Symptoms

Symptoms often develop gradually and worsen with repeated use or nighttime elbow flexion.

Typical signs include:

Numbness or tingling in the ring and little fingers.
Pain or aching on the inner elbow.
Weak grip strength or dropping objects.
Hand clumsiness during fine motor tasks.
Muscle wasting in severe, long-term cases (especially between the thumb and index finger).

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Many patients notice symptoms worsen when the elbow is bent, such as during phone calls or while sleeping.

Diagnosis

At Dr. Burke Orthopedics, diagnosis begins with a thorough neurological and orthopedic evaluation by Dr. Robert L. Burke.

Diagnostic process includes:

Medical history: Reviewing symptom patterns and occupational factors.
Physical examination: Testing sensation, grip strength, and Tinel’s sign (tapping over the nerve to reproduce tingling).

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Imaging studies:

X-rays: Identify bone spurs or arthritis.
Ultrasound: Visualize nerve compression dynamically.
Nerve conduction studies (EMG/NCS): Measure electrical activity to pinpoint the compression site and severity.

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A precise diagnosis guides the most effective treatment—non-surgical or surgical.

Treatment Options at Dr. Burke Orthopedics

Dr. Burke emphasizes conservative care first, focusing on reducing nerve irritation, improving ergonomics, and restoring function.

Non-Surgical Treatments

Activity modification: Avoiding positions or movements that keep the elbow bent for long periods.
Nighttime splinting: Keeps the elbow straight during sleep to reduce pressure on the ulnar nerve.
Ergonomic adjustments: Correcting workstation setup and posture for improved nerve alignment.

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Physical Therapy

Teaches nerve-gliding and stretching exercises to maintain mobility.
Strengthens surrounding muscles and improves shoulder stability.
Reduces nerve tension through soft-tissue techniques.

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PRP Therapy

Platelet-rich plasma injections may help decrease inflammation around the nerve and enhance local healing.

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Anti-inflammatory care: Medications or cold therapy to relieve irritation.

Surgical Treatments

If symptoms persist, weakness develops, or nerve damage progresses, surgery may be required to relieve pressure and restore normal function.

Surgical options include:

Ulnar Nerve Decompression: Removes constricting tissue to create more space within the cubital tunnel.
Ulnar Nerve Transposition: Moves the nerve to a new position in front of the elbow to prevent future compression.
Reconstructive Surgery: For complex cases involving scar tissue, deformity, or previous surgery.

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These minimally invasive procedures aim to protect nerve health and preserve strength and coordination.

Recovery and Rehabilitation

Recovery depends on the treatment chosen and the degree of nerve irritation.

Typical recovery timelines:

Conservative care: 4–6 weeks for symptom improvement.
After surgery: 3–6 months for nerve recovery, with gradual return to full activity as sensation and strength improve.

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Rehabilitation goals:

Reduce pain and swelling.
Restore normal nerve glide and muscle control.
Strengthen grip and arm coordination.
Prevent recurrence through posture and ergonomic education.

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Regular follow-ups ensure nerve healing and optimal long-term function.

Long-Term Outlook and Prevention

Most patients recover fully when treatment begins early. Severe, untreated compression can cause permanent weakness or muscle loss, so prompt care is key.

Prevention tips:

Avoid resting elbows on hard surfaces.
Keep elbows slightly extended when sleeping or driving.
Stretch arms and wrists regularly.
Strengthen shoulders and upper back for postural support.
Adjust workstation height for proper arm alignment.

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Small adjustments can significantly reduce pressure on the ulnar nerve and prevent recurrence.

When to Seek Medical Care

Schedule an orthopedic consultation if you experience:

Persistent numbness or tingling in the ring or pinky fingers.
Weak grip or frequent dropping of objects.
Pain or discomfort along the inner elbow.
Nighttime symptoms that disrupt sleep.

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Early evaluation prevents long-term nerve damage and restores comfort.

Take the First Step Toward Recovery

If numbness, tingling, or weakness is affecting your daily life, expert care can help.
At Dr. Burke Orthopedics, we specialize in diagnosing and treating cubital tunnel syndrome using advanced, minimally invasive methods designed to protect your nerve health and restore function.

We proudly serve Pearland, Houston, Friendswood, and Southeast Texas, providing trusted orthopedic and nerve care with personalized attention.

Call (713) 436-3488 or Request an Appointment Online to schedule your consultation with Dr. Robert L. Burke, board-certified orthopedic surgeon specializing in elbow and upper-extremity nerve disorders.

Medical Disclaimer:

The information provided on this page is for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified healthcare provider with any questions you may have regarding medical condition or treatment. If you experience severe pain, weakness, or numbness, contact a medical professional immediately or visit your nearest emergency center.