Top 10 Things You Need to Know About Cubital Tunnel Syndrome

If you have pain or numbness in your ring & little fingers or your elbow, it’s quite possible that you suffer from Cubital Tunnel Syndrome (CuTS).  CuTS is a repetitive stress injury (RSI) that feels like you hit your funny bone.  CuTS is caused when the ulnar nerve in your arm is irritated, pinched or damaged, typically at the bony point on the elbow.  If left untreated, CuTS can result in extreme pain, surgery or an unusable hand. 

No doubt you have many questions and concerns and are visiting web sites such as for answers.  The CuTS FAQ is a great place to start.  And in this article we provide the ten most important things you need to know about Cubital Tunnel Syndrome:

1.  See a hand surgeon or specialist

Cubital Tunnel Syndrome is a serious medical affliction that requires attention from a specialist who has direct experience treating CuTS.  Do not rely solely on this website, any other website, or your family doctor. 

If your CuTS symptoms are extreme or last more than a few days, be sure to see a hand doctor or surgeon as soon as possible.  Be sure to ask lots of questions.  If you find that your doctor is not a CuTS expert or you have any doubts about his/her diagnosis or advice, be sure to get a second opinion.

2.  NCV test is better than EMG for indicating CuTS

A nerve conduction velocity (NCV) test measures the speed of the impulses traveling along the ulnar nerve.  Impulses slow down when the nerve is constricted.  An electromyogram (EMG) tests the muscles of the forearm controlled by the ulnar nerve.  If the muscles are not working properly, it’s possibly due to nerve damage.

Studies indicate that that reduced velocity across the ulnar nerve is a good indicator of CuTS.  There is some anecdotal evidence that an NCV test is a better indicator of CuTS than an EMG since the NCV evaluates the nerve directly.

3.  It’s possible to have CuTS pain and symptoms with a negative NCV or EMG test

A negative NCV or EMG test does NOT mean you are fine.  Pain, numbness, muscle weakness and atrophy may occur with a pinched nerve.  But if the nerve compression is mild or only a portion of the nerve is affected, then these tests may be negative.

So if you are experiencing CuTS symptoms, do not allow negative NCV/EMG results stop your medical care.  Keep pressing your doctor for a solution.  If you have pain and muscle wasting, you have a real problem, despite what the test results say.

4.  It’s important to find the root cause of your CuTS and fix it

CuTS symptoms appear when the ulnar nerve is pinched or damaged.  The only way you can treat CuTS without surgery is to figure out the activity or activities that are pinching your nerve, then stop or modify those activities. 

For example, if you experience CuTS when using a computer, reduce your computer use, ensure your workstation is ergonomically correct, use special software and hardware to reduce your repetitive motion, etc.

5.  Sleeping with bent elbows will cause or irritate CuTS

Sleeping with your elbow bent and tucked under your head is one of the most common causes of CuTS.  But because this is something you do while you sleep, you may not even be aware that it’s harming you. 

It’s important that you sleep with your arms relatively straight, bending no more than 45 degrees at the elbow.  You can achieve this by wearing a splint at night, wrapping your arm in a folded towel, or retraining yourself to sleep with your arms straight.

6.  Conservative treatment is recommended before surgery

Most doctors recommend that patients undergo conservative treatment before rushing to surgery, except in cases of injury or severe CuTS.  Conservative treatment includes wearing a splint to keep your arm straight while sleeping, physical therapy, change in work habits, using tools and technology to reduce repetitive motion, and taking medication to reduce pain.

7.  But don’t wait too long before surgery

Studies indicate that the worse your CuTS symptoms are before surgery, the less chance you have for a complete recovery.  So if your symptoms are severe or persist after a few months of conservative treatment, you should consider having surgery.

8.  Ulnar decompression is preferred over transposition for CuTS surgery

Ulnar transposition surgery is much more invasive, requires lengthy immobilization of the arm after surgery, and recovery is at least twice as long versus simple decompression surgery.  But there are many valid reasons to choose transposition surgery over decompression, for example, for patients with severe CuTS and a clawing of the hand.

If you are scheduled for ulnar transposition surgery, be sure to ask your doctor why you are having transposition surgery instead of simple decompression.  In your case, there may be a valid reason.  But it’s important that you understand why you need a more invasive surgery with a longer recovery time.

9.  Surgery reduces CuTS pain and symptoms for a majority of patients

Studies indicate the success rate is roughly the same for the three major types of cubital tunnel surgery — decompression, transposition, and medial epicondylectomy.  About 70% of patients see improvement, 20% see little or no improvement, and 10% get worse.  From anecdotal evidence in the CuTS forums, surgery seems to help most patients at least a little bit.

10.  But surgery usually does not completely eliminate CuTS pain and symptoms

CuTS is the gift that keeps on giving.  Though most patients improve after surgery, very few patients see a complete recovery with absolutely no CuTS pain or symptoms ever again.  This is true especially if you return to the activities that caused your CuTS symptoms in the first place.

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  3. Conclusions from Studies on Cubital Tunnel Syndrome
  4. Studies on Cubital Tunnel Syndrome
  5. Integra LifeSciences Develops EndoRelease for Cubital Tunnel Syndrome

Important: This website is for information purposes only and does not constitute medical advice. The information on this website represents the personal experience of cubital tunnel patients and has not been certified by medical professionals. Each person and case is different. Be sure to seek medical advice from a doctor with experience treating cubital tunnel syndrome and get a second opinion if needed.

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