Surgery - Last Resort  E-mail

If conservative therapy doesn't work or your symptoms become severe, your doctor may recommend surgery to relieve pressure on your ulnar nerve. There are a few different procedures depending on the patient and situation:

  • Simple decompression - One of the cubital tunnel ligaments is cut to open the tunnel and reduce pressure on the nerve.
  • Ulnar transposition - Moves the ulnar nerve out of the cubital tunnel to the topside of the elbow.
  • Shave medial epicondyle - The bony medial epicondyle on the elbow is shaved down so the ulnar nerve can shift freely in and out of the cubital tunnel.

Most cubital tunnel surgeries require a 3-4 inch incision over the cubital tunnel on the elbow, and are performed under local anesthetic as an outpatient procedure. The surgery is painful but the drugs on surgery day should help ease that pain.

Recovery and pain depend on how bad the symptoms were and which procedure was used. If you only had the medial epicondyle removed, you'll have just a soft bandage wrapped over your elbow and therapy can progress quickly. Initial recovery from decompression surgery is about a week.  For ulnar transposition surgery, your elbow will be splinted and immobilized for three weeks. When the splint is removed, you will perform assisted movements with a therapist for another three weeks. Active therapy starts six weeks after surgery and includes light isometric strengthening exercises. Three months after surgery you should be back in top shape, hopefully pain-free and ready to work again.

Many people are helped by cubital tunnel surgery. From anecdotal evidence on the Web, the success rate seems to be about 70%, with many people reporting at least some improvement. But complete recovery (no pain or tingling ever again) is less common, especially if you return to the activity that brought you pain in the first place.

Be sure to discuss your situation and expectations with your family, employer and surgeon. Ask your surgeon how many cubital tunnel surgeries they have performed, and what is their estimated success rate. Get a second opinion if you have any doubts.

Check out our surgery forum - Ask questions and see what others have experienced

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