Hey guys,

I am in a bit of a pickle here. I have been unofficially diagnosed with cubital tunnel by my family doc. I have all the signs, numbness and tingling in my ring and pinky, sometimes a nerve pulse, and intense pain in my elbow when I place it on a surface.

My symptoms do tend to go away at night in bed, and sometimes I get full normal sensation back in my fingers. My hand still feels strong.

My problem is I can't get health insurance until Jan 2010 so I risk enomorous health costs if I go to a specialist and get nerve tests down and such.

OTOH, I don't want to risk permanent nerve damage. I can't live the rest of my life with this. It has me so miserable.

My question is would it be safe to wait 5 months if I did need surgery? Or does nerve damage progress quickly? I am going to start night splints and drugs.

You might also try wearing a soft pad on your elbow. There is one brand called a Heelbo if you want to look for more information. It slips on and pads the elbow so when you lean on something it is protected some. It is also great if you are a klutz like me and walk into stuff often.

In my opinion, it wouldn't do much more damage, I was asked to wait 4 months prior to surgery in an attempt to try more conservative treatment and suffered no dire consequences (my surgery did end up with poor results, but that wasn't because I waited). If you can't afford it, I wouldn't be overly concerned about it. Try splinting it at night and using pad as well as a NSAID (prescribed or over the counter, like Lodine, Ibuprofen, or Naproxen). Often these conservative are able to successfully reduce the symptoms and prevent the need for surgery or at least allow you to wait more comfortably.

The answer is simply it depends on how your nerve is. Really the only way to tell is via a nerve test, however if it is mildly annoying and not terrible a doctor or neurologist would be the one to answer. Yes.. you risk permanent damage.. I waited approximately two years before surgery and during my emg was told no signs of permanent damage were there.. but it was minor compared to some other cases I hear about. In my case when I did certain activities (like work on the computer all day for my job) or mountain bike rocky terrain more.. it was worse. I tried conservative treatment.. unfortunately for me it didn't work but for a family member of mine it did and does work for about 90% of the cases so I was told. I didnt have intense elbow pain like you did. As mentioned earlier..maybe a regime of anti-inflammatory, pad, sleeping with arm straight and not using it may help. Dont hold the phone with it, don't lean it on anything especially if it hurts.. and especially on a desk while driving note your arm position. When I sit in a chair and lean over to casually talk with someone now I put the pressure on the back side of my arm leaning on the inside of my leg rather than leaning on the inside of my elbow. All these little things my help it for you. Note though.. it can take _months_ to go away and heal so if it starts to feel a little better.. that is not the time to stop your conservative treatment.

Wow, I have to say most of what I've read has been extremely discouraging.

It's funny that the media has taken notice of this and called it cell phone elbow, and makes it sound like one of those mild irritating pains we can get in life.

But this is definitely the scariest thing I've faced, and I've dealt with gout, back pain, tinnitus and corneal erosions. I can take some comfort in remembering that I was in total despair during those conditions, yet I overcame them. Hopefully I can get a positive attitude and beat this thing as well.


I guess I'm going to have to wait and watch.

The pain level is tolerable even without meds and goes away at night. I would think the fact that I get full sensation back in my fingers is a sign that there is no nerve damage. In fact, my sypmtoms completely disappeared for 6 days around July 4th! They came back on while typing at work on the computer. And I was leaning on my elbow the whole time. If I had only known not to do that!

It is doubtful that a specialist will see me with no health insurance. From what I've read on this forum, it doesn't even sound like EMGs are reliable, and the surgery isn't very successful.

"In fact, my sypmtoms completely disappeared for 6 days around July 4th! They came back on while typing at work on the computer. And I was leaning on my elbow the whole time. If I had only known not to do that!"

that right there is a good sign.. just keep paying attention and I think you'll be in a good position. for me making sure I had a position where my elbows were bent _the least_ when at the computer helped. ie as straight as possible even if it means leaning pretty far away from your desk.. see my picture here if I didnt make sense:

Also as for EMG - I've had six of them... literally. Five related to cubital tunnel.
With a GOOD neurologist/doctor they can tell a heck of a lot of information that others totally miss. The amount of nerve information you can get it actually amazing and there is a waveform they can look at that shows signs of perm. damage.. a neurologist in CA was explaining this to me before. They can also look for signs of nerve diseases, etc etc. After going to other doctors that didn't seem to read it as well and now meeting two doctors that were _excellent_ at it.. there is a wealth of information they can derive from it in more cases than not.

If their equipment for EMG looks old.. run. I was assured by a neurologist it would give same results as newer equipment (such as those running SieraWin software which are the best imho) and lo and behold.. the results on the old equipment said "he has no problem" and the new equipment clearly showed anissue.

I have been lurking on this site for a while and have decided to comment. First of all I find these forums very depressing. I am currently a third year medical student and have been dealing with ulnar neuropathy for a little over a year. I have no pain, numbness or tingling. The only thing I have is a positive tinnels at the elbow that comes and goes with use. My cousin has been struggling with ulnar neuropathies for 11 years and manages it with exercise. No surgeries. I recommend the book "Pain Free at the PC". Being in the medical field I have seen many upper extremity neuropathies. When it comes to ulnar nerves we do not recommended surgery unless the symptoms are severe. Why? Because ulnar nerve surgeries have very poor outcomes and this site just validates it. You can maintain it through personal diligence. What works for me is focusing on keeping my hips anteriorly rotated through exercise. Working out back muscles help too. I do this everyday. Make sure youre drinking a lot of water. Ulnar nerve neuropathies for most of the time can be managed. But you must realize that it is a life style change and it takes work. If youre too unmotivated to put in the time, then I recommend you take the gamble of going under the knife.....