Ulnar Nerve Entrapment

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Ulnar Nerve Entrapment (Cubital Tunnel Syndrome) Overview

Ulnar nerve entrapment at the elbow joint, otherwise known as cubital tunnel syndrome may cause elbow pain along with numbness and tingling in the hands and fingers of patients. This condition occurs when the ulnar nerve becomes compressed or irritated as it wraps around the medial elbow. This is the common problem at the elbow, which is similar to carpal tunnel syndrome at the wrist. Dr. Jervis Yau, orthopedic elbow specialist, is available to assist patients from Santa Barbara, Goleta, Santa Maria, Ventura, California and surrounding areas affected by this condition.

The ulnar nerve is one of the three main nerves in the arm and gives motor and sensation to the arm and hand. The exact cause of ulnar nerve entrapment is unknown, but is likely due to compression in the cubital tunnel of the elbow. This syndrome can be associated with elbow deformity from previous fractures, bone spurs, cysts and those affected by diabetes or other autoimmune diseases.

Ulnar Nerve Entrapment (Cubital Tunnel Syndrome) Symptoms

Cubital tunnel syndrome is marked by pain, numbness and tingling in the ring finger and small finger. The symptoms worsen when the elbow is placed in a flexed or bent position. More severe cases may lead to difficulty with finger coordination, decreased grip strength and muscle atrophy. It is important to note that significant muscle atrophy cannot be reversed. Because of this, patients are strongly encouraged to contact Dr. Yau at the onset of ulnar nerve entrapment symptoms.

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Ulnar Nerve Entrapment (Cubital Tunnel Syndrome) Diagnosis

Dr. Yau will perform a complete medical review and physical examination in order to accurately diagnose the condition. During the physical examination, he will tap on the ulnar nerve at the cubital tunnel to determine the severity of symptoms along with assessing for strength and sensory deficits. A series of x-rays and MRI may be ordered to aid in the diagnosis if necessary. Often, patients will be sent for a nerve conduction study to assess the severity of nerve injury.

Ulnar Nerve Entrapment (Cubital Tunnel Syndrome) Treatment

Non-Surgical

Dr. Yau begins cubital tunnel syndrome treatment with non-surgical measures, unless the patient has severe symptoms such as weakness and muscle atrophy. Standard treatment includes anti-inflammatory medications (NSAIDs) and physical therapy aimed at decreasing scar surrounding the nerve through nerve glides, along with restoring range of motion and strength to the elbow.

Surgical

Surgical decompression will be recommended if conservative measures fail to alleviate symptoms or if a patient presents with severe symptoms such as muscle atrophy and weakness. Surgical decompression is typically performed through an open incision and the nerve sheath is incised with care taken to protect the nerve.  Scar tissue around the nerve is removed.  If the patient has elbow deformity or severe nerve disease, the ulnar nerve may be moved from its original location behind the elbow to a new location at the front of the elbow known as “ulnar nerve transposition.”  For most cases of cubital tunnel syndrome, studies have shown that simple decompression is the recommended procedure.

For additional resources on ulnar nerve entrapment, or to determine the appropriate treatment plan for cubital tunnel syndrome, please contact Dr. Jervis Yau, orthopedic elbow specialist serving the Santa Barbara, Goleta, Santa Maria and Ventura, California communities.

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