Cubital Tunnel Syndrome: information

Nerves can not only be irritated as they exit the spine but also at distant sites away from the spine. These are known as peripheral entrapments.

The ulnar nerve arises from the medial cord of the brachial plexus, a branch of nerve fibres which stem from the neck. This nerve supplies the muscular strength to most of the small muscles of the hand, the Flexor Capri ulnaris and to half of the Flexor Carpi Profundus.

In addition, the ulnar nerve supplies sensation to the inner part of the hand and arm as can be seen below

Because the Ulnar nerve is close to the skin along certain points along its course down the arm into the hand, the nerve is vulnerable to injury at certain sites, namely in the Cubital Tunnel of the elbow and also the Guyon’s Canal of the wrist.

At the elbow, the Cubital tunnel is located behind the medial epicondyle (“funny bone”) and is formed by muscle, ligament and bone. The ulnar nerve can become irritated within this tunnel and as a result, the patient often experiences pins and needles/ numbness along the inner forearm and hand in the distribution of the ulnar nerve (see diagram) with possible weakness of the muscles that this nerve innervates. This condition often occurs in patients with tight wrist and fingers flexors or patients who spend prolonged periods leaning on their elbows or adopting a position which results in prolonged stretching of the ulnar nerve within this confined space.

Treatment options for Cubital Tunnel Syndrome

At the Bodymotion Chiropractic and Sports Injuries Clinic, treatment is initially directed at establishing which activities have predisposed the patient to this condition and how to modify these activities to prevent this complaint being aggravated in future. Chiropractic treatment often involves soft tissue work, mobilisation and manipulation of the wrist and elbow as well as specific nerve mobilisation stretches.

The neck and mid back may also be treated to reduce the possibility of a double crush syndrome whereby if a nerve is mildly irritated in the neck or further up the chain, it will be more susceptible to injury distally lower down the chain such as in the elbow.

In some instances, surgery is necessary and will involve releasing the pressure on the ulnar nerve. This is usually only considered after a course of more conservative treatment.

If you have any questions regarding this complaint, please contact our EC2 clinic on enquiries@body-motion.co.uk.