Cubital tunnel syndrome
- Compression of the ulnar nerve beneath the medial epicondyle with secondary numbness, tingling, or pain in the little and ring fingers, with possible medial elbow aching.
- In later stages patients may develop weakness of grip, poor coordination and muscle wasting.
- Typically exacerbated by activities requiring persistent elbow flexion, or trauma.
- In cases of diagnostic uncertainty, or in patients being referred for possible surgery, consider referral for electromyography and nerve conduction studies.
- Avoid activities that require prolonged elbow flexion.
- Avoid putting pressure on the inside of the arm.
- Non-steroidal anti-inflammatory medicines – suitable in acute presentation to help reduce swelling around the nerve.
- Bracing or splinting. Padded brace or elbow splint worn at night to keep elbow extended.
- Physiotherapy for nerve gliding exercises. Referral Indications: Diagnostic uncertainty, Referral for EMG / NCS, Severe or progressive sensory / motor impairment, Failure to improve with 3 months conservative measure.