Cubital Tunnel Syndrome Elbow Hand Hand Therapy

Advice from a Certified Hand Therapist on Cubital Tunnel Syndrome

Image of patient after injury using elbow stabilizer ** Note: Soft Focus at 100%, best at smaller sizes

Cubital tunnel syndrome: Hand numbness and tingling is not always carpal tunnel syndrome.

I have a funny tingling in my small and ring fingers while holding my cell phone to my ear or while holding a book when reading in bed. Why?

That “funny” sensation could be compression of the ulnar nerve at the elbow. The path of the ulnar nerve runs just behind the boney part on the inside of the elbow. The nerve is close to the skin and runs through a boney ridge without any substantial padding. The nerve must slide and stretch through this cubital tunnel with elbow movement.

Wait a minute! What does the nerve at my elbow have to do with the funny sensations in my hand?

Good question! The job of the ulnar nerve is to facilitate communication from your brain to your hand. This communication operates the muscles that help you perform coordinated movements with your fingers. Another job of the ulnar nerve is to take information about sensation at the ring and small fingers back to the brain. If the nerve is compressed or irritated, it can’t do its job. This condition leads to difficulty manipulating objects with your hand, feelings of weakness and sensations of tingling, numbness, burning or tightness in your fingers.

That doesn’t sound good. What can I do?

There is good news. There are some things you can try that might calm the nerve. Nerves do not like to be crowded. The ulnar nerve becomes crowded at the elbow with direct pressure over its path or when the elbow is held in a bent position for an extended period of time.

Here are a few tips:

  • Avoid resting the elbow on hard surfaces, such as the arm rests in the car or on chairs and tables. If you need to rest your elbows, pad either your elbow or the hard surface.
  • Avoid keeping the elbow bent for long periods of time. Use an earpiece for your cell or work phone. At night, splint the elbow in a straighter position by wrapping and taping a bath towel around the elbow (pictured) or using an orthosis made by a certified hand therapist. There are nighttime orthoses available to purchase online (pictured), as well.

Cubital Tunnel Orthosis - Towel - Hite 2015Cubital Tunnel Orthosis - Neoprene - Heidi Hermann Wright

  • Make the entire path of the ulnar nerve a better place. The ulnar nerve runs behind the pectoralis muscles and through some of the muscles in the neck. Poor posture makes these areas tight and can also cause some nerve compression. If you work at a desk, stand up periodically and stretch your shoulders and neck. I also recommend working on breathing patterns. Make sure to take a few breaths that come from deep in your belly. This helps the muscles in your neck relax.

The tingling goes away if I shake my hands around. I don’t think it is really that serious.

Yikes! It is always important to take care of your nerves. Nerve compression syndromes can worsen over time, and nerves take months to recover even with the best of care. If your issues persist, find a hand surgeon to help. The hand surgeon may refer you to a certified hand therapist for additional non-operative treatment.

 

Stacy Hite, PT, DPT, MS, CHT is a Certified Hand Therapist and member of the American Society of Hand Therapists (ASHT).

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17 Comments
  • November 12, 2018 at 4:45 AM
    Reply

    Nice and very informative post. I would like to visit this site for such a post. keep writing and keep posting thank you.

  • Mark newby
    October 18, 2018 at 5:03 PM
    Reply

    Cold hands in the morning but not always finger next to thumb gets little painful but only in cold weather (cold hand from a child 50 now)

  • Liliana
    October 9, 2018 at 10:14 AM
    Reply

    I have been having this really horrible pain in my left pinky finger for over 2 years now. I went to my orthopedic doctor and after some test he told me I have cubical tunnel syndrome. I had surgery to release the nerve at my elbow. My pain in my finger diminishes but it still gutted every time Anything touches he outside part of it. It has been a year since my surgery and things are getting worst again. I wake up at night with bad pain from my elbow to my pinky finger. It feels like shock, sometimes like a stabbing pain. I don’t know what to do. I also have a bulging disk in the C4-5 area. The doctor believes that might be causing the pain. Any advice? Should I see another doctor? Sometimes the pain is so bad especially if I accidentally hit my finger with something, I feel like cutting it off might be the only solution. Any advice please!

    • ethan
      October 14, 2018 at 10:16 PM
      Reply

      Hey Liliana, if it makes you feel better I’m dealing with the same issue. I had an ulnar nerve subcutaneous transposition on my left arm because of persistent pain and numbness into my left ring and pinky finger. It’s been 15 months since my operation and I feel like my hand is worse than before the operation. It aches and burns if I use it and it’s very annoying for me. I wish there was something that would give me relief.

      • liliana
        October 22, 2018 at 2:34 PM
        Reply

        Well I thought I was going crazy. I read all this comments about cubital tunnel syndrome and none talked about horrible pain the pinky finger only tingling and numbness. I wished I only had that. The pain is so bad, I tried not to use my left hand because I’m afraid to hit my finger, never had such a bad pain in my life not even when I had my kids. If you have any more information I will appreciate it. At least I’m not alone. 🙂

        • Catriona
          December 3, 2018 at 5:45 AM
          Reply

          Hi Liliana and Ethan. For the last 6 weeks I’ve been getting the same pain in my left pinky finger – it feels like it is broken. I have been using a night splint (tried two, the first was way too big and second seemed not to help, in fact it was worse in the mornings after using it – suspect I still bent my elbow somehow, and then plus a restriction: worse pinching). I have carpal tunnel in my right hand which I am going to get the cortisone injection (the 1st worked for some time then it came back, doctor says will hopefully stick next one).
          I am 31 years old (female) and my 70yo mother has terrible rheumatoid arthritis in her hands (though bizarrely with low inflammation markers, but every other symptom is present). I can’t tell you how scared I am of losing any function in my hands/arms at this age.

  • Tyler from Ohio
    July 16, 2018 at 9:20 PM
    Reply

    Hello, thanks for the good article! Odd question, but my triggers seem kind of odd as well: can wearing a heavy backpack or a guitar strap for multiple hours a day cause ulnar nerve entrapment in the shoulder?

    • Kate
      September 23, 2018 at 11:06 AM
      Reply

      Tyler, if the heavy backpack/guitar strap are your only triggers, it sounds like you have backpack palsy. It involves compression of the brachial plexus. Hope that helps!

  • Ciara
    February 19, 2018 at 6:47 PM
    Reply

    Would this condition cause you problems while writing with a pen at a desk?

  • Kristina
    August 29, 2017 at 10:21 PM
    Reply

    I have this problem with both arms, the right being worse than the left.

    Get this, my neurologist says I can’t bend my arms whatsoever, can you believe that?

    He also says that my nerves need to deteriorate to the point that this happens daily before he will help me. And I’ve been dealing with this for over a year and a half.

    • Erin
      December 15, 2017 at 9:08 AM
      Reply

      You need a new neurologist.

    • Nick
      January 21, 2018 at 12:46 PM
      Reply

      ..or if you’re stuck with that Neurologist for some reason, give him what he’s asking for..

  • October 9, 2015 at 8:23 AM
    Reply

    Tingling in some part of the body it happens when your elbow nerve system is not working properly. I had a question I saw in your picture the person wear a bath towel on his hand. This will create any problem? I thought the blood circulation will be halted.

    • Stacy Hite
      October 9, 2015 at 10:21 AM
      Reply

      Excellent question! We make sure to instruct our patients to wrap the towel comfortably snug, but not tight. The advantages of the towel splint are 1. It’s free, 2. It will allow a small range of movement, but block elbow flexion beyond 70ish degrees, and 3. It pads the elbow as the person rests the elbow against the bed to sleep–even propping it up a bit to take the stretch off of the nerve. Hopes this helps!!

  • July 28, 2015 at 7:52 PM
    Reply

    This is a comfortable brace to treat cubital tunnel while typing on the keyboard or sleeping at night. http://www.thelonniebrace.com.

    • Janet
      October 9, 2015 at 6:54 PM
      Reply

      This appears to be a conflict of interest since you designed and evaluated the splint yourself. The other splints do not promote anything or anyone.

    • Dana
      January 27, 2018 at 3:04 PM
      Reply

      Hey Steve. I hope you find someone to design a better shirt for you. The one in your photo is looking a bit large.

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