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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37 Comments
  • Mando
    September 19, 2019 at 2:34 PM
    Reply

    It all started about a month and a half ago when the outside of my right wrist started hurting. Went to doctor, they believed it was a sprain so I was given a wrist splint. The pain in the wrist subsided over time. After that I felt a “sensation” up to my elbow and the numbness in the pinky and wring finger. Went back to doctor and he pushed and pulled on my arm and said he didn’t believe it was anything long-term. I was put on Meloxicam for 10 days and that finished yesterday. I’m freaking out a bit, I’m 35 and I do have an office job which requires me to be at a computer a lot. I bought an ergonomic keyboard/mouse w/separate number pad which I’ve placed on my unaffected left side, and an elbow splint which I use at night, and I treat it topically with a cream my mother gave me. I’m a bit nervous about this getting worse. I take a 15 minute break every hour and stretch now. I’ve scoured the internet for all kinds of tips and have come across that prognosis is usually positive, which gives me hope. Don’t just wait around! Do what you can to control it ASAP. I always worry that it may get worse as I wait for my next apt (this time with a physical therapist this coming Monday). If you’re an office worker, it’s time to get ergonomic. I’ve noticed a great difference with the keyboard. With the number pad separate my arms are closer to my body. The mouse I’m still figuring out so I try not to leave my hand on it if I’m not using it. I’ve also raised my screen so it is level with my head looking forward and no longer looking down which causes me to slouch when looking at the screen. I hope to resolve this before it develops anymore. Be proactive do what you can with the information you have. Any tips would be greatly appreciated… and remember…. you’re not alone.

    • Barbara Morgan
      October 6, 2019 at 1:03 AM
      Reply

      My fingers went numb about 43 months ago; I have struggled to find help, but have not been able to yet. I have been doing exercises that I have found online but my hand strength (I am right handed, and of course it’s my right hand) is greatly reduced and I can’t do many things anymore. The GPs I’ve seen do not get what this is and think I am an old lady imagining it. Very frustrating!

      • Barbara Morgan
        October 6, 2019 at 1:04 AM
        Reply

        Edit: 4 months ago, NOT 43!

        • Amanda
          October 16, 2019 at 1:20 PM
          Reply

          Barbara, same thing here but after 6 months I was diagnosed with cubital tunnel. (Elbow). Impacts the ulnar nerve which goes down into the ring finger and pinky. Weakness is not good. Numbness isnt either but losing strength in the hand is worse. Please go see a specialist.

  • Noah
    September 1, 2019 at 3:09 PM
    Reply

    Hi am 14 I had my elbow bent for a while playing videos games didn’t know what was going on the next day when my left pinky and ring finger was numb thought I just slept on my hand and the numbness would go away but it didn’t it’s been numb for 2 days should I be scared at this age I don’t know what to do please reply anyone

    • Barbara Morgan
      October 6, 2019 at 1:05 AM
      Reply

      TELL YOUR PARENTS! GO SEE A DOCTOR NOW!

  • Danny
    July 3, 2019 at 9:32 PM
    Reply

    I’m a 31 year old male with a generally good health status prior to developing what the doctor called ulnar neuropathy, the right side of my pinky and ring finger are numb to the touch, there’s no pain involved but its been ongoing for the last 2 month and counting. I had an ultra sound done from the wrist to the elbow where it showed no compression, I’m now waiting for an appointment with a neurology specialist in august to have nerve conduction studies done. I wish I knew the cause would love to find a solution it has caused me a great deal of distress, its absolutely horrible. I will post an update, hopefully when I manage to resolve the issue. Would also like to say thankyou to everyone, I really appreciate the comments relating to this, at least were not suffering alone and hopefully others will find solace in reading the stories we post and knowing there not alone also.

  • June 20, 2019 at 7:30 AM
    Reply

    Arthritis is the common problems in hands and Fingers also this is Great content i gain more information from this blog… thanks for sharing with us.

  • Alec Bar
    May 15, 2019 at 12:34 PM
    Reply

    Cubital tunnel in both elbows. Worse in left. Operation in Nov 2018 now much worse, wasting and pain. MRI done on neck now saying need to see a neuro surgeon as may be why not getting better after elbow op. Am a barber and can work until this is sorted. Depressing

  • Gwen
    May 11, 2019 at 9:52 PM
    Reply

    I think in the beginning I had pins and needles with pinky and ring finger. I believed it was a ulnar nerve that had numbness but not so much numbness any more. Only when I wake in the middle of the night my arm is completely numb, in which I have to use my other arm to move it (like moving a dead body… No pun intended) Now it’s mainly weakness and lately stiffness in my pinky and ring finger. Could it be ulnar nerve?

    • Jim
      May 28, 2019 at 8:54 PM
      Reply

      Sounds very similar to my condition. I had ulnar nerve transposition 6 weeks ago, which fixed it. Mostly recovered now accept joint stiffness in elbow.

  • Ronnie
    May 10, 2019 at 8:02 AM
    Reply

    I wish I can give you all hugs. I don’t feel alone.
    I’m so scared of surgery and it’s been over 2 years since I was hit by a truck . Dealing with the depression , and how everyone looks at you like your alright when your in pain.

  • Dave
    April 9, 2019 at 5:38 PM
    Reply

    I’m sorry to hear some of you have this really bad. Mine has not progressed to pain yet but I do ultrasound diagnostic studies that cause it to become irritated. While there a few different reasons why this occurs, it’s still basically compression of the ulnar nerve at some point. This nerve runs down between the bones in your elbow, which is where the compression often occurs. There are a few things I do that might be helpful. Avoid overuse of the affected arm/wrist/hand if you can. I can’t really do that, so I manipulate my elbow and wrist using my other hand in a mostly extended position, pressing behind the elbow and working the 2 bony points of the elbow and wrist. This sometimes alleviates the tingling pins and needles. Try not to rest your head on that hand or bend it more than halfway for any reason. Sleep with your arm extended and preferably elevated by a pillow. Try not to sleep on the affected side if you can. I find how I sleep makes a difference. Remember, your nerve needs blood flow just like everything else in your body. If it is compressed over an extended period it will cease to function as it should, and will eventually stop. Surgery seems not very successful for this condition but may be the last option. Good luck, hope that was helpful.

  • Jill Weidner
    March 24, 2019 at 7:44 PM
    Reply

    I had ulnar nerve surgery 2 years ago on my left arm. The pain is still there. Really didnt do much good. They said my nerves were really bungled up. Hate to go back to this doctor anymore. Can they do this surgery again since it didnt work the first time? It is driving me crazy!! Want to cut my arm off, lol.

  • Michael
    March 15, 2019 at 4:53 PM
    Reply

    I had cubital tunnel release surgery a little over a year ago with no success. I have muscle wasting in my hand and arm. The whole thing has been going on for two years. What should I do? Who do I see? I don’t to see the same doctor again.

  • 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.

          • Renee
            January 21, 2019 at 8:38 AM

            I’m also in my 30’s and I have been diagnosed with cubital syndrome in both my elbows. I’m very saddened by this because the surgeries are not that successful. I feel like my life is over and I feel stress with the pain it affected my life and it been on going for the last 4 months I sleep with splint on and go to a hand therapy

          • Katrina
            February 21, 2019 at 8:59 PM

            I had cubital tunnel and carpel tunnel surgery on my right hand in 2017. I went to an orthopedic surgeon who specializes in arm and hand surgery. He said that, in my case, the symptoms could have been only carpel tunnel (nerves in the wrist) but he’s found that nerves are tricky. When he’s done surgery on just the carpel tunnel the patient still has pain. When he’s done both surgeries at the same time he’s had a lot better success. My pain was gone right after the surgery. The numbness slowly receded over a few months. Huge relief of pain. Hope this helps.

      • Dorcas Edwards
        April 15, 2019 at 3:20 AM
        Reply

        Same thing here; subcutaneous transposition surgery 2 yrs ago and I am still in pain everyday. I don’t know what to do.

  • 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..

    • April
      January 16, 2019 at 6:52 AM
      Reply

      I believe they are trying to above surgery because the risk may outweigh the benefits. I’m also in the same situation and after reading a lot of forums it seem like the surgery doesn’t help everyone. It very frustrating but I’m would seek out other conservative treatments to manage your symptoms before surgery.

      • Elizabeth Norton
        February 9, 2019 at 9:28 PM
        Reply

        I just found out I have this in both of my hands but worse in my left hand. I thought surgery would be better than permanent damage. Now I question that to some degree because it’s seems the surgery isn’t too successful. What to do know. It’s get worse as time goes on.

  • 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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