Physio Penrith Cubital Tunnel Syndrome Treatment
Treatment of Cubital Tunnel Syndrome at Sydney Muscle & Joint Physio Penrith
What is cubital tunnel syndrome?
Cubital tunnel syndrome is one of the most common compression neuropathies of the upper extremity, second only to carpal tunnel syndrome. The cubital tunnel is a space of the dorsal medial elbow and involves compression of the ulnar nerve, mostly commonly at the Arcade of Struthers. Compression of the ulnar nerve will involves changes in sensory and motor function in the forearm, hand and fingers. The neuropathy in cubital tunnel syndrome is caused by increased compression of the nerve as the elbow flexes (bends).
What are some common symptoms of cubital tunnel syndrome?
The neuropathy in cubital tunnel syndrome will present with pain and changes in sensation, including numbness. tingling, burning, pins and needles, along the inner side of the forearm from the elbow into the hand and fingers. Generally the 4th and 5th fingers are involved. Further, complaints of pain around the medial aspect of the elbow (inside of elbow) will be reported and all symptoms may be worse at night and with bending of the elbow (flexion). Weakness in gripping and pinching is also experienced.
Diagnosis of cubital tunnel syndrome
Diagnosis of cubital tunnel syndrome will involve ruling out the neck as a source of compression neuropathy. Dermatomal testing and motor testing of the fingers, wrist and forearm may present with weakness and atrophy of muscles- especially intrinsic hand muscles. Testing of grip strength and finger abduction is crucial. Range of motion of the elbow (especially supination and pronation) may elicit deficits that may contribute to the compression of the ulnar nerve at the elbow. Provocative tests may include tinel sign at the ulnar nerve and the elbow flexion compression test (maximum elbow flexion and supination with wrist extension).
Guideline-based treatment of cubital tunnel syndrome
There is a paucity of literature and high quality studies regarding the conservative management of cubital tunnel syndrome. Regardless, there appears to be a role for non-surgical management in cubital tunnel syndrome.
At Sydney Muscle & Joint Clinic Penrith our physiotherapists and exercise physiologists utilise best available evidence to guide treatment of cubital tunnel syndrome. Education and advice regarding aggravating movements and postures may help to reduce irritability of the pain, followed by passive interventions to correct any deficits in joint restriction and muscle tightness that may contribute to increased compression of the ulnar nerve. Our physios then utilise neurodynamic nerve stretching of gliding in an attempt to help floss the nerve in the groove. Strengthening of triceps, biceps and supination and pronation muscles is also a main intervention in the management of the impairments related to cubital tunnel syndrome.