Are your little finger and ring finger tingling? It could be Cubital Tunnel Syndrome!

Have you ever felt a strange sensation like a jolt running down your arm when you bump your elbow? We all jokingly call it the "funny bone." But it's not really a bone. It's a feeling that comes from a very important nerve that runs along the inside of your elbow. Sometimes this nerve just gets pinched. Then your little finger and ring finger can feel numb and painful. That's what we call Cubital Tunnel Syndrome. Let's talk about it in simple terms today.

Simply put, what is Cubital Tunnel Syndrome?

Cubital tunnel syndrome is a condition in which the ulnar nerve, located on the inside of our elbow, becomes compressed or compressed. This is also called ulnar nerve entrapment.

Now you might be wondering what the Ulnar nerve is. Our body's brain carries messages throughout the body through nerves. Like electrical wires. We have three main nerves in our hand. One of them is the Ulnar nerve. It starts in our neck, goes down our arm, and ends in our palm.

As this nerve passes through the elbow, it goes through a small tunnel made of bone and other tissue. This is what we call the cubital tunnel . This tunnel is located under a small bone bump on the inside of the elbow. In medical terms, we call this bump the medial epicondyle . You can feel it with your hand, that pointy bone on the inside of the elbow. That's what it feels like when you hit that "funny bone."

This tunnel is very narrow. And there is very little tissue to protect this nerve. So the possibility of damage to this nerve is high. If for some reason the nerve gets compressed or trapped inside this tunnel, that is when the symptoms of cubital tunnel syndrome appear.

What happens to our hand with this ulnar nerve?

This nerve is very important for the function of our hand.

• Gripping: This nerve controls some of the large muscles in our hands, so it helps us grip things tightly.
• Feeling in the fingers: This nerve provides feeling to your little finger and the light side of your ring finger.
• Fine movements: This nerve controls many of the small muscles in the hand. This nerve is essential for fine movements, such as typing on a computer or playing a musical instrument.

So now you understand what kind of problems can occur if this nerve gets pinched.

Who is most at risk for this condition?

There are some risk factors that can contribute to the development of cubital tunnel syndrome. However, not everyone who has these factors will develop this disease. However, some people are more at risk than others.

• Having arthritis in the elbow.
• Keeping your elbows bent for a long time (for example, keeping your arms bent and under your head while sleeping).
• The presence of new bone spurs growing on the bones of the elbow.
• Cysts in the elbow joint.
• Having a history of previous elbow dislocation.
• Having had a previous elbow fracture.
• Swelling of the elbow joint.

What is the difference between Carpal Tunnel Syndrome and Cubital Tunnel Syndrome?

This is where many people get confused. Although both conditions are caused by a pinched nerve, the affected nerve and the location of the symptoms are different.

Why does cubital tunnel syndrome occur?

Sometimes even a doctor may not be able to find the exact cause, but there are a few common causes.

• Anatomy: Some people may have a thick layer of tissue over the ulnar nerve. Or they may have extra muscle. These things can cause the nerve to become compressed over time.
• Pressure: Imagine that you are constantly working with your elbow on the table, or resting your elbow on the armrest of your chair. Even something as simple as this can put constant pressure on the ulnar nerve. Then your hand, little finger, and ring finger start to feel like they are tingling.
• Snapping of the nerve: Some people experience the ulnar nerve snapping back and forth when they bend or straighten their elbow. If this continues, the nerve can become damaged and swollen.
• Stretching: If you keep your elbow bent for a long time (especially while sleeping), the nerve can become overstretched. This constant stretching is also a cause of this condition.

What are the symptoms of this condition?

If you have had the symptoms below for more than six weeks , or if you think they are severe , be sure to see your doctor. This is because if left untreated, this nerve compression can lead to muscle wasting in the hand. This means that the hand may become thin and weak. However, if you get treatment quickly, these symptoms can be controlled or completely cured.

The main symptoms are these:

• Tingling and pins and needles in the hands and fingers. This is not constant, it comes and goes.
• Pain on the inside of the elbow.
• It is difficult to move your fingers properly when they are numb.
• Difficulty holding things, weak hand grip.
• Over time, the muscles in the hand become weak and the hand becomes thin.

These symptoms, especially tingling and pain, are most often felt when the elbow is bent . For example:

• When driving a vehicle
• When holding a phone and talking
• While sleeping

How does a doctor diagnose this?

When you go to the doctor, he will first ask you about your symptoms. Then he will do a physical examination. After that, he may recommend several tests to confirm the disease and determine its severity.

• Blood tests: Check for other medical conditions, such as diabetes or thyroid disease.
• X-ray tests: Check for problems with the bones of the elbow (bone spurs, arthritis) and to see if a bone is pinching a nerve.
• Nerve Conduction Studies and EMG Test: This is the most important test to diagnose this disease. It is also called an Electromyogram (EMG) . It measures the speed of nerve impulses and muscle activity. This test can determine exactly where the nerve is compressed and how much it is compressed.

How is it treated?

There are two types of treatment for this condition: non-surgical treatment and surgery. Doctors always try to treat this condition non-surgically first.

Nonsurgical Treatments

• Wearing a brace or splint to keep your elbow straight: Your elbow often bends, especially at night when you sleep. To prevent this, your doctor may recommend wearing a brace or splint to help keep your elbow straight.
• Exercises: There are special exercises (nerve gliding exercises) that help the nerve move more easily through the cubital tunnel. These also help prevent numbness in the hand and wrist. However , you should definitely ask your doctor or physiotherapist which exercises are right for you.
• Hand Therapy: A hand therapist can teach you how to perform your daily activities without putting pressure on the ulnar nerve.
• Painkillers (NSAIDs): Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can reduce swelling around the nerve and control pain. However, these should only be used under the advice of a doctor.

Surgical Treatments

If the above treatments do not help, if the nerve is too tight, or if the muscles are starting to weaken, your doctor may recommend surgery. For this, you will usually be referred to an orthopedic surgeon.

There are several main types of surgery:

• Cubital tunnel release: In this procedure, the surgeon cuts a ligament that acts as the roof of the cubital tunnel and widens the tunnel, relieving pressure on the nerve.
• Ulnar nerve anterior transposition: In this surgery, the nerve is removed from behind the bone of the elbow and placed in front of the bone (closer to the skin). This prevents the nerve from getting pinched by the bone when the elbow is bent.
• Medial epicondylectomy: This involves removing a small portion of the bony bump (medial epicondyle) on the inside of the elbow where the nerve is pinched, allowing the nerve to move freely.

These surgeries are usually outpatient, meaning you can go home the same day without having to stay in the hospital. However, you may need to stay in the hospital overnight. You will need to wear a splint for two to three weeks after the surgery. You may then need physiotherapy to regain movement and strength in your hand.

What can we do to prevent this situation?

While it can't be completely prevented, there are several things you can do to reduce the risk.

• Don't put weight on your elbows. Avoid the habit of resting your elbows on the armrests of tables and chairs.
• If you work in an office, adjust the height of your chair so that your elbows are not bent more than 90° .
• When you sleep at night, try to sleep with your elbows straight . Use something like a pillow if necessary.
• Avoid activities that require you to bend your elbows for long periods of time (e.g., talking on the phone continuously).