Cubital tunnel syndrome involves the ulnar nerve on the inside of the elbow. The ulnar nerve lies between two boney prominences at the elbow: The point of the elbow (Olecranon) and the palpable bone on the inside of the elbow (Epicondyle). When the ulnar nerve gets too much pressure such as when resting on a hard surface or long term positioning on a soft surface you may get a “tingling” of the small and ring fingers. If the ulnar nerve is stretched as when bending the elbow while holding a phone or during sleep, you may also get the same “tingling” sensations. Temporary tingling resulting in a blow to the inside of the elbow is what we often call “hitting our funny bone”.
If symptoms persist for several weeks, you should seek medical advice. The medical professional will most likely order a nerve study called an EMG (electromyography) and/or a nerve conduction study. These tests can diagnose the severity of the nerve impairment.
Conservative treatment consists of patient education for the causes of the symptoms and how to avoid those triggers. It could also involve wearing a custom fabricated night orthosis (splint) preventing elbow flexion or wearing a padded elbow sleeve. Additionally, physical or occupational therapy can be used to decrease irritation of the nerve by using modalities and nerve gliding protocols. Manual therapy may be beneficial for releasing any tight muscles or connective tissue surrounding the nerve.
If symptoms are severe or do not resolve with conservative therapy, then surgical intervention is most likely required. This could be a simple surgery decompressing the ulnar nerve at the elbow or more complex involving decompression with a relocation of the nerve.
If you think you have these symptoms, seek medical advice from your primary care physician to develop the most effective plan of care.