Jones The Hand
Cubital Tunnel Syndrome
What is cubital tunnel syndrome?
Cubital tunnel syndrome results from a trapped nerve at the elbow. This nerve then malfunctions, causing symptoms of pain, numbness, pins & needles and tingling in the little and ring fingers. It is often worse at night.
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If left alone, it does not usually get better unless there is a reversible cause. In most patients, there is no clear cause. If symptoms become constant or severe, the nerve can be permanently damaged leading to incurable symptoms. The muscles in the hand can become weak and wasted.
Treatment
Fortunately, the condition can usually be readily treated. Mild cases sometimes respond to splinting at night time. The most effective treatment for moderate or severe symptoms is surgery.
This involves cutting a tight strap on the inside of the elbow to take the pressure off the nerve. It is usually done under regional anaesthetic, which means the patient stays awake but the whole arm is anaesthetised. Sometime a general anaesthetic is needed, so all patients having this surgery need to be starved for 6 hours before surgery. It is done as a daycase and usually only takes about 30 minutes to do, though there is some setting up time to allow for.
Risks and Recovery
The wound heals in two weeks and must be kept clean and dry during this period. The patient can return to a light job as soon as they feel able (a few days to a few weeks). Heavy work may not be possible until six weeks.
The expected benefits of surgery are pain relief and improvement in numbness and tingling. If you are waking at night with a painful, numb hand, this usually resolves in a couple of days. The main reason for operating is to prevent the symptoms worsening and becoming permanent.
The risks include persistent symptoms, recurrence, further surgery, infection, bleeding, damage to other structures in the area, scarring, stiffness and a rare condition where the limb can overreact to the operation resulting in pain, stiffness and swelling for many months.
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Usually patients experience a significant improvement and return to full activity within 6 weeks.
