Cubital Tunnel Syndrome: Symptoms, Causes, and Occupational Therapy Treatment

Discover what cubital tunnel syndrome is — a common neuropathy that causes elbow pain, tingling, and numbness in the ring and little fingers. Learn more about its causes, symptoms, and the effectiveness of occupational therapy treatment.

What Is Cubital Tunnel Syndrome and the Role of the Ulnar Nerve?

Cubital tunnel syndrome, or compression of the ulnar nerve, is one of the most common entrapment neuropathies. It occurs when the ulnar nerve, which runs along the arm and passes through the cubital tunnel at the elbow, becomes compressed or pinched. This nerve is essential, as it provides sensation and strength to the little finger, the ring finger, and the outer side of the hand.

When the nerve is under excessive pressure, it can cause symptoms such as numbness, tingling, and pain in the arm, hand, and fingers—especially the little and ring fingers. In more severe cases, cubital tunnel syndrome can lead to loss of strength and muscle atrophy in the hand, resulting in the typical deformity known as “claw hand.”

What Are the Causes?

Cubital tunnel syndrome is a multifactorial condition, often linked to a combination of mechanical factors and medical conditions that affect the structure of the nerve and the elbow.

• Mechanical Compression:
  1. Keeping the elbow bent for long periods (e.g., while sleeping or working).
  2. Frequently leaning on the elbow.
  3. Manual work requiring intense, repetitive movements.
  4. Previous injuries, such as elbow fractures or dislocations.
  5. Anatomy of the cubital tunnel, which may be narrower in some individuals.
• Medical Conditions:
  1. Elbow osteoarthritis, which can cause inflammation and narrowing of the cubital tunnel.
  2. Diabetes, hypothyroidism, or rheumatoid arthritis, which may contribute to inflammation and reduced space for the nerve.
• Less Common Causes:
  1. Cysts or tumors pressing on the cubital tunnel.
  2. Nerve dislocation, meaning the ulnar nerve shifts out of place during elbow flexion.

Most Common Symptoms: Tingling, Pain, and Weakness

Symptoms often worsen when the elbow remains bent for long periods, such as at night or while sitting at a desk. The most common signs include:

• Sensation of numbness and tingling in the ring and little fingers.
• Pain on the inside of the elbow, which may radiate to the forearm and hand.
• Hand weakness, with difficulty using the pinch grip between thumb and index finger or holding objects.
• In advanced cases, the appearance of the “claw hand” deformity, indicating worsening nerve compression.

Occupational Therapy Treatment for Cubital Tunnel Syndrome

The main goal of occupational therapy is to reduce pressure on the ulnar nerve, improve arm function, and decrease pain and inflammation.

• Conservative Treatment: In the early stages, treatment is conservative and may include:
  • Custom-made splints to keep the elbow extended at night, preventing nerve compression.
  • Nerve mobilization techniques and surrounding tissue mobilization to facilitate normal gliding.
  • Specific exercises to improve mobility and reduce tension along the nerve.
  • Assessment and modification of daily activities and postures to reduce nerve stress.
• Post-Surgical Treatment: If conservative treatment is not effective, surgery may be necessary. Occupational therapy is crucial in the rehabilitation phase to:
  • Reduce swelling and treat scarring.
  • Regain movement and strength through specific exercises.
  • Support return to full functionality and improve the person’s quality of life.

Occupational therapy provides a complete, personalized pathway—both in conservative and post-surgical phases—to address and overcome the challenges of cubital tunnel syndrome.