After Surgery Instructions for Cubital Tunnel Syndrome

 

There are multiple possible causes. Having the elbow bent, or flexed, for long periods may stretch the nerve, as can repetitive elbow flexion. Direct trauma to the nerve may be involved, or previous injury to the elbow resulting in bony deformity. In rare cases, there may be cysts or other growths that take up room and narrow the tunnel. Other conditions can be involved, such as diabetes.

Numbness is one of the most prominent symptoms. This is typically felt in the outside half of the ring finger and in the small finger. It may radiate up the hand and forearm to the elbow. The numbness is often felt at night, first thing in the morning, or associated with bending the elbow. Pain can also occur, radiating from the elbow to the small and ring fingers. In more advanced cases, weakness in the hand occurs.

The diagnosis is usually made based on symptoms and examination in the office. In many cases, electrical testing ("EMG's") of the nerves is done to confirm the diagnosis. X-rays of the elbow may be needed.

Non-surgical treatment is usually started, unless findings are very advanced. Basic measures include the following:

• Avoiding elbow flexion. This includes maintaining proper working distances for steering wheels and keyboards so that the elbow is not significantly flexed. Telephone use involving elbow flexion should be avoided (use headsets if needed.) Job rotations should be considered to avoid positions where repetitive flexion of the elbow is required.
  
  
• A splint is customarily used at night to prevent the elbow from bending too far. This may be a standard issued splint, or a custom-fabricated splint made by a therapist. A simple splint method is to wrap one or two bath towels around the elbow. They can be held in place with tape or rubber bands. This allows some movement, but prevents full flexion.
  
  
• Vitamin B6 seems to help most patients with this type of nerve problem. Studies are conflicting, but it is most often helpful. The recommended dose is 50 mgs twice daily, which is more than a standard multi-vitamin will have. Dosage should not exceed that amount.
  
  
• Anti-inflammatory medications may be helpful. Risks of any such medication should be known, such as the risk of stomach problems or ulcers. Patients with asthma should avoid these medicines. Patients with sensitive stomachs may require prescriptions anti-inflammatory medicines that are more protective of the stomach. Otherwise, a standard dose would be Advil, 2 tablets three times a day during active treatment of the problem.
  
  
• The use of an elbow pad during work or activities may be useful. Many people reverse this pad for activities to prevent full flexion of the elbow.