Most people are familiar with carpal tunnel syndrome, but they may not have heard about the condition known as cubital tunnel syndrome. Next to carpal tunnel syndrome, cubital tunnel syndrome ranks second as the most common peripheral nerve entrapment syndrome. If you think you may be suffering from cubital tunnel syndrome, here are some of the basic symptoms and causes, along with how physical therapy and other treatments can relieve symptoms.

The Myth of the “Funny Bone”

Have you ever heard someone say they hit their “funny bone?” What they really meant is that they bumped the inside of their elbow in a specific area, which caused a tingling, odd feeling, or a dull pain. Actually, it’s not even a bone. Instead, it’s a nerve, known as the ulnar nerve, which runs along the interior portion of the elbow.

Basic Anatomy of the Elbow and the Ulnar Nerve

The elbow is a hinge joint that’s formed at the intersection of the ends of three bones: the upper arm bone (humerus), the ulna, and the radius bone. The ulnar nerve begins at the neck. It then travels down the back of the arms as well as around the inside of the elbow, ending at the fourth and fifth fingers.

It’s at the elbow where the ulnar nerve runs through the cubital tunnel, which is a tunnel of tissue running under a bumpy bone (epicondyle) on the interior of the elbow. Because the cubital tunnel is extremely narrow, it’s very susceptible to being compressed or injured from trauma or activities that are done repeatedly.


Common Symptoms 

One of the major symptoms is numbness and a tingling sensation in the ring finger and small fingers. This is a result of the ulnar nerve being stressed or stretched. In addition to a painful forearm, other symptoms may include hand and/or muscle weakness, especially in the pinky and ring fingers, which are under the control of the ulnar nerve.


Causes of Cubital Tunnel Syndrome

  • Leaning on an arm or on an armrest is one of the main causes.
  • Anatomy can sometimes be a factor, especially when the ulnar nerve is unstable and fails to stay in place.
  • Stretching the elbow after it’s been bent too long, such as when asleep, can lead to cubital tunnel syndrome.

People Most at Risk

Some people are more at risk to have cubital tunnel syndrome than others.

  • Diabetes mellitus patients are more vulnerable, just as they’re more likely to develop other different types of nerve disorders.
  • People with jobs that require them to have extended periods of elbow flexion are also more at risk, such as jobs that require holding telephones.
  • People who’ve suffered from a direct blow to the ulnar nerve are also more likely to get cubital tunnel syndrome.


Diagnostic Tests

Physical therapists or doctors can conduct certain tests to diagnose cubital tunnel syndrome. First, they need to determine if it’s the ulnar nerve that’s being compressed. Once this has been determined, other tests can be performed, such as:

  • Elbow and forearm inspection
  • The Tinel’s sign test, which involves tapping the nerve located at the elbow
  • Checking for gripping and pinching capability
  • Muscle testing
  • EMG—Sometimes, an EMG (electromyography) is done for determining the nerve’s ability for conducting signals.

Physical Therapy as the First Line of Defense

As for treatment, physical therapy should be the first line of defense. First, a physical therapist determines which activities are causing symptoms so that a patient can stop doing them. A typical physical therapy program may include:

  • Exercises for muscle strengthening
  • Range-of-motion exercises—The purpose of these exercises is for lengthening those muscles that have been shortened because of protective postures. They also help in ensuring the unaffected muscles stay at their normal length.
  • Nerve gliding exercises—These exercises are designed to promote gentle stretching. Consider how nerves are able to stretch out and how physical therapists know just the right positions for the correct nerve stretches.


Other Treatments

Besides physical therapy and other types of modalities used in physical therapy, such as electrical stimulation and ultrasound, a therapist may also recommend noninvasive or conservative treatments for reducing pain. These treatments include icing, bracing, and splinting.

If you struggle with orthopedic-related problems, set up an appointment with the physical therapy specialists at Cawley Physical Therapy and Rebab by calling 570-208-2787 or sending us an email at Please contact us and find out more about how we can help you.

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