Cubital tunnel syndrome

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Patient Information

GP Information

Background Information

  • Compression of the ulnar nerve beneath the medial epicondyle with secondary numbness, tingling, or pain in the little and ring fingers, with possible medial elbow aching.
  • In later stages patients may develop weakness of grip, poor coordination and muscle wasting.
  • Typically exacerbated by activities requiring persistent elbow flexion, or trauma.

Investigation Guidelines

  • In cases of diagnostic uncertainty, or in patients being referred for possible surgery, consider referral for electromyography and nerve conduction studies.

Management Recommendations

  • Avoid activities that require prolonged elbow flexion.
  • Avoid putting pressure on the inside of the arm.
  • Non-steroidal anti-inflammatory medicines – suitable in acute presentation to help reduce swelling around the nerve.
  • Bracing or splinting. Padded brace or elbow splint worn at night to keep elbow extended.
  • Physiotherapy for nerve gliding exercises. Referral Indications: Diagnostic uncertainty, Referral for EMG / NCS, Severe or progressive sensory / motor impairment, Failure to improve with 3 months conservative measure.