Ulnar Nerve Entrapment (Cubital Tunnel Syndrome) Treatment

Ulnar nerve entrapment is a condition that occurs when the ulnar nerve is compressed, or “trapped,” somewhere along its path through the arm. The ulnar nerve is one of three major nerves in the arm that runs from the neck down to the hand. When the ulnar nerve is compressed in the elbow, this is referred to as cubital tunnel syndrome.

The majority of cases of ulnar nerve entrapment occur as the result of repetitive stress to the elbow over a long period of time. This may happen due to:

Repetitive overuse of the elbow in a bent or flexed position, like in cycling
Injuries to the elbow, such as fractures and dislocations

Ulnar nerve entrapment can also develop in individuals who suffer from medial epicondylitis (golfer’s elbow), and in some athletes, with ulnar collateral ligament injuries.

Ulnar nerve entrapment is common in these sports:

• Cycling
• Golf
• Baseball

Symptoms generally develop gradually over time, and may include:

• Achiness on the inside of the elbow
• Numbness and/or tingling in the ring and pinky fingers
• Weakness of the hand muscles

Your doctor will examine your elbow for signs of tenderness in the elbow over the ulnar nerve. He/she will also assess your range of motion, nerve sensation, and strength in the muscles that are controlled by the nerve. Your doctor may want to do nerve conduction studies to help him/her understand where the nerve is compressed, as well as to assess how well the nerve is functioning.

In order to make a diagnosis, your doctor may prescribe the following imaging tests:

• X-rays
• MRI
• Electromyogram (EMG)

Initially, your doctor will prescribe conservative treatments to try to relieve your symptoms. These may include:

• Resting the affected arm
• Icing the arm throughout the day
• Nonsteroidal anti-inflammatory medications (NSAIDs) to relieve swelling
• Wearing a brace

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Ulnar Nerve Entrapment

If your symptoms do not resolve with conservative treatments, or if there is more severe nerve damage as a result of the compression, you may need operative treatment. During surgery to relieve ulnar nerve entrapment, your doctor will remove the cause of compression. This may be a cyst, bone spur, or scar tissue. Once the tissue is removed, the nerve is able to regenerate and heal.

Recovery from ulnar nerve entrapment with conservative treatments may take up to six weeks. If you require surgery, it may take between four to five months for the nerve to heal completely. During this time, you will be asked to work with a physical therapist to regain range of motion and strength in the arm.

You can return to play upon instruction from your doctor. Permission to return to full activities is typically granted once you have regained full range of motion of the elbow with no pain and no weakness in the hand. It may take up to one year for your sensation to fully return.