Introduction
Cubital tunnel syndrome is a nerve condition that affects the ulnar nerve as it passes through the elbow. This nerve is responsible for sensation in the ring finger and little finger, as well as many muscles that control hand strength. When compressed, patients may experience intermittent numbness, tingling, weakness, or pain in the hand and arm.
For patients in Braselton and across North Georgia, Dr. Thomas Neustein provides advanced diagnosis and treatment, including cubital tunnel release surgery and ulnar nerve transposition. His expertise in upper extremity surgery makes him one of the most trusted hand surgeons in the area.
What Is Cubital Tunnel Syndrome?
Cubital tunnel syndrome, sometimes called ulnar nerve entrapment, occurs when the ulnar nerve travels through a narrow passageway at the elbow formed by a bony bump called the medial epicondyle and a layer of soft tissue called fascia. This tunnel provides protection, but it can also become a source of compression.
The cubital tunnel is one of several anatomical “tunnels” in the body where nerves are vulnerable to being pinched. Just as the median nerve can be compressed in the wrist in carpal tunnel syndrome, the ulnar nerve may be trapped at the elbow.
Anatomy of the Ulnar Nerve
The ulnar nerve begins in the neck, travels down the inner arm, and passes behind the bony bump on the elbow, often referred to as the “funny bone.” At this location, the elbow formed by the medial epicondyle creates a tight corridor. The soft tissue called fascia and ligaments complete the passageway called the cubital tunnel.
When the nerve becomes pinched here, it cannot glide smoothly, which can interfere with nerve signaling, muscle function, and even blood flow to the surrounding structures.
Commonly Reported Symptoms
Patients with cubital tunnel syndrome may develop a variety of symptoms that worsen when the elbow is bent for extended periods. The most commonly reported symptoms include:
- Intermittent numbness in the ring finger and little finger
- Tingling or “pins and needles” sensations
- Pain along the inner side of the elbow
- Weakness in grip and pinch strength
- Stiffness in the hand or arm
- Hand clumsiness when writing, typing, or buttoning clothing
When left untreated, severe nerve compression may result in permanent numbness or even permanent nerve damage.
Causes and Risk Factors
Several factors can lead to ulnar nerve entrapment:
- Repeated bending of the elbow during work or sports
- Overuse injuries from activities like weightlifting or throwing
- Resting on the elbow for long hours at a desk
- Development of bone spurs or arthritis
- Ganglion cysts or other masses compressing the nerve
- Prior injuries or fractures that change the anatomy of the elbow
Patients with a medical history of rheumatoid arthritis or other inflammatory conditions may also be at greater risk.
Diagnosis: Thorough Examination and Testing
A thorough examination by a fellowship-trained hand surgeon is essential. Dr. Neustein will evaluate your medical history, review your symptoms, and perform a physical exam.
Tests may include:
- Nerve conduction studies to measure how well the ulnar nerve sends signals
- X-rays to detect bone spurs or joint changes
- Imaging studies to rule out tendon repair injuries or sports injuries
Early medical attention is important to prevent worsening nerve damage.
Conservative Treatment Options
In many cases, patients can begin with conservative treatment options before surgery:
- Elbow pads to cushion the inner side of the elbow
- Wearing a splint to keep the arm loosely in a straight position at night
- Anti-inflammatory medications to reduce swelling
- Steroid injections for temporary relief
- Physical therapy to stretch soft tissue and strengthen muscles
- Activity modification to decrease pressure on the cubital tunnel
When conservative treatment options fail to provide relief, surgery is often the most appropriate treatment.
Surgical Procedure: Cubital Tunnel Release
A cubital tunnel release is a surgical procedure performed in an operating room under local anesthesia with sedation or general anesthesia. The primary goal is to decrease pressure on the ulnar nerve and allow it to heal.
Steps of the Procedure
- A small surgical incision is made near the medial epicondyle.
- The surgeon carefully opens the soft tissue called fascia and other tight areas.
- The ulnar nerve is inspected, and the tunnel is widened to provide more space.
- In cases of severe nerve compression, the surgeon may perform an ulnar nerve transposition, moving the nerve to the front of the elbow so it can glide smoothly.
- Occasionally, a medial epicondylectomy is performed to remove part of the bony bump.
This surgical procedure is precise and tailored to each patient’s needs.
Risks and Complications
As with any hand surgery or elbow surgery, there are risks. These include:
- Infection or infection nerve damage
- Bleeding or injury to blood vessels
- Stiffness in the elbow or fingers
- Scar tissue formation around the surgical area
- Rare cases of permanent nerve damage if compression was left untreated too long
Dr. Neustein takes every precaution to minimize these risks.
Postoperative Care and Recovery Process
After cubital tunnel release, patients receive specific postoperative care instructions:
- Use ice packs and elevation to prevent swelling
- Keep the arm at heart level to increase blood flow and promote healing
- Avoid blood thinners unless prescribed
- Protect the incision and sutures with dressings
- Use plastic wrap to cover the surgical area in the shower
Most patients begin gentle movement quickly, then progress to therapy. The recovery process may take several months, but many patients notice relief within weeks.
Returning to Normal Activities
With time, therapy, and guidance, most patients regain strength and function. Activities such as driving, working, or exercising can gradually resume after clearance. Strenuous activities may take longer, but the goal is to restore safe return to all normal activities.
Related Conditions
Dr. Neustein also treats a wide range of upper extremity surgery conditions, including:
- Carpal tunnel syndrome
- Trigger finger
- Tendon repair injuries
- Joint replacement for arthritis
- Complex sports injuries
Patients across Braselton and North Georgia often see improvement in both pain and function after specialized care.
FAQs: Patient Questions About Cubital Tunnel Surgery
Can cubital tunnel release be performed under local anesthesia?
Yes. Many patients undergo the procedure with local anesthesia and sedation, allowing them to avoid general anesthesia.
How long is recovery?
The recovery process varies. Most patients return to light activity within a few weeks but may take several months to regain full strength.
What happens if cubital tunnel syndrome is left untreated?
When symptoms occur for long periods without treatment, patients may develop permanent numbness or permanent nerve damage, making recovery more difficult.
Will I need physical therapy?
Yes. Physical therapy is important to restore motion, reduce stiffness, and help the ulnar nerve glide smoothly again.
What are the risks of surgery?
Risks include infection, stiffness, nerve damage, and rare cases of failure to fully relieve symptoms. However, most patients experience significant improvement.
Why Choose Dr. Neustein in Braselton, GA?
Patients in Braselton and across North Georgia choose Dr. Neustein because he combines technical skill with compassionate care. He reviews each patient’s medical history, provides a thorough examination, and offers the most appropriate treatment—whether conservative or surgical.
With expertise in cubital tunnel release, ulnar nerve transposition, and advanced orthopaedic surgery, Dr. Neustein helps patients find lasting relief.
Call to Action
If you are struggling with numbness, tingling, or weakness in your hand, it may be time to consider cubital tunnel surgery in Braselton, GA. Don’t wait until symptoms progress to severe nerve compression. Schedule an appointment online or by phone today with Dr. Thomas Neustein.
Early medical attention can help provide relief, prevent worsening, and restore your quality of life.
