Have you ever woken up in the night with pins and needles in your small and ring fingers? Have you been holding a phone to your ear or reading a book that little bit too long and the outside part of your hand starts to go numb? If you answer yes, then you have experienced some symptoms of cubital tunnel syndrome, also known as ulnar nerve neuropathy. A neuropathy can occur when a nerve is compressed or stretched which results in reduced blood supply to the nerve and can result in pain, pins and needles, numbness and in extreme circumstances loss of strength and muscle power.
The ulnar nerve is one of the three main nerves in your arm and it originates from your neck, runs along the inside aspect of your elbow and forearm, to your hand. It is responsible for innervating some of the muscles in your forearm and hand, but also sensation to half of your ring and all your small finger, and the associated area of your palm, both back and front.
The ulnar nerve travels through a tunnel known as the cubital tunnel and under a bump of bone (medial epicondyle) on the inside aspect of your elbow. This area is commonly known as the ‘funny bone’, as the nerve is very close to the skin, and bumping it can cause a shock like feeling that can travel down to your fingers.
Cubital tunnel syndrome occurs due to stretching or compression of the nerve. Your ulnar nerve can get stretched with prolonged elbow bending activities such as typing, holding a phone to your ear, reading, or even the position you sleep in. The ulnar nerve is put on stretch as you bend your elbow, and the longer it stays in this position the more at risk the ulnar nerve is to become unhappy. Compression of the nerve can occur when you hit it or lean on your elbow for too long or if there is swelling in the area. Previous trauma or surgeries around the elbow may also predispose you to similar problems. This squashing of the nerve can result in symptoms such as pins and needles in the small and ring fingers.
What can you do?
There are some basic modifications you can make if you notice you have these symptoms such as:
– Try not lean on your elbows at your work desk or table
– Avoid prolonged elbow bent positions, e.g. take regular breaks from typing or use headphones when on the phone
– Try to modify your sleep position and stop yourself from sleeping with your arms bent up against our body
Often a visit to a hand therapist can be very useful, as your therapist will be able to give you recommendations specific to you and your daily tasks. They will perform a thorough assessment including sensation and strength testing and may recommend you trial an elbow sleeve (such as the one pictured), to help to settle symptoms Your therapist can arrange referral for you to have further testing or see a specialist if they are concerned about your signs and symptoms.