Houston Methodist. Leading Medicine

Elbow FAQ

Question:

I work as a seamstress in a home business that supports me and my 3 kids. I've been having terrible pain on the little finger side of my hand. And I'm starting to get numbness in my ring and little fingers. I can hardly do my work. I saw a doc who wants to do nerve testing on me. Should I go for it?

Answer:

From the description of your symptoms it sounds like you may have a problem called ulnar nerve compression, also known as cubital tunnel syndrome or CuTS. Most people are familiar with carpal tunnel syndrome (CTS). That is a problem with nerve compression affecting the hand, too. Just like carpal tunnel syndrome, cubital tunnel syndrome causes pain, sensations of numbness and tingling, and weakness of the hand. But the areas of the forearm and hand affected are different. The symptoms of cubital tunnel syndrome are very similar to the pain that comes from hitting your funny bone. When you hit your funny bone, you are actually hitting the ulnar nerve on the inside of the elbow. There, the nerve runs through a passage called the cubital tunnel. When this area becomes irritated from injury or pressure, it can lead to cubital tunnel syndrome. Numbness on the inside of the hand and in the ring and little fingers is an early sign of cubital tunnel syndrome. The numbness may develop into pain. The numbness is often felt when the elbows are bent for long periods, such as when talking on the phone, while sleeping, or when sewing. The hand and thumb may also become clumsy as the muscles become affected. Tapping or bumping the nerve in the cubital tunnel (Tinel's test) will cause an electric shock sensation down to the little finger. This is called Tinel's sign. Other diagnostic tests that can be done to confirm cubital tunnel syndrome include electrodiagnostic examination (the kind your physician has suggested). Nerve conduction tests and electromyography to study muscle function are the two main electrodiagnostic tests used for nerve compression. Treatment for cubital tunnel syndrome (CuTS) is usually conservative at first. Antiinflammatory medications, changes in activities, a splint, and physical therapy may be helpful. If symptoms are not improved with nonoperative care, then surgery may be recommended to stop damage to the ulnar nerve. The value of electrophysiological testing is in confirming the diagnosis (making sure you have cubital tunnel syndrome) and in determining the need for surgery. The test also guides the surgeon in making the best recommendation for timing of surgery and provides prognostic information about expected recovery. For example, when there is slowing of nerve signals but not complete loss of signals, then conservative care may be helpful. Likewise, if there are just isolated spots where nerve transmission is slowed, you may respond well to nonoperative care and surgery may not be needed. The testing doesn't provide all the answers but certainly contributes helpful information in planning treatment. Waiting too long could mean permanent damage to the nerve and a missed opportunity to return normal sensation and motor control. Qiyun Shi, MD, MSc, et al. Predictors of Functional Outcome Change 18 Months After Anterior Ulnar Nerve Transposition. In Archives of Physical Medicine and Rehabilitation. February 2012. Vol. 93. No. 2. Pp. 307-312.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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