Cubital Tunnel Syndrome: Symptoms and Causes Explained

Regarding cubital tunnel syndrome?

About a year ago, both of my elbows were impacted, resulting in significant bruising and swelling.
However, X-rays confirmed that there were no bone injuries.
Since I already have arthritis, joint pain is quite common for me, so I didn't pay much attention to the pain in my elbow.
Additionally, I have a deep cut on the inner side of my right elbow.
The symptoms in my right arm include numbness and pain radiating from the cut to my fingers (only when extended), but this improved after a few months.
However, the tremor in my ring finger has persisted for about a year without improvement.
Even lifting lighter objects, such as a spoon to serve soup, causes spills.
Consequently, I started using my left hand and noticed that it also trembles, specifically in the ring finger, although the tremor is not as severe as in my right hand.
After researching online, I found that the symptoms of cubital tunnel syndrome closely resemble my condition.
Could this be due to the strong impact on both elbows a year ago? However, I do not experience severe numbness or pain in my fingers; the tremor occurs when both hands are flat, and it worsens after physical activity, as well as when lifting light objects (like a water bottle, spoon, or chopsticks).
Is this cubital tunnel syndrome? If not, what could be causing it?

weid, 10~19 year old female. Ask Date: 2018/11/06

Dr. Li Zhonghuai reply Surgery

Hello! "Is this due to a severe impact on both elbows a year ago? However, there is no significant numbness or pain in the fingers; it’s just that when the palms of both hands are flat, the ring fingers tremble (the trembling worsens after exercise), and when holding light objects (like a water bottle, spoon, or chopsticks), the hands also tremble.
Is this cubital tunnel syndrome? If not, what could be causing it?" It is recommended to consult a neurologist and undergo nerve conduction studies to clarify any issues.
Take care! Changhua Hospital cares about you!

Reply Date: 2018/11/06

More Info

Cubital Tunnel Syndrome (CuTS) is a condition that arises from the compression of the ulnar nerve as it passes through the cubital tunnel, located at the inner side of the elbow. This syndrome can lead to a variety of symptoms, including numbness, tingling, and weakness in the hand, particularly affecting the ring and little fingers. Given your history of trauma to both elbows and the subsequent symptoms you’ve described, it’s plausible that your condition could be related to CuTS.

The symptoms you mentioned, such as the tremors in your ring finger and the pain radiating from the area of your previous injury, align with typical presentations of ulnar nerve compression. The fact that you experienced a significant impact to your elbows a year ago could have contributed to swelling, inflammation, or even structural changes in the elbow region, which might have led to the compression of the ulnar nerve. Additionally, the deep cut on your right elbow could have further exacerbated the situation by causing scar tissue formation, which can also compress the nerve.

In your case, the tremors in your ring finger, especially when holding light objects, may indicate a loss of motor control due to nerve involvement. The ulnar nerve is responsible for innervating several muscles in the hand, and any compromise can lead to weakness and fine motor control issues, which might explain why you are experiencing tremors when performing tasks like holding a spoon or a water bottle.

It's also worth noting that the symptoms can sometimes be bilateral, as you have observed with your left hand. This could be due to compensatory mechanisms or similar anatomical predispositions affecting both elbows. The fact that you have a history of arthritis may also complicate the clinical picture, as joint inflammation can contribute to nerve compression.

To determine whether you indeed have Cubital Tunnel Syndrome, a thorough clinical evaluation is necessary. This typically includes a physical examination, where a healthcare provider will assess for tenderness, range of motion, and any signs of nerve involvement. Diagnostic tests such as nerve conduction studies or electromyography (EMG) can provide further insight into the function of the ulnar nerve and help confirm the diagnosis.

Treatment options for CuTS vary depending on the severity of the symptoms. Conservative management often includes:
1. Activity Modification: Avoiding positions that exacerbate symptoms, such as prolonged elbow flexion.

2. Splinting: Using a splint to keep the elbow straight, especially during sleep, can help relieve pressure on the nerve.

3. Physical Therapy: Engaging in physical therapy can help strengthen the muscles around the elbow and improve flexibility.

4. Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation and pain.

5. Surgery: In cases where conservative treatments fail, surgical intervention may be necessary to relieve pressure on the ulnar nerve.

Given your symptoms and history, it is crucial to consult with a healthcare professional, preferably a neurologist or an orthopedic specialist, who can provide a comprehensive evaluation and tailored treatment plan. Early intervention can significantly improve outcomes and prevent further complications.

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