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Cubital Tunnel Syndrome Treatment Eliminating Nerve Pain & Symptoms

Chiropractic Specialty Center® (CSC) treats cubital tunnel syndrome through an integrative method of physiotherapy combined with chiropractic in Kuala Lumpur, Malaysia. This article provides detailed information on causes, signs, symptoms, and the best noninvasive treatments that fix the root causes of ulnar nerve pain and symptoms.

The cubital tunnel syndrome is descriptive of a condition resulting from compression or impingement of the ulnar nerve near the elbow, which causes pain, numbness, tingling, and weakness in the arm, wrist, hand, or fingers. 

Cubital tunnel syndrome is a progressive condition, and it is not a life-threatening condition. However, it requires comprehensive treatment without injections or surgery that decompresses the nerve by repairing damaged tissues that compress the ulnar nerve as it passes through the cubital tunnel. Failure to get targeted treatments that repairs damage can result in permeant nerve damage affecting the elbow, forearm, wrist, hand, and fingers.

The cubital tunnel syndrome is also known by other names; we have included them below:

  1. Ulnar tunnel syndrome
  2. Ulnar canal syndrome
  3. Handballers syndrome
  4. Ulnar nerve syndrome

A cubital tunnel syndrome is a condition that can also be diagnosed using the following terms:

  1. Ulnar nerve entrapment
  2. Ulnar nerve compression

What Is The Origin Of The Ulnar Nerve?

The ulnar nerve is named after the ulna bone of the forearm. The forearm is the area between the elbow and your wrist. The two bones of the forearm are the ulna and radius. The ulna bone is closer to the midline (in the anatomical position). The ulnar nerve is named after the ulna bone because it travels along the ulnar bone as it exits the elbow on its way to the wrist and hand. 

The ulnar nerve originates from two nerves:

  1. The C8 spinal nerve which exits below the neck’s last spinal segment (C-7 or 7th cervical spine) 
  2. T1 spinal nerve or the first thoracic spinal segment (T-1 or 1st Thoracic vertebrae (thoracic spinal segment).  

Fibers from the C8 and T1 nerve join near the neck to form the inferior brachial of the brachial plexus. Ulnar nerve branches of the inferior branch as it passes through the axilla or armpit. It is one of five terminal branches that shoot off of the brachial plexus. The brachial plexus (nerve fibers from C5-T1) is a collection and network of nerves from the lower four cervical nerves (C5-C8) and the first thoracic nerve. 

The Brachial Plexus & Ulnar Nerve

The brachial plexuses are networks of nerve fibers located deep within the shoulders behind the collar bone and between the neck and the armpits. Musculocutaneous, ulnar, median, radial, and axillary nerves are the five major branches of the plexus. These nerves supply the muscles and skin of the arm, forearm, wrist, hand, and fingers. 

The ulnar nerve pierces the intermuscular septum in the arm and travels deep to the medial head of the triceps muscle. It is located in a groove behind the elbow (cubital canal), more commonly known as the funny bone. It then enters the inner side of the forearm and travels down to the hand. 

Where Is The Cubital Tunnel?

The cubital tunnel is located just behind the bony bump on the inner side of your elbow or at the funny bone area of the elbow. The floor of the cubital tunnel lies in the groove just beneath the Bony bump of the elbow. The roof of the cubital tunnel is formed by an elastic connective tissue or fascia called the myofascial trilaminar retinaculum. 

What makes the fascia of the cubital canal unique is its various layers. As mentioned earlier, the roof is made of a tri-laminar structure (having three layers). The tri-laminar structure is listed below:

  1. Fascial layer
  2. Tenderness layer
  3. Muscular layer

According to published research, the average thickness of the cubital canal’s myofascial trilaminar retinaculum is less than 0.9 millimeters. Thickening or hypertrophy of this facial layer is the primary factor in developing cubital tunnel syndrome symptoms.

What Causes Cubital Tunnel Syndrome & Ulnar Nerve Pain?

Cubital tunnel syndrome is the second most common peripheral neuropathy, and it is second only to carpal tunnel syndrome. There are several reasons and co-conditions that cause a cubital tunnel syndrome or cubital canal syndrome. A co-condition is when two or more health disorders co-occur––they are also referred to as comorbid conditions. We have listed common coconditions or co-morbid disorders seen in patients with cubital canal or tunnel syndrome below:

  • Rheumatoid or osteoarthritis of the elbow or the ulna (the long bones of the forearm)
  • Previous dislocations or fractures of the elbow
  • Diabetes or hypothyroidism
  • Bone spurs

Now that we have covered the comorbidities associated with a cubital canal syndrome, let’s go over the three most common causes that lead to ulnar nerve compression a scene with cubital canal or tunnel syndrome below:

  1. Anatomical variations
  2. Excessive stretching
  3. Direct pressure

we have defined each one of them in the following subsections:

Anatomical variances: 

Anatomical variances in which the size of the canal is larger than expected, allowing the ulnar nerve to slip and slide (snapping back and forth). The slip and slide or the back and forth snapping of the ulnar nerve leads to nerve irritation and inflammation, producing a cubital canal syndrome symptom mentioned earlier.

Frequent & excessive stretching of the ulnar nerve pain: 

Published studies have confirmed that nerves or elastic. The elasticity of peripheral nerves or even more incredible when they crossover joints. This elasticity allows us to flex and extend our limbs without irritating our nerves. However, individuals that keep their elbows bent for extended periods cause the ulnar nerve to be stretched for a longer time. Prolonged stretching of the ulnar nerve can lead to ulnar nerve pain due to inflammatory processes or swelling at the elbow. Incidentally, the same can happen when you hold your elbows in a bent position during sleep or while using your phone or tablet.

Direct pressure on the funny bone: 

The funny bone is where the ulnar canal is. As mentioned, the ulnar canal is made of three layers with a combined thickness of less than 1 millimeter. As such, it provides minimal padding for the ulnar nerve it traverses (passes) through with activities where you lean over on a flexed or bent elbow. To avoid ulnar nerve pain and symptoms, decrease or stop leaning on a bent elbow. 

What Are The Complications For An Untreated Cubital Tunnel?

Cubital tunnel syndrome patients are advised to get their ulnar nerve compression treated as soon as possible. If left untreated, severe ulnar nerve pain and permanent nerve damage may result. As mentioned, the ulnar nerve is essential for the elbow, wrist, hand, and fingers. Cubital tunnel syndrome compresses the ulnar nerve. Untreated or prolonged compression causes nerve damage: a leading cause of nerve degeneration and death. A damaged and degenerated ulnar nerve is the causes:

  • Elbow pain
  • Wrist pain
  • Weakness in arm, wrist, hand, thumb, and 4th & 5th fingers
  • Muscle wasting and atrophy
  • Paralysis of the thumb, middle & pinkie fingers (1st, 4th & 5th digits)

Ulnar nerve damage is the leading cause of ulnar nerve palsy (claw hand). Claw hand or ulnar nerve palsy is avoidable through focused therapies that target and repairs the cause of ulnar nerve compression. Contact Chiropractic Specialty Center® today for a thorough assessment and best non-surgical treatments to repair the damaged cubital canal today.

Best Treatment For Cubital Tunnel Syndrome?

If you have cubital tunnel syndrome, you have several options that can help you recover. The following is a list of options starting with the most invasive procedure first:

  1. Surgical decompression of the ulnar nerve
  2. Corticoid steroid injections of the elbow (near the cubital canal) in the wrist (at or near the Guyon tunnel)
  3. Chiropractic
  4. Physiotherapy or physical therapy
  5. Physiotherapy and chiropractic combined (integrative in multidisciplinary care)

We have provided a brief description of each in the coming sections.

Surgery: Surgical Decompression Of The Ulnar Nerve

Ulnar decompression surgery is a procedure in which the surgeon explores the region to which the ulnar nerve passes or through arthroscopically, removing tissues that compressed the nerve. It may sound good, but to me, any explorative surgical procedure has not agreed option! The success rate after surgical intervention is arguable–– depending on your definition of success. By definition, success is any measure of improvement. 

For example, if your elbow pain was rated at that on a scale of zero to 10 before surgery, and after surgery, the level of pain dropped to a 9.8 on a scale of zero to 10, you could argue that the surgery was successful. Most of the research published that claim a high success rate may not define their definition for success, and they have their reasons!

Based on my 25 years of clinical experience, patients define success when their pain is eliminated, leaving them symptom-free. 

A published study in the reputable peer-reviewed journal of Advances in Orthopedics (based in the United Kingdom) reported interesting findings on the long-term success rate for ulnar nerve decompression surgery. The study reports their results on 205 patients some 45 months after ulnar nerve surgery. We have listed the main points of their results below:

  • 58% of the patient-reported various levels of improvement 45 months after surgery
  • Only 3% reported complete relief of all symptoms.

Benefits & Harms Of Cortico-Steroid Injections

The infamous steroid injections or becoming famous. Corticosteroid injections or not used for the cubital tunnel because of their proximity to the ulnar nerve. However, some specialists still use them. Cortisone is a potent anti-inflammatory drug that reduces swelling and pain. And patience wet cubital canal syndrome, the surgeon injects this thyroid above and below the nerve. As mentioned, steroid injections near nerves or risky. Benefits or relief of symptoms can last from days two weeks, rarely going over months.

The worrying or harmful impacts of corticosteroid injections are many. In 2019 published report and the journal of Radiology cautioned doctors and patients about corticosteroid injections into tissues and joints. The authors of this published study reviewed the records of 459 Americans who received 1 to 3 corticosteroid injections And their knees or hips. What they discovered was alarming; we have posted the highlights below:

  • A dramatic worsening of osteoarthritis and degenerative process at areas of injection
  • Decreased bone strength due to osteonecrosis (death of bone)
  • Increased risks of insufficiency fractures due to weekend bones
  • Degeneration of soft tissues (muscles, tendons, ligaments, or fascia)

Given the information provided to the research published in 2019, it would be best to avoid steroid injections for any joint, including your elbow. As such, noninvasive therapy or treatments that are alternative to invasive procedures should be sought first. We have provided a brief list of therapies and treatments that are suitable alternatives to invasive procedures below:

  • Chiropractic treatment
  • Physiotherapy
  • Rehabilitation
  • Nutritional supplements that improve soft tissue 
  • Acupuncture
  • A combination of one or more of the above

Chiropractic Combined With Physiotherapy, Nutritional Supplements & Rehabilitation

Chiropractic Specialty Center®(CSC) provides the most holistic, noninvasive, and integrative treatment for ulnar nerve compression due to a cubital tunnel syndrome. CSC has been treating spine and joint patients for over 15 years. Our integrative combined methods of care it’s customized to the individual patient needs, based on the patients’ clinical findings. The aim is to fix and repair damaged tissue that compresses the ulnar nerve without injections or surgery.

Our clinical teams of physiotherapists and chiropractors are amongst the best in Kuala Lumpur. Cubital tunnel syndrome treatments at our center are through manual and therapy devices such as shockwave therapy and high-intensity laser therapy. Also, we may use other therapeutic devices such as electrotherapy, ultrasound therapy, QMD cryo-thermal therapy, or other measures in some instances.

Contact CSC at our main on 03 2093 1000 for information about our services and locations. Discover your best alternative to steroids and surgery. Let our experts provide you with customized cubital tunnel syndrome that gives you lasting relief.


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