Cubital Tunnel Syndrome

Symptoms and Signs

  • Pain, tingling and numbness in ulnar 1 1/2 digits (small and ring finger)
  • Can be provoked by leaning on elbow or keeping elbow bent (e.g.on telephone)
  • +/-Weakness in thumb and finger adduction
  • +/-Wasting in hypothenar eminence, interossei
  • Wake up at night & relieved with movement for 15-20 minutes
  • Dropping items
  • Positive Tinel’s medial elbow 

Initial Management

  • Advise avoidance or modification any provocative activity where appropriate .e.g, wear headset for using telephone; avoid leaning on elbows or wear protective pads.
  • Advise sleeping with arms straight if possible. Resting night splint (wrapping towel around elbow to keep it straight)

Additional resources

Who to Refer

  • If symptoms persistent, severe, especially if associated with weakness / muscle wasting, patient is a surgical candidate and wants to consider surgery.

How to refer

  • If being seen by MSK Physiotherapy, onward referral top hand service will be organised by physiotherapist. 
  • SCI Gateway/Hand Surgery. Patients will be appointed to Advanced Practice Physiotherapist initially.  

Include the following information:
  • Duration of symptoms and any cause of onset
  • Conservative management tried (e.g. any relief through activity avoidance/splinting)
  • Any history of neck problems
  • If symptoms are unilateral or bilateral
  • If any muscle wasting or motor weakness is present