Nerve

Cubital Tunnel Syndrome

Cubital tunnel syndrome occurs when the ulnar nerve becomes compressed or irritated at the elbow, causing tingling or numbness in the ring and little fingers, weakness in the hand, or difficulty with fine movements. Symptoms often worsen when the elbow is bent for long periods, such as during sleep or phone use.

In the early stages, symptoms may improve with night-time elbow splints, activity or posture changes, and specific nerve-gliding exercises. If symptoms persist, weakness develops, or nerve studies show significant compression, surgery may be recommended to relieve pressure.

During surgery, a discreet incision is made along the inner elbow to release tight structures around the nerve. In some cases, the nerve may be gently repositioned to a more protected location or a small area of bone smoothed to prevent irritation. In delayed or complex cases, a nerve transfer may be performed to enhance recovery in terms of strength and sensation.

Procedure time

45–75 minutes


Anaesthesia

Local, Regional or General


Discomfort

Mild–moderate for 1–2 weeks


Dressings

~2 weeks


Light use

From 1–2 weeks


Return to work

Desk: ~2 weeks · Manual: 4–6 weeks


Sports

Gradually after 6–8 weeks


Final result

Gradual sensory/strength gains over months; severe pre-op nerve change recovers more slowly

  • 1. What causes cubital tunnel syndrome?

    This results from pressure on the ulnar nerve at the elbow — often from prolonged elbow flexion (e.g. sleeping curled up), leaning on the elbow, arthritis, previous injury, or nerve instability (“snapping”).

  • 2. Do I need scans or tests?

    Nerve conduction studies may be helpful when symptoms are advanced, when surgery is considered, or when the diagnosis is uncertain. Ultrasound may be used if nerve instability is suspected.

  • 3. Can cubital tunnel syndrome improve without surgery?

    Yes. Early symptoms often improve with:

    – night-time elbow extension splints
    – avoiding pressure on the elbow
    – posture changes
    – nerve-gliding exercises

    If symptoms persist, worsen, or muscle weakness develops, surgery may be recommended.

  • 4. Will my numbness go away after surgery?

    Numbness may take several months to improve. If the nerve has been severely compressed for a long time, some numbness may persist, but surgery helps prevent further deterioration and often improves function and comfort.

  • 5. Why is cubital tunnel recovery slower than carpal tunnel?

    The ulnar nerve is longer and controls fine hand movements — so its recovery is naturally slower. Improvement can continue for 6–12 months, sometimes longer.

  • 6. Will I lose mobility in my elbow?

    Stiffness is uncommon. Gentle movement begins soon after surgery, and hand therapy is offered if needed.

  • 7. Can symptoms come back?

    Yes, recurrence can happen, especially if the nerve was unstable, severely compressed, or if arthritis is present. Revision decompression or nerve transposition is available when needed.

  • 8. When can I drive and return to work?

    You can usually return to driving once you feel confident that you can safely control the vehicle, which for most people is around 1–2 weeks after surgery.

    Desk-based work is typically possible at about 2 weeks, depending on comfort and swelling.

    For manual, physical, or tool-based jobs, recovery time is longer. Most patients need 3–6 weeks, and heavier or repetitive roles may require even more time. Your return-to-work plan will be tailored to the specific demands of your job.

  • 9. Is cubital tunnel surgery covered by insurance?

    Yes — cubital tunnel surgery is an insured procedure, and I am fee-assured.

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