The ulnar nerve is a major nerve that runs through the arm. It is responsible for movement and sensation in the forearm and the hand. It allows intricate hand movements like writing, typing and holding objects, all of which are critical in day to day life.
The ulnar nerve travels through a small tunnel at the back of the elbow called the cubital tunnel. Most people are familiar with the ulnar nerve of the elbow, which is commonly known as the “funny bone”. If you have ever hit your elbow on a table or a hard surface, you know exactly what I am talking about. The nerve is well protected within this tunnel, but can get compressed at times, resulting in cubital tunnel syndrome. Patients with cubital tunnel syndrome experience tingling along the inner side of the forearm, weakness in the hand muscles and pain along the inner side of the elbow.
Diagnosing cubital tunnel syndrome
A physical therapist will conduct an initial examination to identify the cause of pain and nerve compression. A series of tests are performed to identify restrictions in sensation and muscle function. In all cases a proper examination of the neck is performed, since there can be similar symptoms of radiating pain and tingling down the arm as well. Additional tests may be required to determine the extent of nerve and bone abnormalities. An x-ray of the elbow may be conducted to rule out loose bone fragments compressing on the ulnar nerve, however that is not a very common occurrence.
Treatments of elbow pain
In the initial stages of the condition, pain and tingling occur due to constant irritation of the nerve. The referring physician and physical therapist may decide that it’s best for the patient to use a brace. This protects the nerve, muscles and bones as they are healing. As symptoms reduce, therapy emphasizes an improvement in function with the following treatment mechanisms:
1. Range of motion exercises to increase mobility without pain or discomfort. Exercises to encourage intricate movements of the hand and movements such as twisting the forearm (pronation and supination) are emphasized.
2. Strengthening exercises for different muscle groups. Examples include bending and straightening the elbow, rotation movements of the forearm, squeezing an object in the hand, and smaller objects between fingers.
3. Gentle nerve stretching exercises to reduce compression and increase circulation to the nerve. Advanced techniques include massage, mobilizations and manual therapy under the expert supervision of the physical therapist.
Physical therapy helps restore and improve function by increasing motion in the elbow, reducing pain and strengthening the muscles in the hand. The first step is the reduction of pressure on the ulnar nerve within the cubital tunnel. The therapist will also help patients avoid activities that trigger pain and discomfort.
Cubital tunnel syndrome can be a painful condition that can limit the ability to perform daily tasks. Physical therapists can offer simple solutions and exercises to increase joint movement while reducing pain and irritation of the ulnar nerve.
On behalf of our entire team, we want you to know that we are committed to helping you live a healthy, pain free life. If you have any pain or restriction that affects daily activities, we can help. We always work closely with your physician and your insurance company to make sure you have the best care possible. Physical therapy will change your life. All you have to do is to give us a call.
Dr. Daniel Skulavik, PT, DPT, OCS, is with Advanced Physical Therapy located in the Food Lion Shopping Center, Clinton.