We get a lot of people present to us in hand therapy with tingling fingers. The good thing is, we can help with this. The little finger and half of the ring finger are innervated by the ulnar nerve. When patients report tingling in the little finger, it often indicates that the ulnar nerve is irritated somewhere as it makes its way down the arm. A common place for the ulnar nerve to become irritated is at the cubital tunnel.

The cubital tunnel is a passageway between the bony prominence of the inside of the elbow (medial epicondyle) and the tip of the elbow (olecranon process). The ulnar nerve travels through this passageway and is held in there by a covering of tissue called fascia. The exit of the tunnel is between the two muscle origins of flexor carpi ulnaris (FCU).

Cubital Tunnel Syndrome is the effect of pressure on the ulnar nerve at the level of the elbow. It can result in a variety of symptoms including pain, swelling, weakness of finger movements, and tingling/numbness of the ring and small fingers.

Causes of Cubital Tunnel Syndrome can occur from the following:
1. Chronic compression to the area (such as resting on the elbow whilst driving or working at a desk)
2. Chronic stretching of the nerve may occur when a person sleeps with their elbow bent, or holding a phone to your ear with your elbow bend for long periods over time.
3. The fascia covering the nerve may lose its ability to keep the nerve in place during elbow movement creating a situation where the nerve can be injured.
4. Fractures of the elbow may cause deformities which stretch the nerve or narrow the tunnel.
5. Arthritis of the elbow which changes the shape of the tunnel leading to compression of the nerve.

Conservative management of Cubital Tunnel Syndrome aims to relieve the pressure on the nerve. To achieve this, therapy may consist of night splinting to prevent elbow flexion, soft supports, taping, activity modification, and pain control methods. It can take up to six weeks for a nerve to settle down. So, some patience might be needed for this one!