Understanding the Basics Behind Cubital Tunnel Release
What is Cubital Tunnel Release?
There are 3 primary nerves that control sensation and function in your hand.
One of these nerves, the ulnar nerve, or “funny bone,” is located at the back of your elbow joint. When this nerve is compressed, it causes a range of symptoms, from intermittent numbness to pain and weakness in the hand and forearm.
The orthopedic elbow specialists at Kansas City Orthotic Alliance have years of experience treating many kinds of elbow conditions. After your initial examination with a KCOA physician, we will recommend the best treatment for your needs. Our practitioners provide the comprehensive care you need so you can return to the activities you enjoy.
Other indicators someone may require cubital tunnel release include:
- Pain in your hand
- Weakened grip strength
- Persistent, aching pain on the inside of your elbow
Common Signs and Symptoms of Cubital Tunnel Syndrome
Cubital Tunnel Syndrome happens when the ulnar nerve in the elbow is injured, swollen, irritated, or compressed..
Numbness or tingling sensation in your hand, particularly in your ring or little finger, is a common symptom of cubital tunnel syndrome. When a patient visits one of our KCOA offices, a skilled orthopedic specialist will ask you questions regarding your symptoms, what aggravates/alleviates your symptoms, and whether you have attempted prior therapies.
Next comes a thorough physical exam. We will then review any images you bring with you and/or take new images. After determining the cause of your pain, we can then discuss if Cubital Tunnel Syndrome treatment will work best for your needs.
Kansas City Orthopedic Alliance Elbow Injuries Assessment
Assessing the Injury
Finding the right elbow treatment in Kansas City starts with an assessment.
You can think of elbow pain as a spectrum, with some instances being more severe than others. The KCOA orthopedic specialists always focus on each individual patient and their concerns before creating a treatment plan.
Therefore, during your initial appointment, we will often ask questions such as:
The answers to these questions help shape the next steps of the assessment process and guide our physical examination. After a proper assessment, we often begin with a physical examination to help determine the origin point of your pain. In some cases, advanced testing may be required for a full diagnosis.
- Does your pain currently limit you or your activities?
- Has your pain progressed or worsened recently?
- Have you experienced any tingling or numbness in your arm or fingers that makes tasks difficult?
- Have you noticed any change in your symptoms that has made it more challenging to function?
- What are your lifestyle goals?
- How has pain affected those goals?
Also called radiographs, an X-ray captures a picture of the hip. Orthopedic physicians may order an X-ray to rule out the possibility of a fracture (broken bone), osteoarthritis, or other hip-related conditions.
Magnetic Resonance Imaging (MRI)
MRI captures images of muscles, bones, intervertebral discs, and tendons to help provide information other tests can’t detail. During an MRI, you will lie on a table that slides into a tube-shaped scanner. The machine creates a magnetic field around you, using pulsed radio waves to form the MRI images.
Electromyograms (EMG) and Nerve Conduction Studies
Our board-certified physiatrists utilize electromyograms (EMGs) and nerve conduction studies to help determine whether nerves and muscles respond properly to stimuli. The EMG measures the electrical activity of your muscles at rest and in motion, while nerve conduction studies determine how fast and effectively your nerves and muscles receive electrical signals.
Establishing a Care Plan
Based on the results of your interview, examination, and imaging studies, you can expect a custom care plan catered specifically to you.
Many people believe it’s best to wait until pain becomes severe, leading them to “put off” or delay treatments like elbow arthroscopy.
If you are in constant discomfort, have shooting or stabbing pains, have limited range of motion, or an inability to perform your daily activities, elbow arthroscopy may be right for you.
New technologies allow patients with elbow pain to fully recover and enjoy the benefits of a more functional, pain-free lifestyle.
Prior to surgery, you will typically receive at least 2 phone calls:
- A hospital registration representative will call to gather insurance and other personal information.
- A registered nurse will call to review your health history and medication information.
Dependent on your health history, your physician may require:
- Pre-surgical laboratory tests
- Primary care clearance
Pre-operative instructions will vary depending on your physician and the location of your surgery. Always check with your physician prior to surgery.
Most physicians require that patients not eat or drink after midnight prior to surgery the next day.
Additionally, you will need a designated family member or friend to drive you home on the day you are released from the hospital. Surgical patients cannot drive themselves home.
Day of Surgery
If you schedule your surgery with a KCOA physician, you can expect the following on surgery day:
- A receptionist will check you in at the hospital registration desk.
- A nurse will take you back and prepare you for surgery. They will start an IV, prepare the surgical site, and review your medical history and medications.
- Your surgeon and anesthesiologist will visit with you prior to your operation.
- The surgical team will take you to the operation suite for surgery.
How it Works
Cubital tunnel release is a surgical procedure that alleviates ulnar nerve issues. The procedure can either decompress the ulnar nerve by releasing some of the structures around the nerve itself, or by also transposing the nerve by completely removing it from its groove. This creates a new resting point in the soft tissue in front of the elbow.
Your surgeon will determine if an ulnar nerve transposition is necessary based on your elbow and hand function, the severity of your symptoms and after visualizing the nerve and cubital tunnel during the arthroscopy.
During a cubital tunnel release, you will remain under general anesthesia. The surgeon makes a small incision along the course of the ulnar nerve, and opens the roof of the cubital tunnel to relieve pressure on the nerve.
Once they decompress the nerve, the surgeon takes the elbow through a range of motions to determine whether or not transposition is also necessary.
A transposition may be needed if the ulnar nerve remains unstable after pressure is relieved. In those cases, the surgeon will reposition the nerve from behind the bony bump on the inside of your elbow to the front of the elbow.
After your surgery, you will remain in the recovery room while our experienced clinical team monitors you, providing pain relief medication, if needed.
We will place your arm in a dressing and remove it during a subsequent follow-up appointment. You may also be placed in a sling or splint to protect the area.
You can expect swelling, soreness and bruising in your elbow for several days after surgery. The swelling and discoloration may also spread to your hand or lower arm.
It’s important to keep your arm elevated with an ice pack after surgery to reduce swelling and soreness.
What to Expect
Early motion is allowed after surgery, but you should not lift, push, or pull anything greater than a pencil for 6 weeks after surgery.
Overall recovery time varies by individual. It can take at least 2 to 3 months before you start to regain normal use of the extremity.
Physical therapy is often needed and starts 6 weeks after surgery. Improvement in the numbness can be immediate, but in some patients, it can take months to get better.
We recommend regular exercise, eating a balanced diet, maintaining a healthy weight, and monitoring your blood sugar levels if you’re diabetic.
In doing so, you may reduce the amount of stress on your joints to slow down any potential degenerative process.
Causes of Elbow Pain
The body has different kinds of joints, and they all face different challenges. The elbow is a complex joint that connects three different bones: the humerus (upper arm), ulna (pinky side forearm), and radius (thumb side forearm). Covering the surface where these bones meet is articular cartilage, a smooth substance that protects the joint by cushioning and absorbing forces.
On the inside and outside of this joint are ligaments that hold the elbow together and prevent dislocation. Muscles also surround the elbow on the front and back sides, and there are 3 major nerves that cross the elbow joint.
Elbow pain can come from a variety of issues with any of these working parts. Most elbow pain stems from overuse, either in a sport or other repetitive movements that cause strain on the joint.
Surgery, even when minimally invasive like elbow arthroscopy, isn’t necessarily the first choice. Kansas City Orthopedic Alliance physicians prefer a more conservative approach to treatment, so we will typically exhaust all non-surgical options before recommending surgery.
Non-surgical treatments for elbow injuries include:
- Medications – Your doctor may recommend over-the-counter NSAIDs (Non-steroidal anti-inflammatory drugs, such as Advil) or prescription medications. Especially with NSAIDs, you should always talk to your doctor to ensure they are the right treatment for you.
- Injections – Cortisone injections can help reduce inflammation, and the effects tend to last for 3 to 6 months before you might need another one. Many people manage their pain with injections and physical therapy.
- Regenerative Medicines – Regenerative medicines like stem cell injections or platelet-rich plasma can help nourish worn or damaged tissue. This option works best if you have mild-to-moderate elbow pain.
Frequently Asked Questions
Kansas City Orthopedic Alliance is here to help.
Our care is personal. Our team is knowledgeable. And we’re more available than ever.
With access to board-certified specialists across Kansas City, we have the tools to meet almost every musculoskeletal condition.
Overland Park, Kansas10777 Nall Ave Suite 300 Overland Park, KS 66211
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Kansas City, MissouriSaint Luke's Medical Plaza #1 4320 Wornall Rd., Ste. 610 Kansas City, MO 64111
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Merriam, Kansas7450 W. Frontage Rd Merriam, KS 66203
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This place is amazing! I cannot say enough good things about our experience here! From the reception desk where they were beyond helpful and even made phone calls for me to my kids pediatrician to very short wait time then the patience and help of doctors and staff that were great with my 3 year old! Getting same day service this great was so nice! Love this place and highly recommend!!
My experience with Dr. Moore, at Apex Sports Medicine has been very positive. She is very competent and confident in her abilities. She is very thorough in explaining things and answers any and all questions. I am very pleased.
Shannon is very caring and encouraging. She listens to my questions and explains what to expect going forward very thoroughly. Hopefully I don’t need my other shoulder replaced, but if I did I would come back to Shannon and Dr. Van Den Berghe.