The ulna nerve sits very close to the humerus bone in the elbow and there is very little padding between the nerve and the skin. This makes it susceptible to being compressed when pressure is applied to that area. The nerve also slides over the bony bump or medial epicondyle that it sits next to in some people when they bend there elbow and this can cause repetitive irritation of the nerve. Squashing or irritation of the nerve will cause the symptoms described above.
Similar to "hitting your funny bone." Tingling and/or numbness are felt in the ring and little fingers, as well as along the inside of the forearm. Pain may be felt in the same area. Weakness of the intrinsic muscles of the hand which will affect grip strength can also occur and in severe cases the weakness may also affect the wrist and forearm. Symptoms are felt with either repetitive bending of the elbow or if the elbow is pressed against something.
Common physician diagnoses include dorsalgia and lumbago. X-Rays may show degenerative joint disease (DJD), degenerative disc disease (DDD), or spondylosis, all of which are normal age-related processes. With a thorough evaluation, a physical therapist can determine the cause of the low back pain, without first seeing a PCP or a specialist. An MRI is not necessary and generally does not shed any further light on the condition.
Cubital Fossa Syndrome can be diagnosed by a physician or physical therapist after a thorough evaluation. A comprehensive evaluation by a physical therapist will help to determine the strength of specific muscles, evaluate grip strength, and inspect the elbow and forearm.
Non-Surgical treatment is often successful especially if started early. Physical therapy will involve soft tissue techniques to reduce local adhesions and muscle tightness along with specific "nerve glides" to restore mobility of the ulna nerve as it passes around the elbow. Rest from aggravating activities is important. A pad over the elbow to prevent friction or a night-splint to prevent prolonged bending of the elbow might help.
Anti-Inflammatory medications are often useful to decrease irritation.
If a four week treatment regime is not successful then surgery may be indicated. Surgery would involve either an ulna nerve transposition where the nerve is moved away from the bony medial epicondyle or a medial epiconylectomy-removal of the bone to free up nerve movement. Therapy is needed post-surgery to restore elbow mobility, wrist/finger strength and prevent adhesions. Desensitization of the scar may also be needed.
Professions that require individuals to place repetitive stress, vibration, or pressure on the ulna nerve can cause Cubital Fossa Syndrome. In addition, daily activities that require the elbow to be in a bent position for extended periods of time can cause discomfort and pain. Take multiple breaks throughout the day to alleviate pressure on the ulna nerve and adjust elbow and forearm positions to reduce strain on the elbow throughout the day.