Cubital Tunnel Syndrome: Understanding Your 'Funny Bone' Pain and How Osteopathy Can Help
That sharp, electric jolt when you bump your "funny bone" is a familiar sensation. However, when numbness, tingling, or pain in your ring and little finger becomes persistent, it may point to a condition known as Cubital Tunnel Syndrome. This is the second most common peripheral nerve entrapment syndrome in the arm and can significantly impact hand function.
Osteopathy offers a holistic, non-invasive approach to managing cubital tunnel syndrome by addressing not just the site of nerve compression at the elbow, but the underlying factors throughout the arm and neck that contribute to the problem.
Key Facts About Cubital Tunnel Syndrome
The 'Funny Bone' Nerve: It involves compression or irritation of the ulnar nerve as it passes behind the inner bump of your elbow (medial epicondyle), through a passage called the cubital tunnel.
More Than Just an Elbow Issue: The ulnar nerve originates from your neck, travels through your shoulder, and down your arm. Issues anywhere along this pathway can contribute to symptoms.
Impacts Fine Motor Skills: This nerve supplies sensation to your ring and little fingers and powers many of the small muscles in your hand, affecting grip strength and dexterity.
Common Causes and Risk Factors
The ulnar nerve is relatively unprotected at the elbow, making it vulnerable. Common causes of irritation include:
Prolonged Elbow Flexion: Keeping your elbow bent for long periods—during sleep, while holding a phone, or at a desk—can stretch and compress the nerve in the tunnel.
Direct Pressure: Leaning on your elbow on hard surfaces (e.g., a desk or armrest) for extended periods.
Repetitive Motion: Jobs or activities that involve repetitive elbow bending and straightening.
Anatomical Factors: Some people have a naturally narrower cubital tunnel, or the nerve may slide out of its groove (subluxate) with movement, making it more prone to irritation.
Previous Trauma: A past elbow fracture, dislocation, or arthritis causing bony changes can reduce the tunnel's space.
Nerve Tension from the Neck (Double Crush): Stiffness or dysfunction in the lower neck (cervical spine) can put the ulnar nerve under increased tension, making it more susceptible to compression further down at the elbow.
Common Signs and Symptoms
Symptoms often develop gradually and may include:
Numbness and Tingling: In the ring and little fingers, often worse when the elbow is bent.
'Falling Asleep' Sensation: Particularly at night or when holding the elbow in a bent position.
Pain: An aching pain on the inside of the elbow.
Weakness: A loss of grip strength, difficulty with fine motor tasks like typing or buttoning clothes.
Muscle Wasting: In severe or chronic cases, noticeable thinning of the muscles between the bones on the back of the hand.
How Can Osteopathy Help with Cubital Tunnel Syndrome?
Osteopathic management focuses on reducing nerve compression and irritation by improving the mobility of the nerve and the joints it passes through, from the neck to the hand.
During your initial consultation, we will:
Take a detailed history of your symptoms, sleep posture, daily activities, and work habits.
Perform a physical examination including orthopaedic tests (e.g., Tinel's sign at the elbow, elbow flexion test) to assess ulnar nerve irritation.
Conduct a comprehensive assessment of your neck, shoulder, elbow, and wrist to identify areas of joint restriction, muscle tension, or fascial tightness that may be contributing to nerve tension.
This whole-body assessment is critical, as treating the elbow alone may not resolve symptoms if the primary issue originates in the neck.
What Does Osteopathic Treatment Involve?
Using gentle, hands-on techniques, we aim to:
Reduce Local Compression: Gentle soft tissue massage and myofascial release to the forearm and upper arm muscles can decrease tension around the cubital tunnel and improve local circulation.
Improve Joint and Nerve Mobility: Gentle mobilisation of the elbow, wrist, and the joints of the neck and upper back can help create a more favourable environment for the nerve to glide smoothly.
Address the Neck and Thoracic Outlet: A primary focus is on improving mobility in the lower cervical and upper thoracic spine, which can significantly reduce overall tension on the brachial plexus nerves, including the ulnar nerve.
Provide Personalised Advice and Rehabilitation: You will receive practical guidance on:
Postural and Ergonomic Adjustments: For your workstation, sleeping position (e.g., avoiding bent elbows), and phone use.
Nerve Gliding Exercises: Specific, gentle exercises to improve the mobility of the ulnar nerve.
Activity Modification: Strategies to avoid prolonged elbow flexion and direct pressure.
Elbow Padding: Advice on using protective padding if leaning on elbows is unavoidable.
When to Seek Further Medical Help
It is vital to obtain a proper medical diagnosis. Please consult your GP for a referral if you experience:
Persistent or worsening numbness and weakness that does not improve with conservative care.
Noticeable muscle wasting in the hand.
Symptoms that began after a significant elbow or neck injury.
Severe pain or symptoms that suggest other neurological conditions.
Your GP can confirm the diagnosis, rule out other issues (e.g., cervical radiculopathy), and discuss other management options, such as referral to a specialist for nerve conduction studies or surgical opinion, if necessary.
Find Relief from Nerve Irritation
Cubital tunnel syndrome can interfere with your work, sleep, and hobbies. Osteopathy provides a safe, non-surgical approach to alleviate symptoms by treating the root causes of nerve irritation throughout the upper quarter of your body.
Click here to schedule an appointment with one of our experienced osteopaths. Let us help you restore comfort and function to your arm and hand.
References
*Osei, D. A., Padegimas, E. M., Calfee, R. P., & Gelberman, R. H. (2013). Cubital tunnel syndrome: current concepts. The Journal of the American Academy of Orthopaedic Surgeons, 21(11), 647-657. [Link: https://journals.lww.com/jaaos/Abstract/2013/11000/Cubital_Tunnel_Syndrome__Current_Concepts.3.aspx]*
*Svernlöv, B., Larsson, M., Rehn, K., & Adolfsson, L. (2009). Conservative treatment of the cubital tunnel syndrome. Journal of Hand Surgery (European Volume), 34(2), 201-207. [Link: https://journals.sagepub.com/doi/10.1177/1753193408098480]*
*Wright, T. W., & Glowczewskie, F. (2011). Vascular anatomy of the ulnar nerve at the elbow. Journal of Shoulder and Elbow Surgery, 20(1), 1-4. [Link: https://www.jshoulderelbow.org/article/S1058-2746(10)00365-3/fulltext]*
Disclaimer: This blog post provides general information only and is not intended as a substitute for professional health advice, diagnosis, or treatment. Always consult a registered health practitioner, such as your General Practitioner (GP) or osteopath, for diagnosis and treatment of health conditions. The information provided is based on the best available evidence at the time of publication but should not be relied upon as a sole source of information. Individual results from osteopathic treatment may vary based on the individual’s specific condition and response to care. In cases of severe or progressive neurological deficit (significant weakness or muscle wasting), prompt specialist medical assessment is essential.