INJECTION THERAPY FOR CUBITAL TUNNEL SYNDROME

What is cubital tunnel syndrome?

The ulnar nerve is compressed between the two bones on the inside of your elbow, causing cubital tunnel syndrome. When the ulnar nerve is compressed, the symptoms are comparable to when you strike your ‘funny bone.’ A diagnostic ultrasound scan will be required to determine the specific reason of your cubital tunnel syndrome.

The nerve ‘flicking’ over the bone is one typical cause of cubital tunnel syndrome, which can be felt if you bend your elbow. Cubital tunnel syndrome is common in people who work in manual labour, lift weights, or have hypermobility syndrome. The majority of cubital tunnel symptoms go away with rest, but if they don’t, an ultrasound-guided steroid injection to bathe the nerve can assist greatly. Before considering surgery, at least one injection should be administered.

What are the symptoms of cubital tunnel syndrome pain?

The symptoms of a cubital tunnel syndrome are:

  • Pain, pins and needles and numbness on the inside of the elbow, forearm and wrist and hand – specifically into 4th (ring) and 5th (little) fingers
  • Weakness in the hand, especially the 4th (ring) and 5th (little) fingers.
  • Clumsiness and weak grip

If this sounds like your pain, read on…

What are some additional conditions that are similar to cubital tunnel syndrome

pain?

  1. Golfer’s elbow
  2. Tennis Elbow
  3. Posterior Interosseus Nerve (PIN) entrapment

Cubital tunnel syndrome vs golfer’s elbow

Both cubital tunnel syndrome and golfer’s elbow induce pain on the inside of your elbow at the bony spot. Cubital tunnel syndrome, on the other hand, causes pins and needles, numbness, and weakness in the hand and wrist, notably in the little (5th) and ring (4th) fingers (due to its influence on the ulnar nerve). These symptoms are not caused by golfer’s elbow; instead, it causes discomfort, soreness, and weakness.

Anatomy

Cubital tunnel syndrome is the second most frequent nerve compression in the upper limb. Carpal tunnel syndrome, which affects the wrist, is the most prevalent (Willem et al, 2013). Entrapment or compressive neuropathies are the names given to these diseases.

An anatomical ‘pinch point,’ when a nerve is subjected to unfavourable compressive pressure, causes entrapment neuropathy. According to the literature, direct compression of the nerve causes an ischemic reaction, which is a slight restriction of the nerve’s blood supply. The nerve becomes inflamed and painful as a result of the ischemic reaction (Apfel et al, 2006).

Why is it called Cubital Tunnel syndrome?

One of the three main nerves that runs down the arm is the ulnar nerve. It starts at the base of the neck and travels down the inside of the upper arm, forearm, and wrist, ending at the fourth (ring) and fifth (little) fingers.

The ulnar nerve runs through a bone tunnel on the medial (inside) side of the elbow joint (just behind the bony bit of the elbow on the inside). Between the medial epicondyle (bony piece on the inside of your elbow) and the olecranon is the nerve (bony point of the elbow). The cubital tunnel is the name given to this passageway.

Cubital Tunnel Syndrome injection therapy in UK

When the ulnar nerve, which is located in the tunnel, is subjected to prolonged periods of elevated pressure, cubital tunnel syndrome develops. As a result, the nerve swells both before and after the compression point (like standing on a hose pipe).

Many of us have had an acute transient bout of ulnar nerve irritation at some point in our lives! If you’ve ever hit your ‘funny bone,’ you’ve probably felt agony down the inside of your forearm, wrist, and fingers, as well as pins and needles in your 4th and 5th fingers. The ulnar nerve, a nerve that crosses the elbow, is the “funny bone” in the elbow. This can help you understand how sensitive nerves are and how distressing this condition can be.

injections for Cubital Tunnel Syndrome

What causes Cubital Tunnel syndrome?

Cubital tunnel syndrome has a variety of origins, and in some cases, the actual cause is unknown. It’s critical that we try to figure out why it happened in the first place so we can determine the best treatment choice for you.

Cubital tunnel can develop as a result of:

  • Trauma – a fall onto the elbow
  • Repetitive compression – leaning on the elbow for hours when at work
  • Arthritis – you can develop bony spurs (known as osteophytes)
  • Previous fractures/’breaks’ or dislocations at the elbow
  • Accessory muscles for example an extra muscle bely of your triceps muscle
  • Subluxation/slipping of the nerve over the bone (medial epicondyle) – more below
  • Swelling or cyst of the elbow joint
  • Repetitive or prolonged activities that require bending of the elbow such as bench press in the gym
  • Prior injuries to the nerve

Subluxation or dislocation of the nerve is one of the most common causes of cubital tunnel syndrome that we find in the clinic. When the nerve slides over the bone but returns to the groove, it is called a subluxation. This is most commonly seen when the elbow is bent. When the nerve slips over the bone and out of the bony tunnel, it is called a dislocation. This is most commonly seen when the elbow is bent. A gym goer who consistently presses large weights on a bench press is a perfect example.

If you have other medical disorders, you may be more susceptible to this illness, or any nerve entrapment. These are some of the risk factors:

  • diabetes (particularly if poorly controlled)
  • pregnancy
  • obesity
  • arthritis
  • hypothyroidism

How is Cubital Tunnel Syndrome diagnosed?

Clinical examinations, nerve conduction investigations, and diagnostic ultrasound imaging can all be used to diagnose cubital tunnel syndrome.

We can diagnose this disease with a clinical examination and diagnostic ultrasonography during your appointment at Joint Injections. The diagnostic ultrasonography is included in the price.

Terlemez (et al. 2018) found that diagnostic ultrasound imaging is more accurate than nerve conduction testing in identifying cubital tunnel syndrome. Diagnostic ultrasonography scans also have the advantages of being painless (unlike nerve conduction tests) and being a dynamic examination, allowing them to determine whether the nerve has subluxed or dislocated. Previous research has found that nerve conduction tests had accuracy rates ranging from 37% to 86 percent, compared to diagnostic ultrasonography accuracy rates of 98 percent.
Nerve conduction investigations should only be used in severe cases including considerable muscle weakness and/or wasting, as well as when conservative therapies and/or steroid injections have failed.

Ultrasound-guided injections for cubital tunnel syndrome

For many decades, ultrasound-guided steroid injections have been used to treat this ailment and have been proven to be accurate, safe, and successful. Cubital tunnel syndrome discomfort and symptoms can be dramatically reduced with guided steroid injections (Choi et al, 2015). An ultrasound scan is utilised at Joint Injections to direct the injection into the cubital tunnel and bathe the ulnar nerve with a combination of local anaesthesia and corticosteroid in a safe and effective manner. Injections of steroid (also known as corticosteroid) are a powerful anti-inflammatory medicine that is often used to relieve pain and inflammation.

Your doctor will collect a complete history of your problem and perform a number of clinical tests, including a diagnostic ultrasound scan, during your initial evaluation. You may be offered an ultrasound-guided steroid injection when a formal diagnosis of cubital tunnel syndrome has been obtained. This will happen during the same session as your initial evaluation. A referral from your primary care physician is not required.

Joint Injection’s experts are dual-trained, highly specialised physiotherapists and musculoskeletal sonographers with extensive experience diagnosing all elbow disorders, including cubital tunnel syndrome. We provide a ‘one-stop’ clinic, which means you’ll get an examination, a diagnostic ultrasound, and, if necessary, an ultrasound-guided injection.