Q: I may need a procedure called a cubital tunnel release. Can you tell me what is actually done during this procedure? What should I expect after the surgery?
A: The "cubital tunnel" refers to a passageway along the inner part of the elbow. It's bounded by bones, muscles and ligaments. A major nerve called the "ulnar nerve" travels through this tunnel to the hand. If the nerve is squeezed near the elbow, it can cause an ulnar neuropathy. The symptoms include numbness, tingling and weakness in the little finger. It's also called "cubital tunnel syndrome."
But ulnar neuropathy due to cubital tunnel syndrome may also happen without an injury. These can all lead to cubital tunnel syndrome:
1. Leaning on the elbows
2. Repetitive motion
3. Jobs, activities, or hobbies that put pressure on the elbow
4. Arthritis of the elbow
1. Changes in position. For example, don't keep your elbow in a bent position and avoiding leaning on your elbows. This reduces pressure on the nerve.
2. Protective elbow pads
3. Anti-inflammatory drugs or a steroid injection (when arthritis is cause).
If you have significant symptoms that do not improve with these measures, surgery may be the answer.
Several types of surgery can be performed, depending on the cause. For example, a surgeon can make more room for the ulnar nerve by making a small incision (a "release") in the scar tissue or part of the muscle lining that has squeezed the nerve. Or, surgeons may need to remove bone spurs and relocate the nerve to a less compressed area of the elbow.
Recovery time varies depending on the operation. But sutures are usually removed and pain from the incision should lessen within 10-14 days. It's important to keep the wound clean and dry after surgery.
It may take weeks or even months to regain strength in the muscles of the forearm and fingers. Your doctor may recommend a program of stretching and strengthening after the discomfort from surgery has gone away and the wound has healed. In severe cases, complete recovery may take up to a year because nerves grow slowly and it takes them that long to make new connections.
(Robert H. Shmerling, M.D. is a practicing physician in rheumatology at Beth Israel Deaconess Medical Center, Boston, MA, and an Associate Professor in Medicine at Harvard Medical School.)
(For additional consumer health information, please visit http://www.health.harvard.edu.)