Cubital Tunnel Syndrome
NHS Tayside RefGuide
Warning
Who to refer
- If symptoms persistent, severe, especially if associated with weakness / muscle wasting, patient is a surgical candidate and wants to consider surgery.
How to refer
- If being seen by MSK Physiotherapy, onward referral top hand service will be organised by physiotherapist.
- SCI Gateway/Hand Surgery. Patients will be appointed to Advanced Practice Physiotherapist initially.
Include the following information
- Duration of symptoms and any cause of onset
- Conservative management tried (e.g. any relief through activity avoidance/splinting)
- Any history of neck problems
- If symptoms are unilateral or bilateral
- If any muscle wasting or motor weakness is present
Symptoms and signs
- Pain, tingling and numbness in ulnar 1 1/2 digits (small and ring finger)
- Can be provoked by leaning on elbow or keeping elbow bent (e.g.on telephone)
- +/-Weakness in thumb and finger adduction
- +/-Wasting in hypothenar eminence, interossei
- Wake up at night & relieved with movement for 15-20 minutes
- Dropping items
- Positive Tinel’s medial elbow
Initial management
- Advise avoidance or modification any provocative activity where appropriate .e.g, wear headset for using telephone; avoid leaning on elbows or wear protective pads.
- Advise sleeping with arms straight if possible. Resting night splint (wrapping towel around elbow to keep it straight)