Carpal/Cubital Tunnel Syndrome

What is carpal/cubital tunnel syndrome?

Both of these conditions are similar, in that they occur due to compression of nerves in your arm, resulting in numbness, pain and/or tingling further down your arm.

• Carpal tunnel syndrome results from compression of the median nerve in your wrist. This commonly causes pain or tingling over half of your palm and thumb, which often occurs at night and is sometimes relieved by shaking your wrist.
• Cubital tunnel syndrome results from compression of the ulnar nerve in your elbow. This can give tingling and altered sensations down your forearm and into your hand.

If severe, or left untreated for a long time, these conditions can begin to cause weakness and affect grip strength.

What causes carpal/cubital tunnel syndrome?

Carpal tunnel syndrome is caused by compression at the wrist that may be brought on by a variety of factors, such as:

• Sleeping in an awkward position
• Previous wrist injury
• Joint disease, such as arthritis
• Being female
• Being pregnant
• Having diabetes
• Having a family history of carpal tunnel syndrome

Cubital tunnel syndrome is most likely to be caused by repetitive movements of the elbow, so is more likely to arise if you do lots of sport, or if you have had previous injury or arthritis in the elbow.

How is carpal/cubital tunnel syndrome diagnosed?

Both carpal tunnel syndrome and cubital tunnel syndrome can be diagnosed from the description of your symptoms and examination of your arms, which may include some special examinations that can recreate your symptoms. Special nerve conduction studies are also often carried out to assess how well the affected nerves are working.

Treatment and recovery

Sometimes symptoms do resolve on their own, particularly if they are brought on by a temporary situation (such as pregnancy). In these cases, or if you have milder symptoms, measures such as rest, bracing of the wrist (especially at night) and appropriate pain-killing medications can help. Additionally, in some cases ultrasound-guided steroid injections can also provide some benefit.

For some people however, surgery is required to relieve discomfort and prevent progressive compression of the nerve and worsening of your symptoms. The surgery for both procedures is very similar and involves a ‘nerve release’, where tissue is removed to give the nerve more space either at the wrist (for carpal tunnel syndrome) or elbow (for cubital tunnel syndrome). Both procedures can be done under a local anaesthetic, so you shouldn’t need to stay in hospital overnight, and have a normal recovery time of 4-6 weeks to return to your normal daily activities.