Cubital tunnel syndrome treatment

The cost of cubital tunnel syndrome treatment with Circle Health Group depends on a variety of factors, including which type of treatment you have and which hospital you choose. Your healthcare team will ensure you know the cost of your treatment at every stage of your journey with them, including information on how and when to pay it.

Fixed-price packages

Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.

Spread the cost of your payment

Our flexible payment options help you spread the cost of your payment across a time period that suits you. We offer fixed-term monthly payment plans over 10 months to five years with no deposit required. If you decide to pay over 10 months, you will pay interest-free. If you are paying for a longer period, you will pay 14.9% APR.

Private health insurance

If you have private health insurance, your treatment will usually be covered by your provider. Speak to your insurer directly to find out more information on this.

If you have any questions about our fixed-price packages and flexible payment options, you can speak to a friendly member of our advisory team on 0141 300 5009

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Your cubital tunnel sits along the area where your elbow bends, and while cubital tunnel syndrome can lead to pain in this area, most of the symptoms are felt in your hand. The ulnar nerve starts in your neck area and goes all the way down to your fingers, which is commonly where your numbness and/or pain is. So, if you have any of the below symptoms, there's a chance you might need cubital tunnel syndrome treatment:

• Numbness and/or tingling in your ring finger and/or little finger
• Pain in your hand
• Feeling like either your ring finger or little finger is falling asleep
• Difficulty moving your fingers in and out, or manipulating objects
• Sensitivity to cold
• Weakened grip and/or difficulty with finger coordination (e.g., when playing an instrument)
• Muscle wasting in your hand (when muscles decrease in size)

Usually, these symptoms come and go. They tend to be more present when your elbow is bent, such as when driving or sleeping in a certain position.

Your ulnar nerve transmits electrical signals down your arm and into your hand. These electrical signals trigger movement in your fingers, hand, and forearm, along with being responsible for feeling in your ring finger and little finger. Because of the way it sits on the inside of your elbow, close to your skin, your ulnar nerve has to stretch around the ridge of your arm when you bend it.

If you are constantly bending your elbow (e.g., through exercise requiring repeated bending movements, or sleeping in a certain position), you put pressure on your ulnar nerve. Over time, it can become swollen and enlarged. When this happens, your ulnar nerve presses against the tunnel that it passes through (the cubital tunnel), leading to pain and numbness in your hand, forearm, and/or elbow. This compression can happen anywhere along your arm, but mainly it happens at the site of your 'funny bone'.

How arthritis can lead to cubital tunnel syndrome

If you have arthritis, there is an increased chance of you experiencing cubital tunnel syndrome. Longstanding arthritis can cause spurs (or lumps) to form along the bones in your arm, which in turn presses against the nerve and leads to numbness.

Your consultant will start by asking about your general health and medical history to learn how long you've lived with the problem. They may also ask about your work and the activities you do, as this can help them understand the source of your discomfort. The next step will be a physical examination that tests the motor and sensory performance of your arm, elbow, and hand, along with when and where you feel pain and/or numbness. This examination might involve:

• Tapping over the nerve at your funny bone
• Checking if your ulnar nerve slides out of its normal position when you bend your elbow
• Moving your neck, shoulder, elbow, and wrist to see if this causes discomfort
• Checking the feeling and strength in your hand and fingers

After completing these checks, your consultant may run you through some tests to confirm if you have cubital tunnel syndrome.

Nerve conduction studies (NCS)

Tests that help your consultant determine how well your ulnar nerve is working and pinpoint where it is being compressed. By stimulating the nerve in different places, they can see the time it takes for there to be a response. If the response in one area is too long, that is most likely where the compression lies.

Electromyography (EMG)

Measures your ongoing muscle activity and how the muscles along your arm respond to stimulating the nerves.

X-ray

While most causes of ulnar nerve compression can't be picked up by an X-ray, this test is useful for identifying bone spurs, arthritis, or any other issues with your bone that might be compressing your nerve.

Once these tests have been done, your consultant will know whether you have cubital tunnel syndrome and recommend a form of treatment suited to you.

If your consultant discovers that you have cubital tunnel syndrome, they will most likely start by prescribing a series of non-surgical treatments - unless your condition is severe and has caused muscle wasting, in which case they will propose surgery. Some of the possible non-surgical treatments include:

Medication and rest

In cases where your symptoms have just started, it could be that a combination of anti-inflammatory medications and avoiding bending movements with your arm reduces the swelling around the ulnar nerve to a point where you no longer feel pain and/or numbness.

Bracing or splinting

A common treatment for cubital tunnel syndrome is the prescription of a padded brace or splint. You might develop this condition because you bend your arms when you sleep, so the brace or splint is there to make sure your elbow stays in a straight position during the night.

Nerve gliding exercises

Your consultant might instruct you to run through some exercises designed to help the ulnar nerve slide through the cubital tunnel without compressing against it. An example of this would be putting your arm out in front of you with a straight elbow, curling your wrist and fingers toward your body, then extending it away from you, followed by bending the elbow.

If none of these conservative treatments make a difference, your consultant may recommend cubital tunnel surgery.

There are a few ways you can prepare for cubital tunnel syndrome treatment, including:

Avoid eating and drinking

As always, refrain from eating or drinking anything after midnight of the day of your surgery. Take care to not drink alcohol 48 hours prior to coming to the hospital.

Discuss medications with your consultant

Your consultant will most likely discuss any medications you are taking before booking you in for surgery. If you are on any blood-thinning medications (aspirin, anti-inflammatories, warfarin, etc.), you will need to stop taking these two weeks before your operation to reduce the chances of any unwanted bleeding during and/or after the surgery.

Stock up on supplies

When you get home from surgical cubital tunnel syndrome treatment, you won't be able to use the arm that was operated on, so you'll have to avoid tasks like lifting or heading to the shops. So, ahead of the surgery, make sure you already have everything you need within easy reach of wherever it is that you'll be recovering.

Stop smoking

We always encourage people to stop smoking if they are about to have surgery with us (at least two weeks in advance). This is because smoking can negatively affect your breathing during and/or after surgery and potentially compromise how you recover, along with upping the chances of blood clotting. Feel free to get in touch with us if you would like support with smoking cessation or have any questions.

Surgical cubital tunnel syndrome treatment is generally done on an outpatient basis, so you'll be able to go home on the same day of your surgery, although overnight stays might sometimes be required. Usually, the procedure is carried out under local anaesthetic, which means your surgeon will make an injection into your elbow that numbs the entire area. You won't feel anything - nor will you see the surgery taking place.

If you don't want to be awake for your surgical cubital tunnel syndrome treatment, we can put you under general anaesthetic. This sends you to sleep for the full operation, which typically takes around an hour to complete, depending on the type of operation your surgeon decides is best for you.

Your surgeon may use one of three surgical techniques to treat your cubital tunnel syndrome - all of which aim at relieving the pressure on your ulnar nerve.

Cubital tunnel release

Your surgeon will make an incision above your elbow. They will then cut and divide the ligament roof of the cubital tunnel, which has the effect of increasing the size of the tunnel and decreasing pressure on the nerve. The tissue that grows over this newly made division helps heal your ligament and allows your ulnar nerve more space to pass through.

This form of cubital tunnel syndrome treatment is generally used when your nerve compression is only moderate. If your ulnar nerve slides out from behind a bony ridge on your elbow, you may need a more advanced surgery.

Ulnar nerve anterior transposition

If you have a bony bump (or spur) that is pressing against the ulnar nerve and causing pressure, your surgeon will probably opt for ulnar nerve anterior transposition. In this procedure, the nerve is moved from behind the part of your elbow that is inflamed and placed in a new area in front of it. They may also move the nerve to lie on top of your muscle, within your muscle, or under your muscle. Moving the nerve in this way means it no longer presses against the bony bump and stops causing you discomfort.

Medial epicondylectomy

Often used in situations when your cubital tunnel syndrome is more severe, your surgeon will make an incision at the site of your entrapped nerve and remove the bony bump on the inner side of your elbow that is leading to ulnar nerve compression with specialist tools.

Everyone differs when it comes to recovering from cubital tunnel surgery. Depending on factors like your age, general fitness levels, and type of surgery, you could make a full recovery in a few weeks, or it might take a number of months. Generally speaking, however, full recovery from this procedure takes around six weeks.

One to five days after surgery

After surgery, you will be given a bit of time to rest before being discharged. This is not a major surgery, so most people can go home a couple of hours after the procedure has been completed. You might experience a bit of pain, and your nurse will make sure you are given pain relief medication to take home with you.

Your arm may be placed in a splint, which you'll have to keep on for a few weeks, and you'll be in a sling for a few days.³ For the first 24 to 48 hours, your consultant will recommend that you keep your arm elevated and iced to reduce swelling and help the wound heal. After these first two days, you may be able to use your hand for light activities, such as dressing, but we recommend that you rest as much as possible. The bandage we put over your arm is quite bulky, so take care to wear loose-fitting clothing.

When it comes to showering, you will have to put your arm in a waterproof bag until the dressings are replaced, which is generally done five to seven days after your operation at one of our clinics.

One to three weeks after surgery

If your job doesn't involve strenuous physical activity (e.g., desk work), you may be able to return to work one or two weeks after your cubital tunnel surgery. Your break from work will be longer if your job demands lifting or other movements that mean repeatedly bending your elbow.

You will be able to drive again once your wounds have healed and you can safely grip the steering wheel without any discomfort. Usually, it takes two or three weeks for you to reach this stage. Generally, we will make an appointment to remove your stitches 10 to 14 days after surgery. You'll be able to shower or bathe normally after the stitches are out.

Three weeks to two months after surgery

Your splint will be removed three to six weeks after your surgery for cubital tunnel syndrome. During this period, you should feel like you are coming back to full strength again. Your surgeon may recommend a series of physiotherapy exercises that help you regain strength and range of motion in your arm, taking care to adapt the programme to how your recovery is progressing.

At the two-month mark, you will probably be able to return to intensive exercise and the activities that you enjoy, but please speak to your consultant about this first. Some people may require a bit longer to get back to full strength.

Complications with surgery for cubital tunnel syndrome can occur, but these are rare. Your consultant will speak to you at length about the possible risks beforehand, making sure you have all the information you need to make a decision that feels right for you.

General complications of any operation

• Pain
• Bleeding
• Infection in the surgical wound
• Unsightly scarring
• Blood clots
• Difficulty passing urine
• Chest infection
• Heart attack or stroke

Specific complications of cubital tunnel syndrome surgery

• Nerve damage causing permanent numbness around the elbow and forearm
• Elbow instability
• Elbow flexion contracture (when the elbow can't be fully straightened)
• Pain at site of the incision
• Symptoms continue despite surgery (numbness in your ring and little fingers)

When you choose to go private with Circle Health Group, you can expect:

• Flexible appointment times and locations to fit your schedule
• The ability to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans adapted to your specific needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standards and delicious healthy meals
• Affordable, fixed-price packages (aftercare included)
• Flexible payment options to help you spread the cost of your care

If you would like to learn more about cubital tunnel syndrome treatment, book your appointment online today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in November 2022. Next review due November 2025.

1. Ulnar Nerve Entrapment at the Elbow (Cubital Tunnel Syndrome), OrthoInfo
2. Ulnar Nerve Entrapment, Osmosis
3. Medial Epicondylectomy, Resurgens Orthopaedics
4. Treatment for Cubital Tunnel Syndrome, The Royal Orthopaedic Hospital
5. Ulnar Nerve Release Surgery, Baptist Health