Cubital Tunnel Syndrome or Cell Phone Elbow?

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Cubital tunnel syndrome is now being called cell phone elbow. This should not come as a surprise with the increased use and availability of cell phones. The syndrome is not new, but is on the rise.

Cubital tunnel syndrome is a nerve compression syndrome (like carpal tunnel syndrome). In the case of cubital tunnel syndrome, the nerve involved is the ulnar nerve. The location of the compression is at the elbow as the ulnar nerve’s course wraps around the posterior elbow along the medial condyle of the humerus. This is the area often called the “funny bone" when it gets hit. When people hold their elbow flexed for a prolonged period, such as when speaking on the phone or sleeping at night, the ulnar nerve is placed in tension.

As with other nerve compression syndromes, the clinical picture is representative of the nerves enervation (the skin and muscles supplied by the nerve). In the case of the ulnar nerve, this involves numbness or paresthesias in the small and ring fingers. There may also be numbness of the dorsal ulnar hand which will NOT be present if the ulnar nerve compression is in the Guyon’s canal at the wrist level (distal ulnar nerve compression). If the compression is chronic enough, the symptoms progress to hand fatigue and weakness. The small intrinsic muscles of the hand are important in hand strength needed to open jars.

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It may be an old joke (Patient: Doctor, it hurts when I do this. … Doctor: Well don’t do it.), but in the case of cubital tunnel syndrome it fits. Prevention is key. Prolonged extreme flexion of the elbow (elbows bent tighter than 90 degrees) is not kind to the ulnar nerve. Switch hands or use a head set or blue tooth.

Treatment can involve conservative splinting and use of anti-inflammatory medications. When those fail, the the nerve may have to be released surgically.

REFERENCES

Q:What is cell phone elbow, and what should we tell our patients?; Cleveland Clinic Journal of Medicine May 2009 vol. 76 5 306-308 (doi: 10.3949/ccjm.76a.08090); Darowish, Michael MD, Lawton, Jeffrey N. MD, and Evans, Peter J MD, PhD

Cubital Tunnel Syndrome: eMedicine Article, Feb 9, 2007; James R Verheyden, MD and Andrew K Palmer, MD

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