Cubital Entrapment Syndrome: Cause of Shoulder-Elbow pain

Dear Ask The Doctor: I think I possibly have cubital tunnel issues. At this time, I am feeling a tingling on the inside of my right elbow, some tingling in the collarbone area and some underarm pain. I spend a lot of time on the computer and also sleep with my elbow bent. Is underarm pain part of this syndrome? From what I understand, the nerve passes through the underarm.

Dear Susan: According with your description, it correlates with an inflammation of the Ulnar nerve because of its superficial position at the elbow, it is often injured by excessive pressure in this area (leaning on the elbow during work, sleeping or while driving a car) or can be compressed at the wrist level or at an upper level. The symptoms of ulnar nerve entrapment can vary from mild transient numbness in the ring and small fingers to clawing of these digits and severe muscle atrophy of the hand muscles, also may report severe pain at the elbow or wrist with radiation into the hand or up into the shoulder and neck. You may have a hard time in opening jars or turning doorknobs. Early fatigue or weakness may be present if they do a work that requires repetitive hand movements. If you rest on the elbows at work, increasing numbness may appear throughout the day.

The suggested conservative treatment consist of: postural education (i.e.: avoid resting on elbows at work, using elbows to lift the body from bed, and resting elbows on car windows while driving), using an anterior elbow extension splinting (if necessary), and correction of ergonomics at work should correct the transient numbness. Anti-inflammatory medications also are useful to relieve nerve irritation. Oral vitamin B-6 supplements may be helpful for mild symptoms. This treatment should be done out for 6-12 weeks, depending on patient response. Surgical intervention is indicated if symptoms get worse despite adequate conservative treatment.