Cubital Tunnel Surgery

Cubital tunnel surgery is a specialised surgical procedure aimed at relieving the pressure on the ulnar nerve, which runs along the inner side of the elbow. This nerve can become compressed as it passes through the cubital tunnel behind the bone on the inner side of the elbow called medial epicondyle, leading to cubital tunnel syndrome. This condition is characterised by numbness, tingling, and pain in the hand, fingers, and elbow, often worsening over time.

At The Nerve Surgery Centre, our highly qualified and experienced surgeon Mr Tomas Madura offers expert care in the diagnosis and treatment of cubital tunnel syndrome, including cubital tunnel release surgery. The surgical procedure involves creating more space for the ulnar nerve by opening the cubital tunnel or performing a nerve transposition, where the ulnar nerve is moved to reduce irritation. Depending on the case, the surgery may involve removal of part of the medial epicondyle bone (medial epicondylectomy) and releasing tight tissues that compress the nerve. The surgery can be performed under general anaesthetic or regional anaesthetic, depending on patient preference and the complexity of the operation.

Following the procedure, patients begin their recovery at home, with targeted physiotherapy and post-operative care tailored to their needs. This approach helps improve symptoms like pain, numbness, and weakness in the fingers. At The Nerve Surgery Centre, we take pride in delivering the highest quality of nerve surgery care, ensuring every patient receives personalised treatment from initial consultation to post-operative recovery. To learn more about our comprehensive care and our peripheral nerve specialist Mr Madura, click the links for further details.

Cubital tunnel syndrome occurs when the ulnar nerve, also known as the “funny bone” nerve, becomes compressed or irritated as it passes through the cubital tunnel at the elbow. The cubital tunnel is a narrow space at the elbow formed by bone and tissue, which can easily become a site of compression.

This condition can develop from repetitive elbow movements, prolonged periods of elbow bending, or trauma to the area, causing pressure on the ulnar nerve. Many patients will develop the cubital tunnel syndrome without any identifiable cause. 

Common symptoms of cubital tunnel syndrome include numbness, tingling, or weakness in the hand, particularly in the fingers (ring and little finger), as well as pain in the hand that can radiate up to the forearm. These symptoms tend to worsen with activities that require bending the elbow, such as typing, holding a phone, or resting on the elbow. The symptoms commonly appear at night causing the sufferer to wake from sleep. If left untreated, cubital tunnel syndrome can lead to permanent nerve damage, causing more severe weakness and loss of muscle function in the hand.

Surgical options for treating cubital tunnel syndrome typically include cubital tunnel release surgery which can be accompanied by medial epicondylectomy (partial removal of the funny bone) or ulnar nerve transposition. During a cubital tunnel release, the surgeon enlarges the cubital tunnel by cutting and releasing the tissue that is compressing the nerve. In some cases, nerve transposition is required, where the ulnar nerve is moved from its current position to a new, less compressed location in front of the elbow. Both procedures aim to relieve pressure on the ulnar nerve and restore normal function.

Depending on the severity of the condition, non-surgical treatments such as physical therapy, splinting, or medications may be considered before surgery. However, in more advanced cases or when symptoms persist, cubital tunnel surgery becomes the most effective option for long-term relief.

Determining when cubital tunnel surgery is necessary depends on the severity and persistence of the symptoms associated with cubital tunnel syndrome. In many cases, initial treatments like rest, physical therapy, anti-inflammatory medications, or wearing a splint to prevent overbending of the elbow can alleviate pressure on the ulnar nerve. However, if these conservative approaches fail to improve symptoms, or if the condition worsens, surgery may be required.

Key indicators that suggest cubital tunnel release surgery is necessary include:

1. Persistent numbness or tingling: When these sensations, particularly in the ring and little fingers, continue despite non-surgical treatments, it may indicate that the nerve is being consistently compressed and needs to be relieved through surgery.
2. Weakness in the hand: A weakening grip or difficulty using the hand for tasks such as holding objects and decreased grip strength are signs that the ulnar nerve is being significantly affected. If muscle weakness develops, surgery is often recommended to prevent permanent damage.
3. Elbow pain and discomfort: Chronic pain around the elbow or medial epicondyle that radiates down into the fingers or up towards the shoulder can signal severe compression of the nerve. When the pain impacts daily activities, cubital tunnel release can provide relief.
4. Muscle wasting in the hand: In advanced stages of cubital tunnel syndrome, the muscles of the hand—particularly those between the thumb and index finger—can start to waste away. This is a serious sign that surgical intervention is needed to protect the function of the ulnar nerve.
5. Loss of fine motor skills: If you are struggling to perform tasks that require fine motor control, such as writing, buttoning clothing, or using small objects, it could indicate that nerve compression is affecting your coordination and dexterity.

When these signs become evident, particularly if they are progressing, it is crucial to consider cubital tunnel surgery to prevent irreversible nerve damage. The decision to proceed with surgery is often based on a combination of the patient’s symptoms, physical examination, and diagnostic tests such as nerve conduction studies or MRI or ultrasound imaging. Cubital tunnel release surgery or ulnar nerve transposition can provide long-term relief from the debilitating effects of cubital tunnel syndrome and restore normal function.

Cubital tunnel surgery, particularly cubital tunnel release, is a common surgical procedure aimed at relieving pressure on the ulnar nerve at the elbow. The procedure can be performed under general or regional anaesthetic, depending on the patient’s preference and the surgeon’s recommendation. During the surgery, the goal is to alleviate the nerve compression that causes cubital tunnel syndrome.

The surgical procedure typically involves opening the cubital tunnel by cutting the overlying tissue that is compressing the ulnar nerve. This allows the nerve to pass through the tunnel without restriction, reducing the symptoms of numbness, tingling, and weakness in the hand and fingers. In some cases, the surgeon may perform a nerve transposition, where the ulnar nerve is relocated to the front of the medial epicondyle to prevent future irritation. In some patient the cubital tunnel release may be combined with a medial epicondylectomy, in which part of the bone in the elbow is removed to create additional space for the nerve.

The simple cubital tunnel release is an operation that usually lasts around 45 to 60 minutes, depending on the complexity of the case. After the surgical procedure, patients can expect to start their recovery immediately at home, often returning to normal activities within a few weeks. The recovery after simple cubital tunnel release usually takes around 2 months, but it is longer if a medial epicondylectomy or anterior nerve transposition were performed. There may be some discomfort in the elbow area and numbness around the incision site as the skin and tissues heal. However, the long-term outcome is typically very positive, with resolution of pain, numbness and pins and needles as well as  improved function in hand and finger in 8 or 9 out of 10 patients who underwent the procedure.

If you are experiencing persistent symptoms of cubital tunnel syndrome, such as numbness, pain, or weakness in your hand, it may be time to consider cubital tunnel release surgery. 

To book your initial consultation with us simply click here email info@nervesurgery.uk or call 07340 651908

At The Nerve Surgery Centre, our highly qualified and experienced surgeon, Mr Tomas Madura, specialises in cubital tunnel surgery and other nerve-related conditions. With a strong focus on providing individualised patient care, Mr Madura brings a wealth of expertise in surgical procedures that relieve nerve compression and improve quality of life for those suffering from cubital tunnel syndrome.

Mr Madura’s approach to cubital tunnel release surgery is patient-centred and grounded in the latest innovations in nerve surgery. His deep understanding of the anatomy of the ulnar nerve, the elbow, and the surrounding structures allows him to tailor each procedure to the unique needs of the patient. Whether performing a standard cubital tunnel release or a more complex nerve transposition or medial epicondylectomy, Mr Madura ensures that every step of the operation is carried out with precision to minimise discomfort and enhance recovery.

As a leading peripheral nerve specialist, Mr Madura is well-versed in the techniques necessary to provide effective relief from cubital tunnel syndrome. His surgical expertise, combined with his dedication to patient outcomes, makes him the ideal choice for anyone considering cubital tunnel surgery. From initial diagnosis to post-operative care, Mr Madura works closely with patients to ensure they receive the best possible treatment, with a focus on returning them to a life free from numbness, pain, and weakness in the hand and fingers.

If you are looking for an expert surgeon to perform your cubital tunnel release, Mr Madura’s extensive experience and patient-focused approach make him the right choice.

After undergoing cubital tunnel surgery, the recovery process is a critical phase that ensures the success of the surgical procedure. Most patients can return home on the same day the cubital tunnel release is performed, as it is typically an outpatient procedure. 

In the days following the operation, it is important to keep the elbow elevated and avoid putting pressure on the ulnar nerve to help reduce swelling and discomfort. The skin and tissues around the incision will take time to heal, and mild bruising or numbness near the elbow is normal. Patients are usually provided with a splint to immobilise the elbow and ensure proper healing during the first week of recovery.

A significant part of the recovery process is focused on regaining mobility and strength in the hand, fingers, and elbow. A course of physiotherapy is recommended to help restore normal function and prevent stiffness in the elbow. Exercises designed to gently move and stretch the ulnar nerve will assist in reducing the risk of scar tissue formation and ensure the nerve heals properly.

Most patients can resume light activities within a few weeks, but it may take several months for full strength and mobility to return. The results of the cubital tunnel release are generally very positive, with significant improvements in symptoms like numbness, pain, and weakness. However, recovery times can vary depending on the extent of the nerve compression and the specific type of procedure performed, such as a nerve transposition or medial epicondylectomy.

During this time, it is essential to follow the surgeon’s instructions carefully to avoid complications. Keeping the wound clean, managing any postoperative pain, and gradually increasing activity levels will contribute to a successful recovery. If you experience any unexpected symptoms or have concerns during your recovery, our team at The Nerve Surgery Centre is here to provide ongoing support.

To book your initial consultation with us simply click here email info@nervesurgery.uk or call 07340 651908

Choosing the right place for cubital tunnel surgery is essential for a successful outcome, and at The Nerve Surgery Centre, we provide a high standard of specialised care tailored to each patient’s needs. Here are some reasons why we are the leading choice for cubital tunnel release and nerve surgery:

1. Expert Surgeon: Our highly skilled surgeon, Mr Tomas Madura, brings extensive experience in performing cubital tunnel release surgery and other complex nerve-related procedures. Mr Madura’s background in peripheral nerve surgery and his dedication to patient care ensure that each operation is carried out with precision and expertise.
2. State-of-the-Art Techniques: We utilise the latest advancements in cubital tunnel surgery, including minimally invasive approaches, ensuring that patients experience minimal discomfort and shorter recovery times. Whether it’s a standard cubital tunnel release or a more intricate nerve transposition, Mr Madura tailors each procedure to best suit the patient’s condition.
3. Personalised Care: Every patient at The Nerve Surgery Centre receives individualised attention. From the initial consultation to post-operative follow-up, we ensure that your treatment plan is customised to your specific symptoms and condition. Our consultant-led approach means that Mr Madura is with you every step of the way, from diagnosis to recovery.
4. Comprehensive Treatment Options: We not only offer cubital tunnel release surgery but also provide a range of services to treat various nerve compression conditions, including nerve transposition and medial epicondylectomy. Our approach ensures that we address the root cause of your condition to deliver lasting relief from symptoms.
5. Patient-Centred Approach: We understand that dealing with conditions like cubital tunnel syndrome can be challenging. That’s why we focus on delivering compassionate and supportive care, ensuring that our patients are informed and comfortable throughout their treatment journey.
6. No Long Waiting Times: At The Nerve Surgery Centre, we are committed to providing timely treatment. With no long waiting lists, your cubital tunnel release surgery can be scheduled at a time convenient for you, ensuring that your symptoms don’t worsen while waiting for care.

By choosing The Nerve Surgery Centre, you’re not just selecting a clinic – you’re opting for expert care, a highly experienced surgeon, and a team dedicated to improving your quality of life through specialised nerve surgery.

To book your initial consultation with us simply click here email info@nervesurgery.uk or call 07340 651908

How long off work after cubital tunnel surgery?

The amount of time you will need off work after cubital tunnel surgery depends on the nature of your job and how physically demanding it is. For desk jobs or light duties, many patients return to work within 3-4 weeks with staged return to normal activities . For more physically demanding jobs, particularly those involving repetitive elbow use, it may take 2 months or longer before you can return to full duties. If the cubital tunnel release was accompanied with medial epicondylectomy or anterior nerve transposition, the return to normal activities is typically longer.

What problems can occur after cubital tunnel surgery?

While cubital tunnel release surgery is generally safe and effective, potential complications can include infection, wound healing problems and nerve damage leading to permanent numbness in the hand or fingers, although this is very rare. 

In some cases the surgery fails to provide improvement or the problems recur after the initial improvement, which may require further treatment. If the medial epicondylectomy was performed, an instability in the elbow joint could occur, however, this is extremely unlikely. 

Finally, a rare condition called the chronic regional pain syndrome (CRPS) can develop where not only the area where the operation was done is painful, but the pain can affect hand, forearm or arm, which may be long lasting and will require special painkillers and physiotherapy sometimes taking several months to resolve. 

How soon can I drive after cubital tunnel surgery?

Most patients can resume driving within 2-3 weeks after cubital tunnel surgery, depending on how quickly their elbow and hand strength return and whether they can safely control the vehicle. It’s important to avoid driving until you feel comfortable gripping the wheel and moving your elbow without pain or restriction.

How to sleep after cubital tunnel surgery?

After cubital tunnel release surgery, it’s important to avoid bending your elbow excessively while sleeping. Using pillows to keep your arm elevated with gentle bent at the elbow can help reduce swelling and discomfort. Wearing a splint or brace during sleep, as recommended by your surgeon, can also ensure that the ulnar nerve remains in a relaxed position, promoting better healing.

Wait times for cubital tunnel syndrome surgery NHS?

Wait times for cubital tunnel surgery on the NHS can vary depending on location and demand. In some cases, the waiting time can be several months. If you are seeking more immediate treatment, opting for private care at a specialised clinic like The Nerve Surgery Centre can significantly reduce your wait time for the surgical procedure.

How painful is cubital tunnel release surgery?

Cubital tunnel release surgery is usually well-tolerated by most patients and is typically performed under general or regional anaesthetic to prevent pain during the procedure. After the surgery, some pain, discomfort and swelling around the elbow are normal, but pain is generally manageable with prescribed medication. Most patients report improvements in pain within a few days to a week.

Can I bend my elbow after cubital tunnel surgery?

Yes, gentle bending of the elbow is allowed and recommended to maintain elbow mobility and to prevent scarring around the release nerve , which could lead to recurrence of the problems. Every patient will undergo a course of targeted physiotherapy after the surgery to ensure correct healing and to expedite return to normal function.  Your surgeon and physiotherapist will guide you on when it’s safe to resume full elbow bending and straightening activities, often within a few weeks.

Do you need a cast after cubital tunnel surgery?

A full cast is typically not required after cubital tunnel release surgery. However, your surgeon may recommend wearing a splint or brace to keep your elbow in an appropriate position during the initial stages of recovery. This helps protect the ulnar nerve and the surgical site while promoting healing. The splint is generally worn for about a week or two, after which gradual movement is encouraged.

Mr Tomas Madura MD(Hons), PhD, FRCS(Plast), is a highly experienced Consultant Plastic Surgeon specialising in hand and peripheral nerve surgery, with over two decades in the medical field. He has been a Consultant at the Birmingham Hand Centre and Brachial Plexus and Peripheral Nerve Injury Service at the Queen Elizabeth Hospital in Birmingham since 2017. Mr Madura’s distinguished career includes a PhD in Neurobiology from Osaka University, multiple fellowships in reconstructive microsurgery and peripheral nerve surgery, and numerous contributions to research in the field of nerve injuries and paralysis.

He is a Fellow of the Royal College of Surgeons of Edinburgh and a full member of several prestigious organisations, including the British Association of Plastic Reconstructive and Aesthetic Surgeons and the British Society for Surgery of the Hand. Mr Madura has been recognised with the Syme Medal for outstanding contributions to surgical research.

For more information, please visit his About page.

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