Ep 27 - Why Is My Finger Asleep or Numb? Let’s Dive into Cubital Tunnel Syndrome

Understanding cubital tunnel syndrome is vital for managing elbow and hand pain effectively. This episode shares insights into common causes of numbness and tingling in the pinky and ring fingers. 

• Discussion of cubital tunnel syndrome and its symptoms 
• Important tips for alleviating pressure on the ulnar nerve 
• Recommendations for treatment strategies and exercises 

Thank you for watching, thanks for subscribing to the channel. I hope that this information is helpful. Please share and subscribe to help us help more people give pain the middle finger!

Chapters

• 0:12 Introduction to Elbow Issues
• 17:06 Delving into Cubital Tunnel Syndrome
• 5:11:24 Treatment Techniques and Tips

Transcript

Speaker 1: 0:00

Welcome back to the Hand-to-Shoulder Solution. Giving Pain the Middle Finger. I'm your host, carl Petito. I'm an occupational therapist and a board-certified hand therapist. As a hand therapist, I specialize in the rehabilitation of orthopedic conditions affecting the fingertips through the shoulder.

Speaker 1: 0:16

Let's talk about your pinky falling asleep. It's usually the pinky and the ring finger getting numb and tingly going to sleep. What could be causing that? So let's today talk about cubital tunnel syndrome, and there's different syndromes. We talked in the past about carpal tunnel syndrome. Now we're going to talk about cubital tunnel syndrome. Cubital just means elbow. Now, before we talk about it, I want to mention that this is not treatment or treatment advice. This is information sharing. I like to share what I usually do with my patients, what I see in the clinic, so that you can really know some basic material, some basic information about these conditions, so that you can make the best decision for yourself. When seeking care, everybody should at least be evaluated by a physician or a hand therapist and really know exactly what is going on, so that way you can get well in minimal time.

Speaker 1: 1:12

The longer something goes on, the worse it usually gets, and sometimes it can even lead to other conditions. So the cubital tunnel what is it? Why should I not lean on this side of my elbow? If I do, why does my little finger go to sleep? You know, when you cross your leg and your foot goes to sleep, that's pressure on a nerve. It's not a circulatory issue, it's with blood flow. It's pressure on a nerve. And nerves don't like to be leaned on. They don't like pressure, they don't like to be struck, they don't like weight on it. That will cause the numbness and tingling and could make it a long-term problem.

Speaker 1: 1:49

So cubital means elbow, and the end of the humerus, the arm bone, on the inside part, there's a bony knob. You can feel that right there on yourself yourself. And then from that bony knob down to this bone called the ulna, there's a thick, heavy ligament that forms the roof of a tunnel. So the nerves that come out of the neck and travel down through the armpit, down the arm, and branch out and they innervate or plug into muscles and skin and they allow us to have sensation, they allow us to feel and they allow us to have movement. They send electro, electrical signals from the brain to the muscle or cause the muscle bellies to contract, pull on the tendons, and that's how we, that's how we move. So when that ligament forms the roof of the tunnel, the nerve comes down. And the nerve, by the way, is about as wide as this pen, thick like a noodle. It travels through here, then it courses down, it goes between a couple of muscles in the forearm, then it goes to the pinky side of the carpal tunnel through what's called Guion's canal and then it branches out and it plugs into the small finger and the small finger side of the ring finger. So the small finger and half the ring finger.

Speaker 1: 3:11

So if, if a person is leaning on that, such as leaning on the table or sitting in a in the office chair with armrests, or driving with the elbow up on the windowsill or driving with the elbow on the center console, and you start to feel your fingers go to sleep, or what was happening to me, sleeping on my stomach and the inside part of my elbow is pressing into the mattress, wake up and I'm all numb and tingly here, then I just changed my position, put my arm down by my side. Goes away right away. So that's how I knew immediately that I had pressure on my, on my ulnar nerve at the cubital tunnel in my elbow. I treat a lot of truck drivers that are. You know, they're up here on the window, they're on the center console and if they can't break the habit of leaning on that, I actually have them fold a cloth and then put it on the muscles of their forearm, tape it around their arm or over their shirt or jacket or something, and then now they can lean. But now they're on that rolled-up towel and now there's nothing but air on their elbow and their condition goes away. This is one of those things the sooner we can treat this, the quicker it'll go away.

Speaker 1: 4:27

Mine was so bad. For a while I could have sat on the left side of the couch because even when my arm was down by my side and in between the armrest and against the side of my body, it would. It would light this right up. But I started sitting on the other side of the furniture and it went away. The armrests on my desk chair. I didn't realize how much I was touching the armrests and I started to really pay attention. I said, oh, you know, there it is again. I'm touching the armrests. And this one chair I had. It had bolts underneath. I could take the bolts out, remove the armrests and just get rid of them. I had one that didn't. I actually brought it out in the parking lot and just cut them off of the saw and I have had no problems since Now in the clinic.

Speaker 1: 5:10

What do we do in the clinic that a person can't do for themselves at home? Well, a couple of things. I like to loosen up the elbow, so I'll take that radius bone and I'll pull it away from the humerus and do just some light traction. Then I'll just mobilize the ulna a little bit on the end of the humerus to really loosen everything up. Then I'll mobilize the radius on the end of the humerus and the radius on the ulna, I'll mobilize that joint just to really loosen things. And then, you know, the arm bone is connected to the wrist bone, the elbow bone is connected to the wrist bone, right? So I'm going to mobilize the distal radial ulnar joint where they meet down here, and that really loosens up everything around here.

Speaker 1: 5:55

And then what I want to have my patients do is put the inside part of their elbow under cold running water. Only until deeply cold to reduce inflammation. Only until deeply cold means 10 or 20 seconds, I don't really care about the time, it's just right when it's deeply cold, they're done, and I'll have them do that just as a matter of fact. Midday, at lunchtime and before bed or after dinner, some people I'll have them do it you know the office workers or whatever and they're resting on their elbow and you know, as we're getting this to go away, I'll have them do it at every break they have or every time they go to the bathroom and wash their hands. They'll end with a cold running water, especially after work. They'll. They'll do it quick. It's so quick and easy.

Speaker 1: 6:39

I don't want to put heat on this, because heat expands and will increase inflammation and make it worse. One good thing that I like to use in the clinic is cold laser treatment bright red light to penetrate the tissues, to increase blood flow and to decrease inflammation at the same time. So that's very effective. Also, with my patients, I'll do what's called nerve flossing, so that I'll have them bring their arm up to the side, palm toward the ceiling, little finger toward the ear, until they feel a light achy pull. I'm actually feeling that achy pull all the way down right now and that's normal, by the way. If you, if you do this right now, you'll feel an achy pull.

Speaker 1: 7:13

I tell people to hold this for three seconds, one and two and three. Put on slack again one and two and three. Put on slack one and two and three. Put on slack. Three repetitions three times a day for three seconds each repetition. Three, three and three, and that really that gets the, the nerve gliding through the tunnel. Any thick, gooey substance that's that's just forming in there, that because of some internal swelling, because of internal inflammation, really works that out of there. So a combination of everything but nothing will work. As long as the patient is continuing to put pressure on that nerve, nothing will work.

Speaker 1: 7:55

So the main thing I re, I always stress to everyone and I'm stressing to you is if you're having this problem and you're, you know you're aching in the elbow. There's the numbness and tingling is is. You know this is just first aid right here is just stay off the elbow, that inside part of the elbow, and it'll, it'll, it'll go away. The complication, as this goes on too long, it leads to a muscle imbalance in the hand because there's a couple of muscles that really rely on the health of the ulnar nerve. When they are no longer working, it causes what's called claw hand and the big knuckle of the fingers will hyperextend and the small knuckles will bend, and then patients will come in in this position this is now their resting position and they'll go to make a fist and they won't be able to. Or if they can, it'll snap down because now the mechanics this gets a little bit more complex.

Speaker 1: 8:55

This will be another video. Down the road, the mechanics are thrown off to the to the point that they can't normally control their their fingers. So what I do in that case is I make a custom orthosis or a custom splint that goes around the hand and the fingers. It keeps the big knuckles bent down so now they can use their their hand normally and then, as they heal, we can, we can get rid of it, but this is something that should it should never get to this point. Sometimes it does so again. That's why I'm doing these videos. I want the public to understand this stuff, and if you're having numbness and tingling in your little finger side of your hand, then you really have to get that looked at immediately and just nip it in the bud. As with everything else, the sooner you get to it the better. So thank you for watching, thanks for subscribing to the channel. I hope that this information is helpful. It's very mechanical in nature with orthopedics and that makes it fun to talk about. Thank you,