Cubital tunnel syndrome (CuTS) is the compression of the ulnar nerve in your elbow, while carpal tunnel syndrome (CTS) is the compression of the median nerve in your wrist. Treatment options focus on the source of the nerve injury.
Cubital tunnel syndrome happens when the ulnar nerve — a nerve in your elbow that’s associated with that feeling when you hit your “funny bone” — is damaged or compressed. This can cause pain or tingling on the side of your hand near your pinky and ring finger.
Carpal tunnel syndrome happens when the median nerve is pinched in your carpal tunnel, a small opening inside your wrist. Pain and soreness from carpal tunnel syndrome usually affect the side of your hand near the thumb, index, and middle fingers.
Read on to learn how to tell cubital tunnel and carpal tunnel apart by their symptoms and how each condition is diagnosed and treated.
Cubital tunnel syndrome and carpal tunnel syndrome both cause symptoms like pain, tingling, and numbness in your hand.
However, you may feel the pain in different areas of your hand depending on which syndrome you’re experiencing.
| Location | Symptoms | |
|---|---|---|
| Cubital tunnel syndrome | Ulnar nerve, which runs through the elbow, forearm, and pinky and ring fingers | • tingling or numbness in your middle, ring, and pinky finger • pain in your elbow, arm, or hand • trouble using your fingers for coordinated tasks • losing muscle strength in your pinky finger |
| Carpal tunnel syndrome | Carpal tunnel, a small opening in your wrist made of tendons, ligaments, and bones | • tingling or numbness in your thumb, index, middle, and ring finger • pain from your wrist up to your arm and shoulder • losing muscle strength in your thumb |
| Both | • dull, aching pain in your hand • trouble gripping or holding things |
Cubital tunnel syndrome and carpal tunnel syndrome may have similar symptoms, but they have different causes.
Causes of cubital tunnel
Cubital tunnel syndrome happens when the ulnar nerve is damaged, injured, or compressed.
The ulnar nerve runs through much of the arm. It starts in the brachial plexus — a huge web of nerves that run from your spinal cord into your arms and hands — and ends in the hands and fingers, supplying part of your hand with motor function and nerve sensations.
But the most common cause of cubital tunnel syndrome is an injury to your elbow.
There are three main ways the ulnar nerve can be injured that might increase your risk of cubital tunnel syndrome:
- Pressure: pressure on the ulnar nerve from hitting your elbow or pushing your elbow against a surface or object, causing temporary shooting pain
- Overextension: overextending the ulnar nerve from stretching too far or sleeping in positions that bend the elbow abnormally
- Injury: injuring the ulnar nerve when you break a bone, dislocate your elbow joint, experience swelling from an injury, or experience fluid buildup from other conditions
Causes of carpal tunnel
Carpal tunnel syndrome happens when the median nerve is compressed as it passes through the carpal tunnel opening in your wrist.
The median nerve also starts in the brachial plexus. It runs along the arms in a bundle with the brachial artery into the hands through the carpal tunnel, supplying motor functions and nerve sensations to a different part of the hand.
It’s not clear exactly how carpal tunnel syndrome starts. It’s believed that other conditions, along with lifestyle factors, are the most likely triggers of median nerve compression.
Some possible triggers that may increase your risk of carpal tunnel syndrome include:
- compressing the carpal tunnel based on your wrist position while using a keyboard
- vibrations from power tools over a long period
- repetitive motion injuries from activities like typing or playing a piano
- obesity
- diabetes
- thyroid conditions
- retaining fluids during menopause or pregnancy
- autoimmune conditions like rheumatoid arthritis
- wrist injuries or fractures
Here are some tests that a doctor may use to diagnose cubital tunnel syndrome or carpal tunnel syndrome:
Diagnosing cubital tunnel
Diagnostic tests for cubital tunnel syndrome include:
- a physical exam to check your symptoms and overall health
- nerve conduction studies that can measure how quickly nerve signals travel through your wrist
- X-rays of your elbow joint to look for bone spurs, fractures, or other injuries
- magnetic resonance imaging (MRI) to look for other causes, such as nerve abnormalities or aneurysms
Diagnosing carpal tunnel
Diagnostic tests for carpal tunnel syndrome include:
- a physical exam
- nerve conduction studies
- a positive result from a Tinel’s sign test that examines how the median nerve responds to tapping on the wrist
- a positive result from a Phalen’s maneuver test that triggers symptoms when you place the back of the hands together by flexing the wrists and elbows in a bent position
Treatments for cubital tunnel syndrome and carpal tunnel syndrome address the source of the nerve injury or compression and help you reduce your risk of further pain or injury.
Cubital tunnel treatments
Some of the most effective treatments for cubital tunnel syndrome include:
- a brace or pad on your elbow to relieve pressure on your ulnar nerve
- occupational therapy to prevent ulnar nerve compression and overextending your elbow
- physical therapy to help protect your ulnar nerve, including nerve gliding exercises
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), to relieve pain
- surgery to release cubital tunnel compression
Carpal tunnel treatments
Some of the most effective treatments for carpal tunnel syndrome include:
- a wrist splint to keep your wrist from compressing your median nerve
- physical therapy to help build strength in your wrist and hand muscles
- occupational therapy to help you use your hands in a way to reduce the risk of nerve compression
- NSAIDs for pain
- corticosteroid injections to reduce pain and swelling
- surgery to release carpal tunnel compression
You should speak with a doctor if you have severe pain, tingling, or numbness in your hand or wrist that makes it hard to do daily activities. This includes if the pain lasts for a long time without getting better.
What can be mistaken for cubital tunnel?
Cubital tunnel can be mistaken for conditions like golfer’s elbow and tennis elbow.
Why is cubital tunnel so painful?
Cubital tunnel can feel painful because it causes inflammation in the elbow, which can be triggered each time you move your arm.
Cubital tunnel syndrome and carpal tunnel syndrome both cause symptoms like pain, tingling, and numbness in your hand. However, you may feel the pain in different areas of your hand depending on which syndrome you’re experiencing.
A doctor can help confirm a diagnosis and put together a treatment plan to help with your symptoms.