Cubital Tunnel & Ulnar Nerve Release
Ulnar nerve release with Dr. Steven Ward in Tucson and Oro Valley — relieving pressure on the ulnar nerve at the elbow (cubital tunnel) or at the wrist (Guyon’s canal) for numbness in the ring and little fingers.
Call 520-881-1394Typical ranges for general education. Dr. Ward’s plan for you may differ.
What it treats
The ulnar nerve gives feeling to the little finger and half of the ring finger and powers many small muscles in the hand. It can be squeezed in two common places:
- At the elbow (cubital tunnel syndrome) — behind the “funny bone,” where bending the elbow stretches the nerve. Symptoms are often worse with the elbow bent, such as while driving, holding a phone, or sleeping
- At the wrist (Guyon’s canal, or ulnar tunnel syndrome) — often from a ganglion cyst, repeated pressure on the heel of the hand (cycling, power tools), or a narrow canal
- Symptoms include numbness and tingling in the ring and little fingers, a weak grip or pinch, clumsiness, and in advanced cases visible muscle wasting in the hand
Muscle wasting from long-term pressure may not reverse, so see a doctor if symptoms are severe or have lasted more than about 6 weeks.
Is surgery right for you?
Unless there is weakness or muscle wasting, treatment starts without surgery:
- Elbow: avoid leaning on the elbow and keeping it bent for long periods; keep the elbow straighter at night with a padded splint or a towel wrapped loosely around the arm
- Wrist: padding, changing hand position on handlebars or tools, and a short period in a wrist splint
- Anti-inflammatory medication when it is safe for you
- Nerve gliding exercises
Steroid injections are generally not used at the elbow because of the risk to the nerve. Nerve testing (a nerve conduction study or EMG) helps show where the nerve is pinched and how severely. Surgery is considered when symptoms do not improve, the nerve is badly compressed, or there is weakness or muscle wasting. At the wrist, a cyst or other growth pressing on the nerve usually needs to be removed.
How the surgery is done
These procedures are generally done as outpatient surgery.
- Cubital tunnel release — through an incision on the inside of the elbow, the tissue roof over the nerve is divided so the nerve has more room. This works best for mild to moderate compression when the nerve stays in place as the elbow bends
- Ulnar nerve transposition — if the nerve slides over the bony bump when the elbow bends, it may be moved to the front of the bump so it is no longer stretched and caught
- Guyon’s canal release — through an incision at the heel of the hand on the little-finger side, the canal is opened and any cyst or scar tissue pressing on the nerve is removed
How fast does the nerve recover?
Nerves recover slowly. Tingling often eases first, and feeling and strength keep improving for months. Full recovery can take several months to a year.
If the nerve was badly compressed or the hand muscles had already wasted, some numbness or weakness may remain. Surgery is still important to keep things from getting worse.
Recovery overview
Typical ranges only, based on AAOS OrthoInfo patient education. Your plan depends on which procedure you have, and Dr. Ward’s plan for you may differ.
First days to weeks
- A splint may be worn for a few days to a few weeks, depending on the procedure; moving the nerve under the muscle usually needs 3–6 weeks
- Most people start moving the elbow right away to keep the nerve from scarring
- Keep the hand elevated and move your fingers to limit swelling
First weeks
- Avoid heavy lifting with the arm for a few weeks
- Light daily activities as comfort allows
- Therapy exercises may be started to restore motion and strength
Months to 1 year
- Tingling often improves first; feeling and strength can keep improving for up to a year
- Dr. Ward will talk with you about returning to work and all your normal activities
- Recovery may be less complete in long-standing cases
When to call the clinic
Call 520-881-1394 if you notice any of the following after surgery or while you are recovering:
- A fever of 101°F or higher, or chills
- Redness spreading around an incision, or drainage that is cloudy, foul-smelling, or keeps soaking the dressing after the first few days
- Fingers that turn pale, blue, or cold
- Numbness or tingling in the hand or fingers that does not go away once the nerve block or numbing medicine has worn off, or that is getting worse
- A cast, splint, or dressing that feels too tight: throbbing pain, swelling, or numbness under it that does not ease after you raise your hand above your heart and gently move your fingers. Do not cut or remove a cast yourself
- Pain that is not controlled by your prescribed medication, elevation, and ice
It is normal for the hand and fingers to be swollen, bruised, and sore for a while, and for the hand or arm to stay numb and weak for several hours after a nerve block or numbing medicine. Keep your hand raised above your heart, and move the fingers that are not splinted as you were shown. Call if something feels different from what you were told to expect.
for chest pain, shortness of breath, or trouble breathing. These can be signs of a blood clot in the lungs and need emergency care.
If something does not match the instructions you were given, call the office. Dr. Ward or one of his physician assistants will get back to you.
Related resources
Exercise guides
Hand & wrist handouts, including carpal tunnel exercises and hand and finger exercises.
Open pagePatient resources
Surgery packets, pre-op and post-op instructions, exercise guides, and videos in one place.
Open pagePost-op packets
Dr. Ward’s post-operative instructions and packets, organized by joint.
Open pagePhysical therapy locations
Find a therapy clinic near you in Tucson and Oro Valley if hand therapy is part of your plan.
Open pageOrthoInfo: Cubital tunnel syndrome
Patient education on ulnar nerve entrapment at the elbow from the AAOS. OrthoInfo also has a page on ulnar tunnel syndrome of the wrist.
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