Cubital Tunnel Syndrome with Intermittent Ulnar Paresthesias: No Weakness or Atrophy
Clinical scenario
This protocol applies to patients presenting with intermittent paresthesias in the ulnar nerve distribution, where examination and electrodiagnostic studies show no first dorsal interosseous muscle weakness, no intrinsic hand muscle atrophy, and no evidence of axonal loss. Patients with this presentation — intermittent symptoms consistent with cubital tunnel syndrome, without axon loss, weakness, or atrophy — are candidates for nonoperative treatment.
Approach
Management focuses on nonoperative measures, including orthotic and physical interventions alongside activity and postural modification strategies.
The complete, sequenced protocol — including all recommended interventions and their application — is available via the link below.
Treatment goal
Resolution of intermittent paresthesias in the ulnar nerve distribution at 3 months.
References
DOI: 10.1016/j.jhsg.2022.07.008
Patients with intermittent symptoms and clinical examination consistent with CuTS without evidence of axon loss, weakness, or atrophy are candidates for nonoperative treatment.
Nonoperative approaches include orthoses to prevent elbow flexion, elbow pads, avoidance of triceps exercises, postural/behavior modification, nonsteroidal anti-inflammatory drugs, night splints, physical therapy, US, pulsed signal therapy, ergonomics education, and corticosteroid injections.
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