Cubital Tunnel Syndrome Test | Indication , Steps and More

Cubital Tunnel Syndrome loosely known as ulnar neuropathy is ailment resulting from entrapment and or pressure on the ulnar nerve in the cubital tunnel region. This syndrome presents itself with pains, numbness, and tingling sensations in the ring and little fingers as well as in rare cases muscle weakness in the hand. There are examinations that are useful in the diagnosis of this disease and they include; Tinel’s Sign, Elbow Flexion Test, and Pressure Provocative Test.

Indication for Cubital Tunnel Syndrome Test

Cubital Tunnel Syndrome Test  are indicated for patients presenting with:
 

• Sensory changes involving the ulnar nerve distribution over the ring and little fingers and the palm, may include numbness or tingling.
• Drainage of the elbow joint or discomfort on the inner part of the joint.
• Digital weakness or reduction in the size of the muscles present in the hand.
• They indicate that some of its symptoms are precipitated by flexing the elbow.

Cubital Tunnel Syndrome Tests

There are some tests that physiotherapists apply in order to test for Cubital Tunnel Syndrome. 

The commonly used tests and their procedures are:

Tinel's Sign:

1. Positioning the Patient: The position of the patient is sitting with the elbow not fully extended but also not tightly flexed.
2. Procedure: The physiotherapist rolls a small tuning fork against the skin over the ulnar nerve in the cubital tunnel , which is the medial part of the elbow.
3. Positive Test: Some numbness, or “tingling” or “pins and needles” sensation along the distribution of the ulnar nerve which involves the ring and little fingers.

Elbow Flexion Test:
 

1. Positioning the Patient: With reference to the given patient, the patient is either seated or standing.
2. Procedure: According to the instruction the patient should extend the elbow to the maximum, supinate the forearm also extend the wrist. It’s maintained for 60 seconds in this position.
3. Positive Test: Copying of sensations of numbness or tingling in the distribution of the ulnar nerve.

Pressure Provocative Test:

1. Positioning the Patient: This position of the patient is seated with the elbow slightly flexed and and the forearm lying in a supinated position.
2. Procedure: The physiotherapist holds the forearm of the patient so that their palm faces upward and then flexes the patient’s wrist in a way that compresses the cubital tunnel, which contains the ulnar nerve, for about one minute.
3. Positive Test: TGS of hypaesthesia or anesthesia in the ulnar nerve area of distribution.

Assessment Outcome of Cubital Tunnel Syndrome Test

• Positive Tests: The tests include Tine’s sign, which involves tapping the nerve; elbow flexed test; and positive Tinel sign, in which tingling, numbness, or pain occurs in the ulnar nerve distribution during any of these tests is suggestive of Cubital Tunnel Syndrome.
• Negative Tests: Lack of symptoms during those tests means that Cubital Tunnel Syndrome is less probable.

Making Differential Diagnosis with Cubital Tunnel Syndrome Test

Tests for Cubital Tunnel Syndrome are useful for differentiating this condition from other pathologies such as:

• Cervical radiculopathy (C8-T1 distribution)
• Guyon's Canal Syndrome
• Medial epicondylitis (Golfer's elbow)
• Elbow joint arthritis
• By rubbing the ulnar nerve with direct pressure in the region of the cubital tunnel these tests assist in localizing the source of the symptoms originating from the affected nerve.

Related Special Tests for Cubital Tunnel Syndrome 

Other tests related to ulnar nerve assessment include:

• Froment’s Sign
• Wartenberg’s Sign
• Ulnar Nerve Compression Test

New research on Cubital Tunnel Syndrome 

Evidence-based physiotherapy research supports a comprehensive approach to managing Cubital Tunnel Syndrome, incorporating:

• Activity Modification: Informing patients about the things that should be avoided in order to prevent the worsening of the symptoms which may include flexing the elbow for a long time or making frequent elbow movements.
• Splinting: Wearing splints during the night that helps to keep the elbow straight so that nerve is not compressed while people sleep.
• Nerve Gliding Exercises: Applying technique of certain exercises which aims to mobilise the ulnar nerve and decrease the density of adhesions.
• Manual Therapy: Including techniques like soft tissue mobilization and myofascial release to eliminate the symptoms.
• Ergonomic Adjustments: Adjusting equipment and layout of the work place to minimize pressure on the contributing structures in the elbow and ulnar nerve.

Newer research also focuses on the identification of the disease at its early stage as well as timely management so that patients do not suffer from chronic complications and nerve involvement. Studies also observe that ultrasonography and nerve conduction studies are additional helpful tools in relation to clinical tests in order to achieve better identification of disease and the assessment of treatment outcomes.

To ensure desired and the best results, the physiotherapists should assess the existing literature for the best practices and adjust the intervention plans for the particular patient. The follow-up and adequate information dissemination regarding the illness are vital to the long-term management and prevention of the occurrence of similar complications.