It's a sign of the times, as more and more people use cell or mobile phones and other high tech equipment they are more likely to end up with what the lay press calls cell phone elbow and what the doctors call cubital tunnel syndrome.

What Is Cubital Tunnel Syndrome?

Cubital tunnel syndrome is the second most common nerve compression syndrome in the upper extremities after carpal tunnel syndrome, say Dr Peter J Evans, Director of the Hand and Upper Extremity Center at the Cleveland Clinic in Ohio, USA, and colleagues in a question and answer article on the subject in a recent issue of the Cleveland Clinic Journal of Medicine. The article also covers diagnosis and treatment.

The syndrome commonly occurs after prolonged cell phone use and manifests as "pins and needles" tingling, aching, burning or numbness in the ulnar forearm and hand. The ulnar forearm is the lower half of your arm, between the elbow and wrist, that faces away from you when you bend your arm to touch your shoulder.

In most cases treatment is effective and makes the pins and needles, tingling and numbing go away but patients who "present early have a better chance of full sensory and motor recovery," say Evans and colleagues.

It happens when the part of the ulnar nerve that goes from the upper to the lower arm around the elbow becomes compressed when you keep your elbow bent for long periods, for example when you hold a cell phone to your ear or, type for long periods at a workstation, or sleep with your arm bent.

Evans and colleagues explain that such positions put the ulnar nerve in tension and stretches it by another 5 to 8 mm. Also, the bent position narrows the space available for the nerve, increasing the pressure in the tunnel that contains the nerve by as much as 20-fold. This is further aggravated by leaning on the elbow, for instance talking on the phone while leaning on the bent elbow at a desk or table.

The end effect is that the blood supply to the nerve diminishes which leads to swelling, so there is even less room in the tunnel, and a vicious cycle is established.

A less common cause of the condition is when the nerve slips in and out of its "groove" in the back part of the elbow. This also causes inflammation and swelling because of the repetitive friction of gliding in and out.

While the exact incidence of cell phone elbow is not known, Evans and colleagues suggest that it paralles the rise in the use of cell phones and deskworking with computers. There are now about 3.3 billion cell phone contracts worldwide, or about one for every two humans on this planet.

The authors say that in many cases the condition can be treated just by changing the way you use your body and avoiding doing things that make the condition worse, such as changing the cell phone to the other hand, or using a hands-free kit.

Cubital tunnel syndrome also occurs as a result of a cluster of activities that involve using the arm bent, with or without pressure to the elbow. For example, do you find yourself talking on the phone while leaning on your elbow? Or sitting for long hours at a computer or workstation with your arms extended in front of you with your elbows bent at greater than 90 degrees? Do you drive a lot with a bent elbow pressed against the window or door? These positions when adopted for too long or too frequently can aggravate the symptoms.

The condition can also be aggravated at night. Especially if you sleep with your arms bent. Preventing "elbow flexion" by for example wrapping a towel around your elbow at night is a simple but effective way to overcome this, say the authors.

If nerves become very inflamed and the simple physical strategies don't work, then anti-inflammatory injections are available. These reduce inflammation of the ulnar nerve. After that, if symptoms persist, there is surgery where the nerve is decompressed or moved from the outside to the inside of the elbow, thus relieving the tension on the nerve.

"Q:What is cell phone elbow, and what should we tell our patients?"
Michael Darowish, Jeffrey N Lawton, and Peter J Evans.
Cleveland Clinic Journal of Medicine, May 2009; 76(5):306-308
doi:10.3949/ccjm.76a.08090

Written by: Catharine Paddock, PhD