Explanation of Diagnosis

Cubital tunnel syndrome occurs when the ulnar nerve (the "funny bone" nerve) is compressed or irritated as it passes through the cubital tunnel at the elbow. This can cause numbness, tingling, and pain in the ring and pinky fingers, along with weakness in grip strength. Symptoms often worsen with prolonged elbow bending (such as sleeping with the elbow flexed or resting the elbow on hard surfaces).

Specific Work Modifications

• Avoid prolonged elbow flexion (e.g., keeping the elbow bent at 90° while typing or holding a phone).
• Modify desk setup: Use an ergonomic chair/desk to keep arms in a relaxed, extended position.
• Use a headset instead of holding a phone to your ear.
• Avoid resting elbows on hard surfaces (use padding if necessary).
• Take frequent stretch breaks to move and straighten the elbow.

Specific Activity Modifications

• Avoid prolonged elbow bending (e.g., playing guitar, painting, or knitting for long periods without breaks).
• Modify sports (e.g., cycling, tennis) to avoid excessive elbow flexion or direct pressure.
• Use an elbow pad if your hobby involves resting the elbow on a hard surface.
• Take frequent breaks and perform nerve-gliding exercises.

Recommended Supplements

• Vitamin B6 100 mg daily – Supports nerve health.
• Alpha-lipoic acid (600 mg daily) – May help nerve regeneration.
• Magnesium (300-400 mg daily) – Supports muscle relaxation and nerve function.
• Turmeric (500 mg twice daily) – Reduces nerve inflammation.

Recommended Nutrition and Hydration

Diet Recommendations:

• Anti-inflammatory foods: Leafy greens, berries, fatty fish (salmon), nuts, and turmeric.
• Nerve-supporting foods: Avocados, eggs, dark chocolate, and almonds (rich in B vitamins and magnesium).
• Avoid excessive alcohol and processed foods, which can worsen nerve health.

Hydration Tips:

• Drink 2–3 liters of water daily to maintain nerve function.
• Limit caffeine and alcohol, which can dehydrate and affect nerve conductivity.

Home Exercise Prescription

Perform 2-3 times daily to relieve pressure on the ulnar nerve:

1. Ulnar Nerve Glides (Nerve Flossing)

1. • Start with your arm at your side, palm up.
   • Slowly bend the elbow while extending your wrist and fingers (as if holding a tray).
   • Straighten your arm while bending the wrist down.
   • Repeat 10 times per session, 2-3 times daily.

2. Elbow Extension Stretch

1. • Straighten your arm fully and hold for 20-30 seconds, repeat 3 times.

3. Wrist Flexor Stretch

1. • Extend the arm, palm up, and gently pull back on the fingers with the opposite hand.
   • Hold for 20-30 seconds, repeat 3 times.

4. Grip Strength Exercise (if weakness is present)

1. • Squeeze a stress ball or therapy putty 10-15 reps, 2 times daily.

Avoid repetitive gripping or forceful elbow bending until symptoms improve.

Helpful Books

1. "Why Do I Hurt? A Patient's Guide to Overcoming Chronic Pain" – Adriaan Louw
2. "The Pain-Free Program: A Proven Method to Relieve Back, Neck, Shoulder, and Joint Pain" – Anthony Carey

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.