Cubital
Tunnel Release
Cubital Tunnel Release relieves pressure on the ulnar nerve at the elbow, treating numbness, tingling, and weakness in the ring and small fingers. The surgeon releases tight tissue around the nerve - sometimes repositioning it. Outpatient procedure, 20 minutes, same-day discharge.
Board Certified
Neurosurgeon
15+ Years
Experience
5000+
Procedures Performed
Get In Touch
Contact us today to schedule your consultation and take the first step toward relief.
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What Is a Cubital Tunnel Release?
Cubital Tunnel Release is a Peripheral Nerve Procedure. We loosen the tissue encasing the nerve to release the tunnel for it. If there are circumstances that keep displacing the nerve out of position, or if the anatomy puts the nerve at constant risk, it can be moved to a new location, which is known as ulnar nerve transposition. Whatever the approach, the aim remains the same: relieve the nerve pressure so that it may heal.
This is a procedure used to relieve pressure on a nerve at the elbow called the ulnar nerve, which can cause numbness, tingling, or weakness in the hand, especially in the ring and small fingers. This condition is commonly known as cubital tunnel syndrome.
During the procedure, the surgeon releases the tight tissue around the nerve to give it more space and reduce irritation. In some cases, the nerve may be repositioned to prevent further pressure. It is typically done as an outpatient procedure. The goal is to relieve symptoms and improve hand and arm function. The procedure takes approximately 20 minutes, and you go home the same day. Patients with a desk job typically return to work within 1 day. If you have a more labor-intensive job, please ask your doctor when you may return.
30 Minutes
Same Day Procedure
General Anesthesia
2-6 Weeks Recovery
What This Procedure Treats
Ulnar nerve compression builds slowly. Most patients shrug off the early signs - an arm that falls asleep during a phone call, fingers that feel odd after sitting with a bent elbow for too long. By the time they come in, the symptoms are usually affecting their work and sleep. Cubital Tunnel Release is designed to treat:
01
Numbness and Tingling in the Ring and Small Fingers
The ulnar nerve provides sensation to the ring and little fingers. Compression at the elbow causes intermittent or constant numbness and tingling in these two fingers - often worse when the elbow is bent, such as while sleeping or talking on the phone.
02
Elbow Pain or Aching Along the Inner Arm
A common early warning sign is a dull ache on the inner side of the elbow radiating down the forearm. Some patients say it adds soreness that never goes away. Other reports mention sharp pain when you make certain movements and positions.
03
Weakness in the Hand and Fingers
The ulnar nerve controls most of the small muscles inside the hand. When it's compressed long enough, grip weakens, pinching becomes difficult, and tasks that used to be effortless - opening a jar, turning a key, playing an instrument - become noticeable challenges.
04
Symptoms That Worsen with Elbow Bending
When the elbow is bent, there is stretching of the ulnar nerve and a reduction in the size of the cubital tunnel. Patients often notice their symptoms flare when they do things that keep the elbow bent - When they’re sleeping with the elbow bent, driving, or doing desk work without elbow support.
05
Clumsiness or Reduced Dexterity
Dropping things, fumbling with small objects, or finding that the hand just doesn't respond the way it used to - these are signs the nerve has been compressed long enough to affect motor function, not just sensation.
06
Muscle Wasting in the Hand (Advanced Cases)
In cases where nerve compression has gone unaddressed for a long time, the small muscles between the fingers and along the inner hand begin to shrink. This visible flattening of the hand is called intrinsic muscle atrophy, and when it appears, earlier surgery leads to better outcomes than waiting further.
Ready to Get Back to Daily Activities?
Find out whether Cubital Tunnel Release is the right treatment for your symptoms.
When Patients Become Candidates
Surgery is not where we start with cubital tunnel syndrome. The majority of patients try conservative management first, and many do well. Carrying out your daily activities like sleeping with a cocked arm can prevent less pressure on the nerve. Using an elbow pad, wearing a splint at night to keep the elbow straight, and setting up a workstation can also help. When those measures don't hold, surgery becomes the right conversation.
Conservative Treatment Has Not Provided Lasting Relief
Splinting, activity modification, and physical therapy are tried first. When symptoms keep returning despite consistent conservative care or the relief from these approaches fades within weeks, it's a signal that the compression needs a more direct fix.
Symptoms Have Persisted for Several Months
Numbness, tingling, or pain in the ring and small fingers that has been present for months without real improvement, despite lifestyle changes, warrants a surgical evaluation. If you wait any longer than this, you may risk permanent nerve damage.
Hand Weakness Is Developing
When the hand starts losing strength, struggling with grip, pinch, or fine motor tasks that were previously effortless - it means the nerve is not just being irritated, it's being damaged. At that stage, conservative care alone rarely reverses the weakness.
Nerve Compression Confirmed on Testing
EMG and nerve conduction studies measure exactly how well the ulnar nerve is functioning across the elbow. Significant slowing on these tests confirms the diagnosis and helps gauge severity, which factors directly into the surgical recommendation.
Symptoms Are Disrupting Work or Sleep
When numbness regularly disrupts sleep or hand weakness begins to interfere with a person's ability to work, surgery becomes a quality-of-life issue, not just a medical one.
Visible Muscle Wasting Has Appeared
Flattening or hollowing between the tendons on the back of the hand, or a sunken appearance along the inner edge of the palm, signals that the nerve has been compressed long enough to affect the muscles it controls. This finding typically makes surgery the recommended next step without further delay.
Key Benefits
Numbness and Tingling Begin to Resolve
For most patients, the abnormal sensations in the ring and small fingers begin to improve within a few weeks after surgery as the nerve decompresses and starts to heal. Mild or recent cases tend to resolve more quickly than those that have been present for years.
Elbow Pain Decreases
The aching on the inner side of the elbow caused by an irritated ulnar nerve typically improves once the nerve is given enough room to move freely. Most patients notice a meaningful reduction in elbow discomfort within the first few weeks.
Hand Strength Gradually Returns
Grip and pinch strength improve as the nerve recovers. Patients with early-stage weakness tend to see a faster return of strength than those with visible muscle wasting, which is why earlier surgery generally yields better results.
Outpatient ProceduresSame-Day Discharge
No hospital stay. You come in, have the procedure, and go home the same day. For most desk workers, returning to light activity happens within a day or two.
Return to Daily Life and Work
The goal is to get patients back to what they were doing before the nerve problem started - working, using their hands without frustration, and sleeping without being woken up by elbow or finger symptoms.
What Happens During the Procedure
Anesthesia
Local anesthesia with light sedation is used. You won't feel the procedure. General anesthesia is not needed for this.
Small Incision at the Elbow
A small incision is made along the inside of the elbow, directly over the cubital tunnel. This gives access to the ulnar nerve without disturbing the surrounding tissue unnecessarily.
Releasing the Tight Tissue
The ligament and tight tissue compressing the ulnar nerve are carefully cut. Once released, the nerve has room to sit without pressure, which is what stops the symptoms.
Nerve Transposition if Needed
In some cases, the nerve is moved to a new position - forward of the elbow joint - so it no longer stretches or catches when the arm bends. This step is done when the anatomy puts the nerve at continued risk even after release.
Closing the Incision
The incision is closed with sutures and bandaged. The whole procedure takes about 20 minutes from the first incision to closure.
Going Home
This is an outpatient procedure. After a short recovery period at the facility, you go home the same day. No overnight hospital stay required.
Why Choose Capital Spine & Pain Institute
Fellowship-trained neurosurgeon.
Dr. Buchholz is board-certified and fellowship-trained with over 15 years of experience - not a general orthopedic surgeon dividing attention across multiple specialties.
Conservative-first philosophy.
Surgery is recommended only when non-surgical options have been given a genuine chance. We don't push procedures - we find the right answer for each patient.
Nerve study-guided diagnosis.
We confirm cubital tunnel syndrome through EMG and nerve conduction testing before any surgical discussion. No guessing, no assumptions.
Honest Evaluations.
If surgery isn't what you need, we'll say so directly. The goal is the right outcome, not a full schedule.
What to expect week by week
Recovery varies, but here's how most patients progress.
Same Day
Go home. Rest.
Procedure done. Mild soreness at the injection site is normal. Skip driving — you'll need a ride.
24–48 Hours
Soreness fades.
Site soreness clears in a day or two. Some patients notice early pain improvement starting here.
1 Week
You should feel a difference.
Most patients see a meaningful reduction in neck and arm pain as the steroid reaches full effect.
Weeks–Months
Continued improvement.
Relief can last weeks to months. A second injection or PT can extend it further if needed.
Expert Spine Surgeon
Dr. Avery L. Buchholz is a board-certified neurosurgeon with fellowship training in complex spine surgery. With over 15 years of experience and 5,000+ procedures performed, he specializes in both minimally invasive and complex surgical techniques.
His expertise spans the full spectrum of spine care, from non-surgical interventions to advanced reconstructive procedures, always prioritizing patient safety and optimal outcomes.
Frequently Asked Questions
Get answers to common questions about our practice and procedures
What is Cubital Tunnel Release?
Surgery that frees the ulnar nerve at the elbow. Tight tissue gets cut, pressure comes off, and symptoms settle.
How long does the procedure take?
20 minutes on the table. A couple of hours in total, including preparation and recovery time before going home.
Is Cubital Tunnel Release painful?
Not during — you're numbed. After, the elbow is sore for a few days. Most people get through it with Tylenol.
When can I return to work?
Desk job — next day for most. Physical work — depends on the job, ask Dr. Buchholz at your visit.
Will the numbness go away after surgery?
Usually yes, but slowly. Ring and small finger tingling fade over weeks. Caught early, recovery is faster.
What's the difference between Cubital and Carpal Tunnel Release?
The cubital — ulnar nerve at the elbow affects the ring and small finger. Carpal — median nerve at the wrist, which affects the thumb and index finger. Different nerve, different spot.
Do I need physical therapy after surgery?
Not always. Mild cases skip it. If the grip was already weak before surgery, some hand therapy can help it return more quickly.
Can the cubital tunnel come back after surgery?
Rarely. Most patients stay symptom-free. Recurrence happens sometimes if the habits that caused it — like constant elbow bending — don't change.
Our Locations
Serving patients across VA and the DC area
Falls Church, VA
6400 Arlington Blvd, Suite 710
Open
Alexandria, VA
6244A Little River Turnpike
Open
Richmond, VA
Address coming soon
Opening Soon
Charlottesville, VA
Address coming soon
Opening Soon
Washington, DC
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Opening Soon
Get In Touch
Contact us today to schedule your consultation and take the first step toward relief.
Address
6244 Little River Turnpike, Suite 101
Alexandria, VA 22312
Phone
FAX
Office Hours
Monday - Friday: 9:00 AM - 6:00 PM
Saturday: 9:00 AM - 6:00 PM
Sunday: Closed
This form is intended for scheduling purposes only and is not a HIPAA-compliant form. Please avoid sharing any sensitive medical information.
By submitting, you consent to being contacted using the information provided.
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