Carpal Tunnel vs Cubital Tunnel Syndrome: What’s the Difference?

3 minutes ago

2 min read

by Osteopath Carien Boshoff

Pins and needles, numbness or weakness in your hand? You may think carpal tunnel, but another condition called cubital tunnel syndrome can cause similar symptoms.

Both involve irritation or compression of a peripheral nerve, but they affect different nerves and different areas of the hand.

What’s the difference?

	Carpal Tunnel	Cubital Tunnel
Nerve	Median nerve	Ulnar nerve
Compression site	Most commonly in wrist	Most commonly in the elbow
Common symptoms	Numbness, tingling, pain or weakness	Numbness, tingling, pain or weakness
Fingers commonly affected	Thumb, index, middle + part of ring finger	Little finger + part of ring finger
Often aggravated by	Sustained wrist positions (flexion or extension)	Bent elbow or pressure on the inside of the elbow
Night symptoms	Common	Can occur
Possible weakness	Grip or thumb function	Grip, pinch or fine hand movements

Carpal tunnel syndrome

Carpal tunnel syndrome occurs when the median nerve is compressed within the carpal tunnel at the wrist. Symptoms commonly affect the thumb, index and middle fingers and part of the ring finger. Some people notice symptoms at night or during activities involving sustained wrist positions.

Cubital tunnel syndrome

Cubital tunnel syndrome involves the ulnar nerve around the elbow, the same nerve responsible for the familiar “funny bone” sensation. Symptoms commonly affect the little finger and part of the ring finger. Keeping the elbow bent for prolonged periods or leaning directly on the inside of the elbow may aggravate symptoms for some people.

Is all hand tingling carpal or cubital tunnel?

No. Numbness and tingling in the hand can have several potential causes. Nerves travel from the neck through the upper limb to the hand, so assessment may involve considering the neck, shoulder, elbow, wrist and hand, depending on your presentation.

Where does osteopathy fit?

An osteopath can assess your musculoskeletal and neurological presentation to help determine whether your symptoms may be consistent with peripheral nerve involvement.

Depending on your individual presentation, management may include:

• Education about aggravating activities or positions

• Individualised movement or exercise advice

• Management of associated musculoskeletal symptoms

• Hands on treatment where clinically appropriate

• Referral for further investigation or medical assessment when indicated

When should you seek further assessment?

Seek appropriate healthcare assessment if you experience persistent/constant or worsening numbness, progressive weakness, reduced hand function or visible muscle wasting. Further investigation, such as nerve conduction studies, may be considered depending on your presentation.

Take home message

An easy way to remember the difference:

Carpal tunnel → median nerve → wrist → thumb side of the hand.

Cubital tunnel → ulnar nerve → elbow → little-finger side of the hand.

If you're experiencing persistent hand or upper limb symptoms, an osteopath can assess your presentation and determine whether musculoskeletal management or further referral may be appropriate.

References

American Academy of Orthopaedic Surgeons. (2024). Management of carpal tunnel syndrome: Evidence-based clinical practice guideline. American Academy of Orthopaedic Surgeons.

Genova, A., Dix, O., Saefan, A., Thakur, M., & Hassan, A. (2020). Carpal tunnel syndrome:

A review of literature. Cureus, 12(3), e7333. https://doi.org/10.7759/cureus.7333

Nakashian, M. N., Ireland, D., & Kane, P. M. (2020). Cubital tunnel syndrome: Current concepts. Current Reviews in Musculoskeletal Medicine, 13(4), 520–524. https://doi.org/10.1007/s12178-020-09650-y