Ed Zimney, MD

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Posted in: Healthy Living

Cell phone elbow isn’t always due to cell phone use

Published Jun 4, 2009

Recent media activity has called attention to a repetitive use syndrome called ‘cell phone elbow,’ which can cause pain, numbness or tingling in the forearm and hand.  But cubital tunnel syndrome, as it’s known medically, isn’t only caused by excessive cell phone use. In fact, it can be caused by any repetitive activity in which the elbow is bent at a greater than 90 degree angle. This could include holding any kind of phone to the ear for long periods of time. It just happens that because cell phone use has increased exponentially and because people can now use their phones while walking, while driving, literally anywhere, some people are spending much more time on the phone than they did previously. And some of them are paying the price with painful hands and arms.

Cubital tunnel syndrome is similar in many respects to the more widely known and more common carpal tunnel syndrome. In the latter, repetitive use injury causes the median nerve to become compressed as it passes from the forearm to the hand through the wrist. In the former, cubital tunnel syndrome, which is the second most common nerve compression syndrome of the arm, it’s another nerve, this time the ulnar nerve, which becomes compressed as it passes around the elbow, giving the condition its nicknames of cell phone elbow and even “cellbow.” Everyone has experienced banging their elbow and the resulting sharp pain and tingling that occurs immediately thereafter. We call it hitting our funny bone but it’s not a bone at all but rather the ulnar nerve that’s being hit and causing the pain. You can see the ulnar nerve, shown below in yellow, as it passes around the inner aspect of the elbow right along the bone.

Whenever we bend the elbow more than 90 degrees it both stretches the ulnar nerve and compresses the tunnel through which it passes. Normally we don’t hold this position for long periods of time, which allows the nerve to regain its normal length and relieves the pressure. But if you keep your elbow bent for hours at a time on a daily basis, it can cause reduced blood flow to the ulnar nerve, resulting in localized tissue swelling and eventually the symptoms of pain and neurologic issues like numbness and tingling.

You can actually develop cubital tunnel syndrome while you sleep! Some people sleep on their side with their elbows bent sharply and their hands tucked under their head and some remain in that position for many hours each night. Some people sleep on their side and then hold a phone to their ears all day, further compounding the problem. You can also cause problems by leaning heavily on your elbow while driving or working. Some folks keep their arms bent while keyboarding. It’s even known to occur in people who play the guitar for hours at a time because the action of working the fretboard not only keeps the arm bent but also puts pressure on the thumb and forefingers at the same time – a perfect setup for cubital tunnel syndrome.

As mentioned, the symptoms are typically pain and/or numbness and tingling along the inner arm and hand (the pinky and ring fingers). Some people also develop fatigue and weakness of the affected hand leading to difficulty opening jars. Long term or severe problems can lead to permanent muscle problems including the inability to straighten out the pinky and ring fingers.

In the early stages or in non severe cases, treatment consists simply of avoiding the offending movement or position, which allows the nerve to heal. If it’s due to cell phone use, cutting back, switching hands and/or using a headset are usually effective. Becoming aware of all your activities that cause long term elbow bending, whatever they are, is key to modifying those behaviors. If elbow bending occurs during sleep, wearing an elbow brace that prevents or limits bending can be effective. Another nocturnal trick is to wrap a towel around the elbow (use a safety pin to keep it in place) to provide a bulky obstacle to bending.

People with more severe symptoms may require treatment with anti-inflammatory drugs, which might be taken orally or injected locally depending on the individual circumstances. In rare cases surgery is required either to decompress the nerve tunnel at the elbow or in some cases actually to reposition it. Early identification and treatment is the best way to prevent long term complications. Awareness of one’s behaviors is most important because many of these activities are done without conscious thought. You might not even realize you’re bending your elbow for hours on end until pain and other symptoms cause you to stop and take a good look at exactly what’s going on.

Have you had problems with cell phone elbow or with other causes of cubital tunnel syndrome? What did you do to get relief? Please leave a comment below so that others can learn from your experience. We look forward to hearing from you.

Posted in: Healthy Living

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