The Effects of Physiotherapy in the Treatment of Cubital Tunnel Syndrome: A Systematic Review

Abstract

Background: To date, various forms of physiotherapy are used in the treatment of cubital tunnel syndrome (CuTS). The effectiveness of physiotherapy for CuTS is inconclusive. The aim of this systematic review was to evaluate the effects of physiotherapy in the conservative treatment of CuTS. Methods: The six databases were searched from December 2020 to March 2022. The inclusion criteria were randomised controlled trials, case series, and case reports that evaluate the effects of physiotherapy in the treatment of adult participants with diagnosis CuTS. A total of 11 studies met the eligibility criteria, capturing a total of 187 participants. Results: In three types of papers, pain, muscle strength, and limitation of upper limb function were the most frequently assessed characteristics. Physiotherapy was most often based on manual therapy, neurodynamic techniques, and electrical modalities. One clinical trial rated the risk of bias “high” and the other two “some concerns”. In case-series designs, five studies rated the risk of bias as “serious” and three as “moderate”. Most of the studies showed a significant improvement in the clinical condition, also in the follow-up study. Only one clinical trial showed no therapeutic effect. Conclusion: There is no possibility of recommending the best method of physiotherapy in clinical practice for people with CuTS based on the results of this systematic review. More high-quality studies are required.

Precision of Ultrasound-Guided versus Anatomical Palpation-Guided Needle Placement of the Ulnar Nerve at the Cubital Tunnel: A Cadaveric Study

“…However, conservative options are recommended in mild-to-moderate cases where there is no motor weakness. Several physical therapy techniques have been used in the management of cubital tunnel syndrome, e.g., manual therapy, neurodynamic interventions, or electrical techniques [9][10][11][12]. Although peripheral neuromodulation has been used for more than 50 years and the technology has been available for decades [13], its evolution over the last two decades has made it a key treatment option for pain management [36].…”

“…Physiotherapy is one of the most common and effective conservative treatments for peripheral neuropathies [8]. To date, various techniques of physiotherapy, including percutaneous electrical nerve stimulation, have proven to be potentially effective in the treatment of cubital tunnel syndrome [9][10][11][12]. Percutaneous electrical nerve stimulation is an emerging technique that applies electrical biphasic current for pain treatment.…”

The Unpredictable Ulnar Nerve—Ulnar Nerve Entrapment from Anatomical, Pathophysiological, and Biopsychosocial Aspects

“…The exact mechanism(s) to locally reduce pain by subcutaneously or intradermally applying botulinum toxin A is not known, but the treatment may be efficient [ 65 , 67 ]. These treatment modalities can be utilized by the treating surgeon, but the use of physiotherapy seems to have a limited place in pain treatment connected to surgery for ulnar nerve entrapment [ 87 ]. Other treatment strategies involve graded motor imagery and mirror therapy, however, mostly used in the treatment of problems related to amputations [ 85 ].…”

Surgery for Cubital Tunnel Syndrome: A Comparative Study of Small Incision with Classic Anterior Nerve Transposition

“…4 The prevalence of CuTS is found to be 2 -6%, with an annual incidence of 24.3 cases / 100,000 population. 5,6 Apart from intrinsic hand muscle atrophy (which may or may not be present), patients with cubital tunnel syndrome usually present with little and ring finger numbness. CuTS are also characterized by a lack of ability to perform fine motor activity.…”