High-Tech Elbow Pain: Computers, Cellphones, and Cubital Tunnel Syndrome

Posted May 13, 2009

It may begin with aching, tingling, numbness, or burning in your hand, forearm, and elbow. Perhaps the elbow pain and other symptoms seem worse when you're talking on your cellphone or using a computer. The symptoms may indicate cubital tunnel syndrome, also referred to as "cellphone elbow." It's a problem that doctors say they're seeing more of as people become more reliant on technology, including cellphones and computers.

When talking on a cellphone without a headset, the elbow is usually held in an unnatural, flexed position, at an angle greater than 90 degrees. Doing that for a prolonged period of time can lead to cubital tunnel syndrome. But that's not the only way this condition can develop. It can also happen as a result of long periods of sitting at a desk while either leaning your elbow against an armrest on a chair, or flexing your elbow as you use a computer. And some people sleep with their elbow in a flexed position, resulting in chronic elbow pain. In all of these cases, the ulnar nerve—which runs from underneath the collarbone down along the interior of the upper arm, and then through the cubital tunnel (located on the inner side of the elbow)—can become compressed, resulting in symptoms that can spread from your hand to your forearm. The nerve also runs through the arm and into palm side of the hand.

"Cubital tunnel, like carpal tunnel, is a nerve-compression syndrome, where the ulnar nerve is actually stressed behind the elbow," says Rachel Rohde, an orthopedic surgeon at William Beaumont Hospital in Royal Oak, Mich., and a spokesperson for the American Academy of Orthopaedic Surgeons. "Holding the cellphone up to the ear can stress that nerve. It can get so bad that you actually lose strength in your hand."

Cubital tunnel syndrome is the second most common type of nerve-suppression syndrome after carpal tunnel syndrome, according to an article about cellphone elbow that was published this month in the Cleveland Clinic Journal of Medicine. Rohde said that in her practice, elbow pain tied to cellphone use is the most common complaint she hears about that is a result of technology. (This isn't the first time concern has been raised about a possible link between cellphones and health problems.)

"What's happening when you're flexing your elbow is that the [ulnar] nerve is put on stretch, plus the tunnel where the nerve is traveling through is now being kinked and narrowed," says Peter J. Evans, director of the hand and upper extremity center at the Cleveland Clinic and one of the authors of the Cleveland Clinic article about cellphone elbow. Eventually, the nerve "starts to misfire," he says, and if you keep doing the activity that caused the problem, your elbow pain will only get worse.

"The elbow isn't meant to be hyperflexed for 10, 15, 20 minutes at a time," says Sabrina Strickland, assistant professor of orthopedic surgery at the Hospital for Special Surgery in New York and a spokesperson for the American Academy of Orthopaedic Surgeons. So it's important to pay attention. Likewise, it's easy to get engrossed in work at your computer and not realize that you're harming your elbow in the process. The goal is to position your desk and chair in a way that allows your elbows to be bent at an angle that is less than 90 degrees.

Delia Cabe, 49, a freelance journalist based in Boston, developed cubital tunnel syndrome as a result of computer use. The pain got so bad that she had trouble typing or even using a pen or pencil. "My hands would fall asleep at night, and it would wake me," she says. "My grip had lessened. My arm felt dead or heavy. Sometimes I would just drop a plate" because of numbness, she says.

If you develop cubital tunnel syndrome symptoms, the first step is to try to identify the source of the problem. "The first treatment is to keep the nerve from getting stretched and compressed," Rohde says. Those experiencing elbow pain should straighten the joint and rest it. If cellphone use seems to be the culprit, there is a simple solution: Buy a cellphone headset. Or try switching hands frequently while talking on the phone in order avoid unduly stressing one arm or the other.

Cubital tunnel syndrome treatments include wearing elbow pads or splints in order to keep the elbows properly positioned. Physical therapy is another option. Anti-inflammatory medications can be given orally or by injection. "A lot of time, we can get inflammation to calm down over time," Rohde says. "Usually, we will try maybe six weeks of this kind of treatment." But ultimately, some people need surgery, which involves decompressing the ulnar nerve and moving it to ease tension.