Cubital Tunnel Syndrome Cause Shoulder and Neck Pain

Cubital tunnel syndrome is caused by compression or irritation of the ulnar nerve at the elbow. 

This condition is the second most common nerve compression disorder after carpal tunnel syndrome, affecting approximately 25 out of 100,000 people per year in the United States. It impacts men and women, typically between the ages of 30 to 60 years old.

While the classic symptoms involve the outer two fingers and inner forearm, some of my patients have reported shoulder and neck pain as well. 

It surprised me at first, but research shows there may be a link between cubital tunnel syndrome and these more distant pains.

In this blog post, I’ll cover the basics of this little-known condition, explain how it can cause shoulder and neck discomfort, and recommend some chiropractic treatments that can help.

What is Cubital Tunnel Syndrome?

Cubital tunnel syndrome, also known as ulnar neuropathy, is the second most common nerve compression disorder after carpal tunnel syndrome. It occurs when the ulnar nerve becomes compressed or irritated as it travels through the cubital tunnel on the inner side of the elbow, says Johns Hopkins Medicine.

This tunnel protects and stabilizes the nerve as we bend and straighten our elbow. However, this area is vulnerable to increased pressure, stretching, or nerve irritation. Cubital tunnel syndrome develops when these injuries first inflame the nerve and later form scar tissue that compresses it.

Symptoms of Cubital Tunnel Syndrome

The ulnar nerve originates from the neck and branches into the ring and pinky fingers. So, cubital tunnel syndrome typically causes the following symptoms in these areas:
  • Stiffness and discomfort in the ring and pinky fingers
  • Sharp, shooting pain from the elbow to the hand
  • Wasting away of the hand muscles
  • Clumsiness and inability to grip or pinch
  • Elbow pain that can radiate into the forearm and wrist
However, our nerves are networked, and nerve issues in one area can manifest with pain in others. Related, Shockwave Therapy for Carpal Tunnel Syndrome

Shoulder and Neck Pain With Cubital Tunnel Syndrome

Can cubital tunnel syndrome cause shoulder and neck pain? Cubital tunnel syndrome disrupts signaling from the ulnar nerve back to the neck. Our body may misinterpret these signals, producing pain in the shoulder, upper arm, or neck. I call these types of indirect pains “referred pains.” For example, a heart attack can cause pain in the jaw, left arm, or upper back. With cubital tunnel syndrome, the true origin is the ulnar nerve, but patients sense pain arising elsewhere, like the shoulder and neck. Research specifically on cubital tunnel syndrome is limited, but studies on similar neuropathic conditions provide some insight:
  • A paper in the Archives of Physical Medicine and Rehabilitation found that over 60% of carpal tunnel syndrome patients reported neck discomfort or pain. The authors proposed that abnormal nerve signaling spreads to nearby nerves, causing widespread symptoms.
  • Another study found that nerve injuries in the arm can reorganize connections in the spinal cord and brain so that areas once devoted solely to the forearm and hand also represent the shoulder. This blurring of boundaries may explain the referred shoulder pain.
  • Finally, nerve issues are thought to sensitize pain receptors not only around the injury site itself but also in surrounding tissues. By spurring inflammation in nearby areas like the shoulder and neck, cubital tunnel syndrome may directly incite pains in those regions.
There does seem to be some connection between neuropathic arm conditions and neck/shoulder discomforts. Although these mechanisms are still unknown, the above studies provide plausible explanations for this phenomenon.

Diagnosing Referred Shoulder Pain

Determining whether shoulder pain is referred from cubital tunnel syndrome or originates from an independent shoulder problem can be difficult. However, specific characteristics provide clues:
  • Referred shoulder pains often emerge later, only after elbow and hand symptoms are long-standing
  • The shoulder discomfort mirrors and changes in tandem with elbow symptoms
  • Physical examinations of the shoulder joint itself are typically normal
  • Imaging like X-rays or MRI scans find no visible shoulder pathology
Trial treatments can also help diagnose the true origin of pain. For example, my chiropractic protocols often alleviate shoulder pains stemming from cubital tunnel syndrome but leave shoulder pains unrelated to this nerve issue unchanged.

Chiropractic Protocols to Managing Cubital Tunnel Syndrome

While advanced cases may require surgery to decompress the ulnar nerve, most patients with cubital tunnel syndrome respond well to my conservative chiropractic protocols focused on reducing nerve irritation.

The key is to relieve pressure on the ulnar nerve at the cubital tunnel inside the elbow. I employ a combination of manual manipulations, muscular treatments, lifestyle changes, and special exercises tailored to each patient’s needs:

1. Manual Joint Manipulation

Gently moving the elbow, wrist, and finger joints can improve the ability of the ulnar nerve to glide and slide during arm motions. When nerve mobility decreases, it exerts more traction on the nerve with elbow bending. I apply controlled force to restricted joints to break up blockages while not over-stretching the irritated nerve.

2. Myofascial Techniques

Muscle imbalances or trigger points inside muscles can also squash or tug abnormally on the ulnar nerve. I release these using gentle sustained pressure, micro-stretching approaches, and myofascial release therapy. These direct tissue techniques restore muscle flexibility and neutral positioning.

I also often recommend kinesiology taping – special elastic tape applied to the forearm muscles to lift them slightly off from pressing on the underlying nerve.

3. Lifestyle Changes

Simple daily modifications to reduce repetitive elbow bending or external compression on the cubital tunnel can allow the ulnar nerve to rest and recover effectively. Wearing protective elbow pads at night, changing arm postures during work, and avoiding constant phone scrolling are some examples.

I advise patients on techniques to pause and reposition the elbow if needed without limiting overall activity levels excessively.

4. Physiotherapy Modalities

Non-invasive electric nerve stimulation, ultrasound therapy, contrast baths, and laser or heat treatments can stimulate healing and reduce inflammation around the ulnar nerve. Physiotherapy also helps maintain muscle strength despite nerve dysfunction. Under my supervision, patients perform targeted elbow, wrist and finger exercises to maximize function without aggravating symptoms.

The gold standard of care for cubital tunnel syndrome should encompass manual manipulation, muscular treatments, activity modifications, physiotherapy, and a home exercise plan – with or without taping. This comprehensive chiropractic approach resolves most cases, including those complaining of associated shoulder and neck discomforts.

Ergonomic Strategies for Cubital Tunnel Syndrome

I also guide patients on designing their workstations, techniques, and home environment to prevent cubital tunnel syndrome flare-ups:
  • The keyboard and mouse should be positioned for computer work to keep elbows close to the body rather than extended outward. Frequent stretch breaks are also essential to restore movement to the elbow joint.
  • For lab work requiring microscopes, chairs must be height-adjustable, and counters must be positioned to limit sustained elbow flexion.
  • For smartphone use, we recommend holding devices at eye level with both hands to avoid constant hunching of the neck and abnormal postures like the painful “cell phone elbow.”
By applying the proper ergonomic and chiropractic protocols under medical guidance, most patients with cubital tunnel syndrome recover well without needing surgery.

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The Final Words

Cubital tunnel syndrome is a nerve compression syndrome affecting the inner elbow region. While classic symptoms involve the 4th and 5th fingers, hand weakness, and outer elbow discomfort, patients can also experience mysterious shoulder and neck pains.

Referred pains stem from the intricate connections between our nerves, such that issues in one part of the network manifest with pain messages arising elsewhere. Advances in neuroscience research help explain how cubital tunnel syndrome links to remote shoulder discomforts.

My tailored chiropractic protocols focused on protecting the ulnar nerve can resolve these symptoms non-invasively for most patients. Care includes joint manipulation, muscular treatments, lifestyle changes, elbow braces, and physiotherapy modalities. 

When combined with ergonomic modifications, this approach reduces irritation of the ulnar nerve so that associated neck and shoulder pains also subside.


Meet Dr. Craig Eymann, a dedicated chiropractor and yoga enthusiast with over two decades of expertise in spinal health, sports chiropractic, and personalized care, prioritizing misalignment correction for swift injury resolution.

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