Comparative Efficacy of Soft Tissue Mobilization and Ulnar Nerve-Specific Strengthening Exercises in Patients With Cubital Tunnel Syndrome

Summary

Cubital tunnel syndrome occurs when the ulnar nerve is compressed or irritated near the elbow. It can cause elbow or forearm pain, numbness or tingling in the ring and little fingers, hand weakness, and difficulty performing daily activities.

This randomized clinical trial will compare two conservative physiotherapy programs for adults with mild to moderate cubital tunnel syndrome. A total of 56 participants will be assigned by computer-generated randomization to one of two groups. Group A will receive soft tissue mobilization combined with ulnar nerve-specific strengthening and nerve-gliding exercises. Group B will receive soft tissue mobilization alone. Both groups will also receive education about activity modification, ergonomic correction, and avoiding prolonged elbow bending.

Treatment will be provided three times per week for four weeks, for a total of 12 sessions. Participants will be assessed before treatment and at the end of the fourth week. The main outcomes will be pain intensity, measured using the Numeric Pain Rating Scale, and upper-limb disability, measured using the Disabilities of the Arm, Shoulder and Hand questionnaire.

The study aims to determine whether adding ulnar nerve-specific strengthening and nerve-gliding exercises to soft tissue mobilization provides greater improvement in pain and upper-limb function than soft tissue mobilization alone.

Conditions

• Cubital Tunnel Syndrome

Interventions

OTHER

Soft Tissue Mobilization

A physiotherapist will apply standardized manual soft tissue techniques to the medial elbow and flexor-pronator muscle region of the affected upper limb. Techniques will include myofascial release, longitudinal soft tissue mobilization, effleurage, and deep transverse friction massage. The intervention is intended to reduce muscular and fascial restrictions, improve tissue extensibility and local circulation, and decrease mechanical irritation around the cubital tunnel. Treatment will be administered three times per week for four weeks, for a total of 12 sessions. This intervention will be provided to participants in both study arms.

OTHER

Ulnar Nerve-Specific Strengthening and Nerve-Gliding Exercises

Participants will perform progressive strengthening exercises targeting the wrist flexors, forearm stabilizers, intrinsic hand muscles, and grip musculature. Exercises will include resisted wrist flexion, hand-grip training, finger abduction and adduction, thumb opposition, and resisted finger flexion, generally performed in two to three sets of 10-15 repetitions. Controlled ulnar nerve-gliding exercises will also be performed within a pain-free range. Supervised treatment will be provided three times per week for four weeks, and participants will be instructed to complete the prescribed strengthening and nerve-gliding exercises at home once daily.

Sponsors & Collaborators

• Hamna Sarfraz

  lead OTHER

Principal Investigators

• Ahmed Umair · Riphah International University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

30 Years

Max Age

55 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-10-22

Primary Completion

2026-06-14

Completion

2026-07-15

Countries

• Pakistan

Study Locations