Tinel's Sign at the Elbow: How to Check for Cubital Tunnel Syndrome

Tinel's Sign is a classic orthopedic test used to detect an irritated or compressed nerve. At the elbow, it is the primary test used by physiotherapists to assess for Cubital Tunnel Syndrome (ulnar nerve compression).

1. Purpose

The primary purpose is to **test for** irritation or compression of the Ulnar Nerve as it passes through the cubital tunnel at the medial elbow. This condition is known as Cubital Tunnel Syndrome.

2. How to Perform

1. The patient is positioned in sitting with their elbow comfortably flexed to about 20-30 degrees.
2. The examiner locates the cubital tunnel, which is the groove between the medial epicondyle and the olecranon (the "funny bone").
3. The examiner firmly but gently taps over the ulnar nerve within this groove.
4. The examiner typically taps 4 to 6 times and asks the patient about their symptoms.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test (indicating nerve irritation) is:

• Reproduction of the patient's familiar symptoms, which is a tingling sensation, "pins and needles," or an "electric shock" feeling down the forearm into the ulnar side of the hand (the 4th and 5th fingers).

Negative Sign (Test is NEGATIVE):
A negative test is the absence of any tingling or neurological symptoms when the nerve is tapped. The patient may feel the tap, but it does not radiate.