Radial Tunnel Syndrome

Radial Tunnel Syndrome: What You Need To Know

What is Radial Tunnel Syndrome?

Radial tunnel syndrome is a painful condition caused by the radial nerve entrapment in the radial tunnel. The Radial nerve starts in the armpit, travels down the arm and forearm, controls muscle movements, and supplies overlying skin. The radial tunnel in your elbow is formed between muscle and the bone below the elbow. While passing through this tunnel, increased pressure on the radial nerve leads to pain in the top and back of the forearm. Symptoms may also occur at the back of the hand or wrist.

What are the causes of Radial Tunnel Syndrome?

The compression of the radial nerve may be due to:

  • Excessive use of the forearm
  • Movements such as twisting the forearm
  • Injury to the elbow
  • Inflammation of the nerve or surrounding tissue
  • Disease conditions like the diabetes
  • Swelling of the forearm

People with certain occupations are at increased risk of developing radial tunnel syndrome.

What are the symptoms of Radial Tunnel Syndrome?

In radial tunnel syndrome, you may experience the following symptoms:

  • Dull, aching pain in the forearm
  • Cutting, stabbing, or piercing pain at the back of forearm when straightening the wrist of fingers
  • Tenderness and swelling below the elbow
  • Decreased strength of grip and weakness
  • Difficulty gripping and extending the wrist

How to make a diagnosis of Radial Tunnel Syndrome?

Your doctor will make the diagnosis based on the following:

  • Symptoms such as the pain area of the forearm
  • Medical history in which he may ask you about your occupation, hobbies, or any recent injury
  • Physical examination, i.e., your doctor will ask you to point your middle finger against resistance. Or he may ask you to keep your elbow straight and then move your palm up against resistance. If you feel pain performing these tests, you have radial tunnel syndrome.
  • Electromyography (EMG) test to check how well your muscle and nerve are working.
  • Imaging tests like X-rays or MRIs to check for the severity of the condition or rule out other conditions

What is the prognosis of Radial Tunnel Syndrome?

For most patients with radial tunnel syndrome, rest combined with physical therapy and medications will relieve symptoms. It may take less than a month for your forearm to be pain-free. But if these treatments don’t work for you, you may need surgery.

What are the treatments of Radial Tunnel Syndrome?

The doctor may recommend the following:

  • Rest—to decrease repetitive forearm use, and using ice and heat on top of the forearm
  • Over-the-counter medications like ibuprofen or naproxen to relieve pain and inflammation. The doctor may also recommend prescription medications.
  • Steroid injection to relieve pain and let you exercise and perform daily activities to some extent.
  • Splints or braces to immobilize the forearm and wrist to facilitate healing
  • Work modifications decrease repetitive use of the forearm.
  • Nerve gliding exercises and muscle stretching and strengthening exercises
  • Surgery, as the last resort to increase the space between muscle and bone for the radial nerve.