Radial Tunnel Syndrome

What is radial tunnel syndrome?

Radial tunnel syndrome may occur when the radial nerve, which extends from the neck to the hand, becomes constricted at the elbow joint. At the elbow, the radial nerve enters what is called the radial tunnel, which is enclosed between bone, muscles, and tendons. It is at this point where the radial nerve is most likely to become entrapped.

What are the symptoms?

Radial tunnel syndrome is typically characterized by dull, aching pain in the forearm, though some patients may experience sharp pains. Typically, the pain is centered a few inches below the elbow, where the radial nerve travels beneath the supinator muscle. This pain typically occurs when the arm is extended or straightened. In addition to pain, patients may experience weakness or fatigue in the arm and wrist.

What causes the radial nerve to become entrapped?

When nerves are pinched in any part of the body, it can cause pain and discomfort. The radial tunnel at the elbow is one of the most common places where the radial nerve becomes pinched. Frequent bending, gripping or pinching of the wrist can lead to radial nerve pain, as can twisting of the elbow. Over time, activities involving repeated movement in the arm can lead to radial tunnel syndrome.

Radial tunnel syndrome can develop on the job, for instance in construction or manufacturing work.  A direct blow to the forearm or elbow can also injure the radial nerve.

How is radial tunnel syndrome diagnosed?

Because there is no specialized diagnostic test, radial tunnel syndrome can sometimes be difficult to diagnose. One test involves the patient extending their elbow with their palm facing upwards, while the doctor restricts movement. Discomfort while trying to move the arm against the doctor’s resistance is a primary symptom of the syndrome.

Treatment Options

Nonsurgical treatments

An important step to recover from the an entrapped radial nerve is to avoid the repetitive movements that caused the problem.Three to six weeks of rest may help relieve symptoms. Over-the-counter medications, steroid injections, exercise, hot and cold compresses, and splints may also be necessary to recover from radial tunnel syndrome.

If the condition is caused by activities done at work, then the work environment may need to be changed to accommodate the recovery of the nerve. Patients should take frequent breaks to prevent the overuse of the arm. Athletes should perform proper stretches before using their arm to avoid further injury.

Surgical treatments

Surgery for radial tunnel syndrome is uncommon. It may be performed as an outpatient procedure, allowing the patient to return home the same day. The goal of surgery is to relieve the pressure, or "release" the radial nerve.

Surgery performed to relieve radial tunnel syndrome is called radial tunnel release. It may be conducted with general or local anesthesia. The physician widens the radial tunnel in the areas where the nerve is constricted, allowing it more space and reducing pain and inflammation.