Radial tunnel syndrome is comprised of a set of symptoms that include fatigue or dull, aching pain at the upper part of the forearm with use. Even though less common, the symptoms can also occur at the back of the hand or wrist.
The symptoms are triggered by compression of the radial nerve which is usually at the elbow. The radial nerve runs from the neck to the back of the upper arm. It eventually crosses the exterior of the elbow and down to the forearm and hand. At the elbow, the radial nerve enters a constricted tunnel made out of muscles, tendon and bone which is called as the radial tunnel.
Radial tunnel syndrome can cause dull aching pain at the upper part of the forearm up to the exterior of the elbow or rear part of the hand. The pain can also be piercing, cutting or stabbing. It most often occurs when the individual straightens his/her fingers or wrist.
There is also fatigue and weakness in the forearm muscles as well as wrist weakness. The condition can also affect the muscles but does not involve the nerves.
Causes of radial tunnel syndrome
Once the radial nerve is pinched anywhere along its length, it can trigger pain. The tunnel at the elbow is one the usual spots where the nerve is pinched or compressed since it passes between the muscle and under the fascial bands (tissue fibers that enclose, separate or bind muscle, organs or other soft structures).
Overusing the arm to push or pull as well as overuse of the hand by pinching, gripping or bending the wrist can irritate the nerve and trigger pain. Engaging in activities with repetitive movement can squeeze the radial nerve. Over time, this can lead to the development of radial tunnel syndrome.
Who are at risk?
- Sports or occupations that require constant twisting movement of the wrist
- Poor physical arm and wrist flexibility and strength
- Lack of proper warm-up before playing sports
- Underactive thyroid gland
- Direct forceful blow to the forearm
- Swelling or buildup of fluid in the arm that squeezes on the radial nerve
- Inflammation of the radial nerve
- Presence of tumors or ganglion cyst in the arm that adds pressures on the nerve
The pain in the hand and forearm are the symptoms that urge an individual to set an appointment with a doctor. Just remember though that there are no tests to prove that an individual has radial tunnel syndrome.
The doctor depends on the physical examination and the type and location of the pain. During the exam, the individual is instructed to turn his/her palm up with a straight elbow while the doctor limits arm and hand movement. If there is pain while moving the arm or hands against resistance, it is an indication of radial tunnel syndrome.
Another test can be performed in which the individual is instructed to point his/her middle finger against resistance. If there is pain during this movement, it indicates radial tunnel syndrome.
Treatment for radial tunnel syndrome
The treatment usually starts by resting the arm from any activity that triggered the symptoms. In most cases, rest along with medications for 3-5 weeks can relieve the symptoms.
- Over-the-counter medications to minimize the swelling
- Steroid injections to reduce the pressure and inflammation on the radial nerve
- Application of heat or cold, ultrasound and exercises to reduce the effects of constant movement
- Wrist and/or elbow splints to minimize irritation on the radial nerve
The objective of treatment is to prevent the recurrence of symptoms. If the occupation of the individual is the cause of the condition, the work site should be changed. Taking breaks is needed throughout the day and avoid heavy pushing or pulling if possible.