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Radial Tunnel Syndrome

Introduction

Radial tunnel syndrome occurs when the radial nerve in the arm is compressed.  The radial nerve travels through the radial tunnel located on the top of the forearm.  The nerve can be compressed or irritated in the radial tunnel due to repetitive movements, forceful forearm movements, or injury.

Anatomy

Your radial nerve originates from nerve roots in the neck which then combine about the base of the neck and shoulder, and travels down the arm.  The tunnel is made of muscles and bones.  The radial nerve controls movements in the muscles on the back of the arm and forearm, which are mainly extensors.

Causes

Radial tunnel syndrome occurs when the radial nerve is compressed.  This can happen if the radial tunnel is too small.  Repetitive movements, such as twisting movements of the forearm, forceful wrist movements, gripping, and pinching can irritate, stretch, or compress the nerve.  This type of injury can be caused by your job, such as construction or manufacturing, or by a direct blow to the forearm or elbow.

Symptoms

Radial tunnel syndrome causes an aching pain in the forearm, and the pain is centered a few inches below the elbow joint.  The pain may become worse with wrist extension, turning of the palm upward, or holding something with the arm is straight out.  The forearm, wrist, and hand may feel weak. One may have difficulty extending the wrist, which is termed “wrist drop.”

Diagnosis

Your doctor can diagnose radial tunnel syndrome by reviewing your medical history and examining your arm.  You should tell your doctor about your activities, injuries, and symptoms.  X-rays will be performed to check for abnormalities that may be affecting the nerve.  Pinpointing the location of the pain source is necessary to distinguish radial tunnel syndrome from other conditions.

Treatment

The most important way you can relieve your symptoms is to avoid the repetitive movements that caused the problem.  If repetitive movements are part of your job, you should take frequent breaks and modify work duties.  A physical therapist can show you ways of changing your physical activity to put less stress and irritation on the radial nerve.  Your therapist can assist in choosing a splint that will position the arm to allow the radial nerve to heal.  Your therapist will use modalities, such as icing and heat, to ease your pain.

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