What is Radial Tunnel Syndrome?
Radial tunnel syndrome is a group of symptoms that lead to fatigue, dullness, and aching pain in the top of the forearm.(1) In some, there is also pain at the back of the hand or wrist. Radial tunnel syndrome makes everyday activities of lifting objects or using the wrist difficult. Radial tunnel syndrome occurs due to injury to the radial nerve.
The radial nerve starts in the neck and runs down the arm. It plays the role of controlling the movement of the muscle in the upper arm. Radial tunnel, an area below the elbow, is where the radial nerve enters and travels down the wrist. If it gets pinched anywhere in the arm, there is pain and weakness, and difficulty in performing daily activities.
If moving an arm anytime to perform functions like pulling, pushing, or grabbing, the radial nerve gets irritated. Repeating these motions can squeeze the radial nerve and over time cause radial tunnel syndrome.
Symptoms of Radial Tunnel Syndrome
Pain and weakness in the arm is the main symptom of radial tunnel syndrome. Other symptoms are as follows:
- Pain in the back of the arm
- Difficulty in grabbing objects
- Pain just below the elbow
- Difficulty in lifting or pushing objects
- Pain worsening on rotating the wrist and extending the fingers
- Difficulty in wrist extension
- Tenderness outside the elbow
- Trouble in lifting or pushing objects
The symptoms differ in people in severity and occurrence.
How to Diagnose Radial Tunnel Syndrome?
A medical professional diagnoses the condition. He would question about the pain location. He would also enquire about a person’s hobbies, as radial tunnel syndrome is caused by repetitive motions.
- A few tests are performed by the medical professional to know the actual cause of pain.
- The patient is asked to push against resistance using arm and hand without bending the elbow and middle finger.
- If there is pain in any of the above movements, chances are high that the patient is suffering from radial tunnel syndrome.
Electromyography is a test done to look over the performance of muscles and nerves including radial nerve.(2)
It is done in two parts:
- Nerve conduction study, in which the electrodes are placed on the skin of the arm. It measures how well the radial nerve and triceps muscles are communicating.
- Needle EMG, in which a needle is used to insert electrodes in the arm muscle. The electrodes measure the electrical activity of the muscle.
- Radial tunnel syndrome is diagnosed if the EMG shows that the pain is caused by an injury to the radial nerve in the radial tunnel.
Treatment Options for Radial Tunnel Syndrome
In the beginning, less invasive treatments are given such as:
- Taking a break from the activity that might be a cause of radial tunnel syndrome
- Over-the-counter painkillers to reduce pain
- Elbow and wrist splints
- Physical therapy and occupational therapy
The doctor advises on how to cut down the motions causing radial tunnel syndrome, such as:
- Taking a break during the workday
- Stretching before engaging in sports
- Avoiding heavy push-ups and pull-ups
The next step involves steroid injections that are given in the arm. These may help reduce swelling in the arm muscle and relieve pressure on the radial nerve.
The goal of the treatment is to reduce pain from coming back. Physical therapies may be advised to strengthen arm muscles, which can prove to be helpful.
- In many people, these symptoms would not alleviate with the above treatments. There would not be any pain relief. Here comes the role of surgery.
- In radial tunnel surgery, the radial tunnel is widened. This releases pressure on the radial nerve and allows more space.
- Recovery following radial tunnel surgery can take 6-8 months. The patient needs to wear an elbow splint and keep the arm wrapped. Recovery involves rest and physical therapy that begins with small exercises, massages, and stretching.
- After 6 months new exercises can be added that can help regain strength in the arm and hand.
- The patient should not do any activity that involves bending the elbow. Radial tunnel syndrome is treatable and a person mostly recovers within 3-6 weeks.