(Image to depict location of compression/impingement on the forearm)
What is Radial Tunnel Syndrome?
Radial tunnel syndrome occurs when there is compression or impingement of the radial nerve in the elbow or forearm which can lead to pain, discomfort, and impacted motor functioning of the affected limb at the elbow, wrist, and/or hand. The radial tunnel is the space that the radial nerve passes through which is muscular structures on the forearm.
Radial Tunnel Syndrome Symptoms
It is important to rule out tennis elbow as it possesses similar symptoms and location. Location of pain can differ based on the location of impingement, however tenderness outside of the elbow that spans to the forearm may be experienced. The pain can be described as an ache which causes general fatigue of the affected limb. Long term affects can include muscle weakness below the elbow.
Potential symptoms can include:
- Decreased grip strength
- Decreased range of motion of the wrist
- Wrist drop
- Pain at night
Activities which may aggregate radial tunnel syndrome include:
- Prolonged use of the affected arm in everyday tasks
- Heavy lifting
- Straightening the elbow excessively
- Forearm rotation (ex: pal facing up and palm facing down)
- Wrist being bent towards forearm
What Causes Radial Tunnel Syndrome?
Inflammation to the structures such as bone, muscle, or fascia of the elbow or forearm can cause the radial nerve to become compressed and lead to the symptoms stated above. The following activities may lead to radial tunnel syndrome which include:
- Repetitive motions at work or home such as typing
- Push and pull activities such as throwing a ball
- Direct trauma to the outside of the elbow/forearm
- Gripping, pinching, or bending the wrist repetitively
Radial Tunnel Syndrome Conservative Treatments
It’s important to avoid the movement that caused the inflammation in the first place. Treatment may include:
- Rest and stopping the activity that produces the symptoms
- Ice packs (to reduce inflammation)
- Strengthening and stretching exercises from your OT or other healthcare provider
- Anti-inflammatory medicines (such as ibuprofen or naproxen)
If these treatments do not work, your healthcare provider may talk to you about:
- Compression brace for forearm or elbow or night time brace for protection
- Steroid injections to help reduce inflammation and pain
- A special type of ultrasound that can help break up scar tissue, increase blood flow, and promote healing
- Surgery
What Does Radial Tunnel Syndrome Surgery Look Like?
The premise of radial tunnel surgery is to decompress the pressure on the radial nerve while it passes through the different structures of the elbow and forearm. This surgery is not uncommon and can be completed without general or local anesthesia as you will be awake for the procedure while the affected arm is numbed.
Precautions/Contraindications?
It is important to seek treatment for radial tunnel as it is rare if this condition goes away by itself as it typically can worsen in symptoms which can lead to chronic pain. It is also important to avoid reinjury to the radial nerve as nerves tend to recover at a slower pace of about 1 in. per month.
References:
https://my.clevelandclinic.org/health/diseases/15658-radial-tunnel-syndrome
A little bit about Amy Eckert, our visiting OT student…
