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by EBSCO Medical Review Board

Radial Tunnel Syndrome

(Radial Nerve Entrapment)

Definition

Radial tunnel syndrome happens when there is abnormal pressure on the radial nerve. This can cause pain and weakness in the arm and hand.

Causes

The radial nerve controls muscles of the forearm. It starts under the armpit and runs down the arm. It passes through a tunnel at the elbow. This tunnel is surrounded by tendons and muscles. Certain movements or overuse of the forearm can shrink the tunnel. This can irritate and press on the nerve.
An injury or abnormal growth can also increase pressure on the nerve.
Muscles of the Hand and Forearm
IMAGE
Copyright © Nucleus Medical Media, Inc.

Risk Factors

Things that may raise the risk of this problem are:
  • Having a small radial tunnel
  • Jobs or sports that overuse the:
    • Arm to twist, push, or pull
    • Hand to grip, pinch, or bend at the wrist
  • Poor arm and wrist strength
  • Tumors or cysts that put pressure on the nerve
  • A buildup of fluid in the arm
  • Trauma

Symptoms

Problems may be:
  • An ache in the forearm that may spread to the hand or outside of the elbow
  • Weakness of the wrist and forearm

Diagnosis

The doctor will ask about your symptoms and health history. You may also be asked about the activities that you do. A physical exam will be done. It will focus on the arm. This is often enough to make the diagnosis.

Treatment

It will take 3 to 6 weeks to heal. Any underlying causes will need to be treated.
The goal of treatment is to ease pain and promote healing. This will mean avoiding activities that are causing pain. Treatment may also include:
  • Supportive care, such as warm or cold compresses
  • Medicine to ease pain and swelling, such as:
    • Over the counter pain relievers
    • Steroid injections
  • Wearing a splint to limit movement
  • Physical therapy to help with strength, flexibility, and range of motion
People who are not helped by these methods may need surgery. The goal of surgery is to make the radial tunnel bigger to ease pressure on the nerve.

Prevention

To lower the risk of this problem:
  • Avoid repetitive movements
  • Slowly increase the intensity and duration of activity
  • Use the right techniques and equipment for sports and activities
  • Exercise regularly to keep arm muscles strong

RESOURCES

Family Doctor—American Academy of Family Physicians
http://www.familydoctor.org
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES

Canadian Neurological Society
http://www.cnsfederation.org/societies/society/canadian-neurological-society/2
Health Canada
http://www.hc-sc.gc.ca

References

Lateral elbow tendinopathy. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/lateral-elbow-tendinopathy. Accessed February 2, 2021.
Moradi A, Ebrahimzadeh M, et al. Radial tunnel syndrome, diagnostic and treatment dilemma. Arch Bone Jt Surg. 2015 Jul;3(3):156-162.
Radial tunnel syndrome. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/hic-radial-tunnel-syndrome. Accessed February 2, 2021.

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