Radial Nerve Neuritis / Radial Tunnel Syndrome


 

The Radial nerve controls the muscles that extend, or straighten the wrist and fingers. Radial tunnel syndrome is a painful condition that occurs when the nerve is compressed just beyond the elbow, as it runs under the muscles down the back of the forearm to the wrist.

 

Common Causes

Often seen with weightlifting, or other exercises that cause increased forearm muscle bulk. May occur with repetitive upper arm activities, especially gripping and squeezing.

 

Symptoms

A deep aching running down the back of the forearm, sometimes to the wrist. Usually aggravated with lifting and gripping. Occasionally there is tingling, or a ‘funny feeling’ on the back of the arm or hand.

 

Physical Findings

Tenderness over the radial tunnel, where the radial nerve passes under some of the forearm muscles. The discomfort may be worsened by certain physical exam tests.

 

Workup

The diagnosis is primarily based on history and physical examination. Electrodiagnostic studies may be helpful, although are often interpreted as ‘normal’ in patients with this condition.

 

Non-operative Treatment

Rest, avoidance of aggravating activities, and anti-inflammatory medication will generally resolve most cases. A well placed corticosteroid injection is often curative.

 

Surgical Treatment

Decompression of the nerve by releasing all of the constricting structures on top of the nerve.

 

Injury Comment

Surgery is rarely indicated with this condition. All nerve decompression surgeries work by taking the pressure off of the nerve, and allowing it to heal on its own. This is much like taking a ‘pot-bound’ plant, and repotting it in a larger pot. The goal of surgery is to prevent progression, and allow for the nerve to recover. Prolonged compression of a nerve may cause permanent damage. Think of a garden hose after your car has parked on it for a very long time. Even after you decompress a nerve, it may not recover completely.