Radial Tunnel Syndrome - Symptoms, Risk Factors, Treatment and Prevention - Health Education - DesiMD Healthcare - India

Radial Tunnel Syndrome - Symptoms, Risk Factors, Treatment and Prevention

Authored by DesiMD Doctor on 3 Mar 2016 - 12:03


Radial Tunnel Syndrome (RTS) also known as Radial Nerve Entrapment is a condition of the nervous system in which the radial nerve is pressed tightly by the surrounding structures in the elbow or forearm. It is characterized by weakness in the wrist and hand. It is caused by elevated pressure on the radial nerve, as it travels from the upper-arm to the hand and wrist.

The RTS disease is more common in women aged between 30 to 50 years age group and occurs by sporadic (stopping and starting at irregular intervals) compression on the radial nerve from the radial head to the inferior border of the supinator muscle, without obvious extensor muscle weakness. Radial tunnel syndrome usually affects the muscles and not the nerves, therefore the tingling or numbness sensation in the arm, wrist, or fingers is not observed.

As compared to para-clinic tests like electro-diagnostic test and imaging studies, clinical examination is more important to diagnose radial tunnel syndrome. Even though non-surgical treatments such as rest, NSAIDs, rehabilitation and injections may not provide permanent comfort, it is necessary to undergo this treatment before surgery. Surgery is advised only when all the other treatments fail.

Radial Tunnel Syndrome is a set of symptoms that include:

  • Diffused pain in the forearm and hand: Radial tunnel syndrome causes unbearable pain in the forearm. The pain is centered few inches below your elbow joint where the radial nerve travels below the supinator (A muscle that assists in supination). The pain worsens when you try to extend or straighten your wrist and fingers.
  • Decreased forearm strength: Radial tunnel syndrome may cause a dull pain or weakness in the muscles of the forearm. Nerve pressure inside the radial tunnel leads to fatigue in the muscles on the back of the forearm and wrist, thereby making it difficult to steady the wrist when grasping and lifting.
  • Outer (lateral) elbow soreness: Pain from radial tunnel syndrome often starts near the bony point on the outside of your elbow joint (lateral epicondyle). The pain worsens when you bend your wrist backward, turn your palm upward, or hold something with a stiff wrist or straightened elbow. In tennis elbow, the pain begins where the tendon attaches to the lateral epicondyle and in radial tunnel syndrome, the pain is centered about two inches further down the arm, over the spot where the radial nerve goes under the supinator muscle.
  • Difficulty in extending your wrist: You may find difficulty in extending or rotating your wrist which is termed as wrist drop. Pain worsens when you rotate your wrist (using a screwdriver or opening a door)

Risk factors that develop Radial Tunnel Syndrome include:

  • Any sport/ games or jobs that require a continuous wrist twisting motion
  • Poor physical arm and wrist strength and flexibility
  • Failure to warm up properly before the activity
  • Health disorders like diabetes mellitus or underactive thyroid gland; tumors or ganglion cysts (mass or lump) in the arm, that puts pressure on the nerve
  • Swelling in the arm that squeezes the nerve
  • Inflammation of the radial nerve
  • A hard blow to the forearm
  • Activities that involve repetitive and/or strenuous wrist and forearm movements (tennis or carpentry).

Treatment for Radial Tunnel Syndrome:

  • Rest: The most effective way to treat RTS is to avoid repetitive motion that caused the condition in the first place. Be it recreational activity or work, you need to take frequent breaks or modify your work duties.
  • Corticosteroid injections: Corticosteroid injections can help diminish the inflammation and pressure that is put on the radial nerve.
  • Pain-killers: While this is normally a temporary measure to get rid of symptoms, anti-inflammatory medication can help reduce the pain and inflammation
  • Ice treatment:  Applying ice for about 10-15 minutes every 2 to 3 hours, especially during the onset of symptoms helps diminish swelling. It constricts blood flow in the broken capillaries. Heat therapy is sometimes used prior physical therapy to help relax and make your muscles more flexible.
  • Physical Therapy: Self-directed nerve gliding exercises can help loosen a compressed area in the radial tunnel and pull the nerve free of obstruction. According to Dr Nathan Wei, a rheumatologist and director of the Arthritis and Osteoporosis Center of Maryland, indicates using basic, low-impact gliding exercises.

Preventive Measures for Radial Tunnel Syndrome:

  • Warm up and stretch properly before the activity.
  • Avoid repetitive movements including twisting the forearm and extending the wrist; gripping. However, if you have to perform these motions, make sure you take frequent breaks
  • An occupational therapist can evaluate your workstation and may be able to help you prevent injuries
  • Integrate activity modifications to protect your radial nerve
  • Maintain physical fitness








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