Radial tunnel syndrome is a painful condition of hand and elbow. It is caused due to compression of radial nerve when it passes through a tunnel near the elbow. Radial tunnel syndrome is difficult to diagnose as there is lot of symptom similarity with the other condition called tennis elbow.
Radial nerve can get irritated and inflamed when it is compressed by muscles of forearm. Repetitive twisting of forearm and elbow, a blow on outer aspect of hand, pushing or pulling forcefully can irritate the radial nerve. Patient suffering from radial nerve syndrome may complain of intense pain in the upper back of forearm when he tries to straighten his fingers or wrist.
In majority of cases, the condition is treated conservatively with medication, rest etc. If these measures fail to provide relief, surgery may be necessary to reduce compression on the radial nerve.
Causes Of Radial Tunnel Syndrome
The roots of radial nerve originate from the cervical spine. It then travels from the upper arm to forearm and wrist. Radial nerve passes from the back of upper arm spiraling from the elbow joint down to the forearm and wrist. While traveling down the forearm, it has to pass through a tunnel in the elbow. This tunnel is made up of bones of elbow joint and muscles.
Passing from the tunnel downwards, it runs below a muscle of forearm called supinator muscle. The supinator muscle allows rotation of wrist in clockwise direction. Once the radial nerve comes out from below the supinator muscle, it further travels down the back of forearm innervating muscles of the forearm.
The primary reason for radial tunnel syndrome is pressure on the radial nerve. Irritation and pressure can occur in several ways. Repeated twisting movement of arm such as twisting the screw driver, forcefully pushing or pulling an object, stress produced while gripping an object or overuse of hand and wrist while doing any physical activity all can cause irritation and inflammation of radial nerve.
A traumatic injury on the back of hand can cause damage to the muscle and underlying nerve, the radial nerve. Radial nerve can get compressed while passing through the radial tunnel, if the space in the tunnel is small. The nerve can get squeezed leading to pain.
Radial Tunnel Syndrome Symptoms
Radial nerve irritation can cause pain and tenderness on the back of hand and elbow. The pain becomes worse on bending the wrist backwards, holding heavy object, bending the fingers backwards. The pain of radial nerve syndrome is 4 to 5 cm below the elbow on the back side of forearm. There is deep burning and aching sensation.
Radial tunnel syndrome also causes weakness in the muscles of forearm. Compression of radial nerve in the radial tunnel of elbow joint can result in fatigue in muscles on the back of forearm where the nerve innervates. If the compression is severe, this may also lead to wrist drop.
Usually the sensation on skin does not change in radial tunnel syndrome. It is because a branch of radial nerve which innervates the skin parts just above the elbow joint instead of passing from the radial tunnel.
Home Treatment For Radial Tunnel Syndrome
Treatment of radial tunnel syndrome is mainly conservative.
The most important part of treatment is to stop activities which may have caused radial tunnel syndrome. Avoid activities which may require frequent bending of wrist in backward direction. Avoid repeated use of wrist in twisted motion, for example while using a screw driver.
- Apply ice fomentation on the affected painful area. It helps to reduce inflammation caused due to muscle or ligament damage in the elbow joint. Ice fomentation also helps to restrict seepage of blood from the capillaries.
- Anti inflammatory medications such as NSAID’s are beneficial in reducing pain and swelling. Patient should take them for few days.
- Wear an arm splint, especially during night as the elbow movement during sleep will become restricted. This will provide comfort and less irritation to the radial nerve. It will provide time for easy recovery.
- Few days after the initial treatment, patient is advised by his physician for physiotherapy exercise. This will help to strengthen the weak muscles.
If all conservative measures fail, surgery is recommended to relieve the radial nerve from pressure in the radial tunnel.