The Understanding Behind Radial Tunnel Syndrome
By Neurosurgery Singapore
Radial tunnel syndrome is a condition that causes pain along the top of your forearm and in your hand. It’s caused by pressure on a nerve in your arm called the radial nerve.
Your radial nerve starts in your neck and runs down your arm. It controls the movement of the muscle in your upper arm, called the tricep.
The radial tunnel is an area below your elbow. Your radial nerve enters this tunnel of muscle and bone and then travels down to your wrist.
When your radial nerve is pinched anywhere in your arm, it can cause pain and weakness. The pinching is the result of some common daily activities.
You can irritate your radial nerve any time you use your arm muscles to move objects by:
Using your hands and wrists can also irritate your radial nerve. For example, when you repeatedly perform certain motions for your job or a hobby you do regularly, it can lead to overuse and radial tunnel syndrome.
What are some symptoms of a radial tunnel syndrome?
Radial Tunnel Syndrome is characterized by pain in the forearm that generally centers a few inches below the elbow.
Some of the symptoms of Radial Tunnel Syndrome include:
- Pain that worsens when rotating the wrist
- Outer elbow tenderness
- Decreased ability to grip
- Loss of strength in the forearm, wrist, and hand
- Difficulty extending wrist
Not everyone with radial tunnel syndrome will have all the same symptoms. Some people will have mild symptoms and others will have more severe symptoms.
If you’ve had any of the symptoms listed above, it’s a good idea to discuss them with our Specialist. He will be able to determine if your symptoms are caused by radial tunnel syndrome or a different condition.
“Radial tunnel syndrome is a set of symptoms that include fatigue or a dull, aching pain at the top of the forearm with use. Although less common, symptoms can also occur at the back of the hand or wrist. “
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What types of diagnosis?
We highly recommend seeking professional help instead of self diagnosis to identify the issue and enable faster recovery. Our Specialist will discuss your medical history and general health. He may also ask about your work, your activities, and what medications you are taking.
However, there are no tests to prove a person has radial tunnel syndrome. This makes the diagnosis difficult. Our Specialist must depend on the patient’s physical exam and the type and location of the pain. As part of the exam, the patient is asked to turn his or her palm up with a straight elbow while the doctor restricts arm and hand movement. If the patient feels pain while trying to move the arm or hands against resistance; it is a sign of radial tunnel syndrome. In another test, the patient is asked to point with his or her middle finger against resistance. Pain with this movement is another sign of radial tunnel syndrome.
Possible treatment methods?
There are a variety of treatment options that can be used to treat Radial Tunnel Syndrome.
The first step is usually an EMG (electromyography) or a nerve conduction study to diagnose this condition. Depending on the extent of the damage, nonsurgical treatments or surgery may be recommended. Non-surgical treatments are usually recommended as a first step towards addressing this condition, and in many cases, conservative methods prove to be effective.
- Rest – The most important way to treat Radial Tunnel Syndrome is to avoid repetitive motion that caused the condition in the first place. Depending on your occupation, this may involve modifying your work duties or taking more frequent breaks. In some cases, immobilization with a splint or cushioning of the nerve with an elbow pad are used to facilitate healing.
- Physical Therapy – Our physical therapist can provide soft tissue massage, which can help to improve circulation to the area. The therapist might also recommend gentle stretching and strengthening exercises.
- Corticosteroid Injections – Corticosteroid injections can help reduce the pressure that is put on the radial nerve, and help reduce inflammation.
- Medications – Pain medications or anti-inflammatory medication can help with the inflammation and pain, although this is usually a temporary measure to alleviate symptoms.
- Hot / Cold Treatment – Hot/cold treatment involves applying cold (ice) to your injury for 10-15 minutes every 2 or 3 hours. Heat treatment is sometimes used before stretching or physical therapy to help make your muscles more flexible.
With conservative treatment options, you should start to notice an improvement within 4-6 weeks. If symptoms continue after this point, surgery may be considered.
In more severe cases, surgery may be required to reduce pressure on the nerve. Surgery for radial tunnel syndrome is often used only when other treatment options have been exhausted.
The goal of surgery is nerve decompression by division of fascial bands. During surgery, tissue that is compressed against the radial nerve will be cut and the pressure reduced.
As with most injuries, prevention is the best medicine. It’s important to take frequent breaks when twisting the forearm, extending the wrist or gripping to prevent an overuse injury from occurring. It is also recommended that you have routine examines to ensure that you aren’t putting too much strain on your muscles and nerves.