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What is Radial Tunnel Syndrome?

The radial nerve is one of the three main nerves supplying the arm. It runs from the neck, down the back of the upper arm and across the outside of the elbow. Just after the elbow, as it courses into the forearm, the radial nerve forks. A portion of the nerve, known as the Posterior Interosseous Nerve (PIN), then enters a narrow tunnel. This tunnel is called the Radial Tunnel and is bordered by bone, tendons and muscles.

Radial tunnel syndrome often gets misdiagnosed as Tennis Elbow and vice versa. This is as they can present with pain in the same area and have similar causes. It is important to get it right though as some Tennis Elbow treatments can make Radial Tunnel Syndrome worse. For more information on Tennis Elbow click here.

CAUSES

Radial Tunnel Syndrome is a condition caused by compression of the radial nerve within this Radial Tunnel. Compression can result from a number of causes including:

  • Local swelling (oedema) and/or inflammation

  • Overuse of the hand and wrist through repetitive movement

  • Bleeding as a result of trauma, and in some cases

  • The presence of space-occupying lesions in the Tunnel.

SYMPTOMS

The symptoms of Radial Tunnel Syndrome can include:

  • Deep burning or aching pain at the top of the forearm, usually over the muscle bellies about 4-5cm from the outer elbow

  • Pain that may also travel to the outside of the elbow and down to the back of the hand

  • Increased difficulty with activities involving extending (bending backwards) of the wrist and fingers

  • Fatigue or weakness in the forearm muscles

  • Reduce movement at the elbow and wrist

Occasionally, Radial Tunnel Syndrome may also cause tingling or numbness down the top of the forearm. As the nerve compressed in the Radial Tunnel does not provide sensation to the skin, this is rare.

TREATMENT

The easiest step you can take to help with the symptoms of Radial Tunnel Syndrome is to rest the affected arm. Avoiding repetitive and excessive movement at the elbow and wrist can help to reduce pain. Along with rest, you can add applying ice to the muscles on the top of your forearm below the elbow, or heat if you are stretching the muscles.

WHAT CAN YOU DO TO MAKE IT BETTER?

  • Rest

  • Avoid lifting with your arm out straight

  • Avoid bending your wrist backwards for long periods of time

  • Apply ice to the sore spot on the forearm

  • Stretch the muscles in the forearm

  • Work with your hand therapist to figure out what is causing the condition in the first place and how to modify those activity

If you find that trying these does not remediate the problem you can contact a hand therapist to help you find out what is causing the condition. We can show you how to modify the way you perform activities or adapt your environment to help relieve symptoms. The goals and outcomes of hand therapy for Radial Tunnel Syndrome include:

  • Resolution of symptoms to maximise pain relief with function

  • Regaining independence with daily living/leisure/work tasks

  • Regaining radial nerve glide without compression

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