Radial Tunnel Syndrome
Radial Tunnel Syndrome
Radial tunnel syndrome, sometimes also known as supinator syndrome, refers to increased pressure and compressive forces on the radial nerve as it passes through the forearm and elbow. The symptoms of this condition are can appear similar to the symptoms of tennis elbow. Therefore, there is a need for a precise, in-depth examination with a Physiotherapist who can apply the proper neurodynamic (nerve) testing so that the appropriate diagnosis can be made.
Where is the radial tunnel?
The radial nerve originates from the spinal nerves in the neck, it becomes the radial nerve in the brachial plexus located deep to your upper trapezius, travels through the radial noth located just below the insertion of the deltoid shoulder muscle. The nerve twists outward and crosses the lateral part of the elbow before it goes down the forearm and hand. At the elbow and forearm, the radial nerve enters the radial tunnel which is formed by a group of muscles. In the tunnel, the nerve runs below the supinator muscle and down into the hand, ending on the top of the index finger.
What is radial tunnel syndrome?
Radial tunnel syndrome is a compressive neuropathy of the radial nerve of the forearm. In this condition, the radial nerve becomes irritated due to excessive compression or friction by the musculature in the forearm. This normally occurs between supinator and the radial head.
Causes of radial tunnel syndrome
The most common causes of radial tunnel syndrome includes:
- A direct blow to the outside of the elbow
- Overuse: repetitive forceful pushing and pulling, bending of the wrist
- Working with the elbow extended
- Repetitive, forceful gripping, and pinching
- Constant twisting movements of the arm – common in assembly work
- Ganglion cysts
Symptoms of radial tunnel syndrome
This syndrome produces pain that is felt at the top of the forearm, at the spot where the nerve twists under the supinator muscle. The pain gets worse when bending the wrist backward, turning the palm upward, or hold something with a stiff wrist or straightened elbow. The condition may also cause a more achy type of pain or fatigue in the muscles of the forearm which makes it difficult to steady the wrist during grasping and lifting motions. In more severe cases,numbness, pins and needles and weakness in the hand, thumb and wrist are often present.
Treatment of radial tunnel syndrome
The treatment of radial tunnel syndrome may include a combination of the following procedures:
- Avoiding repetitive activities that require repeated twisting or bending of the wrist
- Workstation alterations
- Taking frequent breaks as you work
- Postural awareness or changes
- Limiting heavy pushing, pulling, and grasping
- Wrist straps, splints
- Lightweight plastic arm splint during sleep
Physiotherapy can help ease symptoms and improve elbow function by employing:
- Electrical stimulation
- Soft-tissue massage
- Nerve gliding / nerve flossing exercises
- Stretching exercises
- Functional strengthening exercises that mimic one’s daily and work activities
- Hands-on stretching to improve range of motion
- Exercises to improve forearm and hand strength
- Laser Therapy to reduce inflammation around the radial nerve
- Shockwave Therapy to break up adhesions and scar tissue in the supinator muscle