Radial Tunnel Syndrome
(Radial Nerve Entrapment)
Radial tunnel syndrome is pain and weakness in the arm and hand. It can make it hard to use your forearm.
The radial nerve controls muscles of the forearm. It starts under the armpit and runs down the arm. It passes through a tunnel at the elbow. This tunnel is surrounded by tendons and muscles. Certain movements or overuse of these muscles can shrink the tunnel. This can irritate and press on the nerve.
An injury or abnormal growth can also increase pressure on the nerve.
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Factors that may increase your risk of getting radial tunnel syndrome include:
- Having a small radial tunnel
- Jobs or sports that require repetitive motion, such as:
- Overuse of the arm to twist, push, or pull
- Overuse of the hand to grip, pinch, or bend at the wrist
- Poor arm and wrist strength
- Tumors or cysts that place pressure on the nerve
- Fluid in the arm (edema)
- Trauma or injury
Symptoms will vary but may include:
- Ache in the forearm that can reach to the hand or outside of the elbow
- Weakness of the wrist and forearm
You will be asked about your symptoms and past health. You may also be asked about your activities and injuries. A physical exam will be done. Your doctor may ask you to move in certain ways to see what causes problems. Diagnosis is often made after the physical exam.
Imaging tests are not often needed. If you do not respond to treatment the doctor may want to see if there is damage to the area with one of the following:
Symptoms will often go away on their own once the pressure on the nerve is removed. It may take 3 to 6 weeks for them to fully pass. Injuries or other medical issues may also need to be treated.
Basic care is often all that is needed. Steps may include:
- Avoid activities that are causing pain.
- Ice the area to help decrease swelling and pain.
- Wear a light splint at night. This will limit movement and allow the area to rest.
Physical and occupational therapy may help return the arm to full use. An exercise program may help to improve strength, range of motion, and flexibility. The therapy may also include the use of ice, heat, or ultrasound. This type of therapy may also show you ways to prevent it from happening again.
Medicine may help to decrease swelling. A steroid medicine may be used.
Surgery may be needed if rest and medicine has not worked. The goal of the surgery is to make the radial tunnel bigger. This should improve or stop symptoms.
To help reduce your chance of getting radial tunnel syndrome:
- Avoid repetitive movements.
- Stretch your arm and elbow.
- Keep your muscles strong with strengthening exercises.
- User proper techniques when playing sports.
Family Doctor—American Academy of Family Physicians
National Institute of Neurological Disorders and Stroke
Canadian Neurological Society
Moradi A, Ebrahimzadeh M, et al. Radial tunnel syndrome, diagnostic and treatment dilemma. Arch Bone Jt Surg. 2015 Jul;3(3):156-162.
Neal S, Fields K. Peripheral nerve entrapment and injury in the upper extremity. Am Fam Physician. 2010 Jan 15;81(2):147-155. Available at: http://www.aafp.org/afp/2010/0115/p147.html. Accessed May 12, 2018.
Radial tunnel syndrome. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/hic-radial-tunnel-syndrome. Updated January 29, 2015. Accessed May 12, 2018.
Last reviewed September 2018 by Michael Woods, MD Last Updated 5/12/2018