Radial Tunnel Syndrome

A squeezed nerve in the radial tunnel close to the elbow causes radial tunnel syndrome, which is a form of repetitive strain injury (see our RSI article for more information). This condition is often linked to long term overuse in athletes, and can be difficult to diagnose due to the similarity of its symptoms to those of tennis elbow.

Symptoms

Pain along the outside of the elbow, usually accompanied by tenderness. This pain generally begins a short distance from a bony protuberance (the lateral epicondyle) on the outside of the joint, where the nerve crosses the supinator muscle. Pain may also be present as an ache in the forearm. The radial nerve assists in the movement of your forearms and hands as it interacts with various muscles, and therefore the pain is likely to increase when you perform tasks such as turning or bending your wrist, extending your palm upwards, or lifting objects with a straight arm. Your arms and hands can also feel weakened. The elbow joint might feel rigid in the morning. In particularly serious cases, the condition may result in temporary paralysis of the fingers or wrist.

Causes

There are at least five places in the radial tunnel where the nerve can become pinched. Repetitive movements associated with many sports can cause excessive pressure on the radial nerve, leading to unnatural stretching and pinching of the nerve. Over time, strenuous gripping, wrist bending, arm twisting, and hard pushes and pulls can all contribute to the injury. Potentially damaging repetitive motions are common to sports including golf and tennis. Occasionally a strike. to your elbow spontaneously squeezes the nerve.

Treatment

The injury is sometimes misdiagnosed as tennis elbow and medical tests can prove futile in distinguishing between these conditions. Nevertheless it is important to see a doctor, who will conduct a physical exam and ascertain the cause of the injury. The better they can identify the exact location of the pain, the greater the chances of a correct diagnosis.

Treatment is often not easy. You should refrain from continuing with any repetitive activity that provoked the pinched nerve, and other activities that may worsen the injury. Add breaks to your training or work routine, and be sensible with lifting, pushing and pulling, avoiding these as much as possible. With persistent night pain, the doctor may recommend an arm splint to hold your elbow in a relatively fixed position. It will be beneficial to speak to a physical therapist who can assist both with limiting strenuous activities and gently maintaining strength in your arms and hands through stretching. Icing the area can reduce pain and any inflammation.

Symptoms are not always resolved, and may last for anything from a few weeks to a number of years depending on severity. Surgery might be employed in major cases to reduce pressure on the radial nerve.

Prevention

Strengthen your muscles gradually during recovery to avoid intense strain. Take frequent breaks, and remember that repetitive strain injuries are incremental, so that little aches and damages add up over time. Therefore modify your sporting or other habits to avoid repetitive movements where feasible, and do not grip objects too tightly or place a lot of pressure on the arm.