How is radial tunnel syndrome treated?

Treatment begins with resting the arm from the activity that is causing the symptoms. For most patients, rest combined with medical treatment for 3 to 6 weeks will relieve symptoms.

Treatments include:

  • Over-the-counter medications to reduce swelling
  • Steroid injections to relieve inflammation and pressure on the radial nerve
  • Wrist and/or elbow splints to reduce irritation of the radial nerve
  • Exercise, techniques to reduce the effects of repetitive motion stress, ultrasound, heat and cold

The goal of treatment is to prevent the return of symptoms. If the job is causing the problem, the work site may need to be changed. More breaks may be needed during the workday and heavy pulling and pushing should be avoided if possible.

For sports injuries, strength and flexibility exercises and adequate warm-up time before playing or practicing are important.

Wearing an arm splint at night can keep the arm in a position that prevents pinching the nerve.

Is there a surgical treatment for radial tunnel syndrome?

The results of surgery for radial tunnel syndrome vary. Doctors recommend surgery only when time and non-operative therapy fails.

Radial tunnel surgery is uncommon, and usually is done as an outpatient surgery (the patient does not stay in the hospital overnight). It can be done with total anesthesia (the patient is asleep) or a partial anesthesia. Partial anesthesia blocks the feeling only in the arm being operated on. The patient is awake if partial anesthesia is used.

The operation to treat radial tunnel syndrome is called radial tunnel release. In this operation, the surgeon divides all compressive sites within the radial tunnel. This makes the radial tunnel bigger so the radial nerve has more space. After the operation, new tissue grows across the split, and builds a permanently larger tunnel.

What happens after surgery for radial tunnel syndrome?

After surgery, patients wear an elbow splint with the arm wrapped. One week after surgery, the patient will start on a gentle exercise program. Patients use ice packs, soft-tissue massage, and stretching to improve patients’ range of motion.

After 6 weeks, patients begin strength-building exercises for the forearm and hand under a therapist’s supervision. During recovery, lifting and other activities that require bending the arm at the elbow are not allowed. In the final stage, the therapist adds exercises to stabilize and strengthen the wrist, elbow, and shoulder, and improve fine motor control in the hand.

Full recovery after surgery can take 6 to 8 months or longer. How long it takes to recover depends on the amount of damage to the nerve before surgery.

Last reviewed by a Cleveland Clinic medical professional on 01/29/2015.

References

  • Naam H, Nemani S. Radial Tunnel Syndrome. Orthop Clin North Am. 2012; Oct 43(4):529-36.
  • Floranda EE, Jacobs BC. Evaluation and Treatment of Upper Extremity Nerve Entrapment Syndromes. Prim Care. 2013;Dec;40(4):925-43.
  • Hagert E, Hagert CG. Upper Extremity Nerve Entrapments: The Axillary and Radial Nerves-Clinical Diagnosis and Surgical Treatment. Plastic & Reconstructive Surgery. 2014; July 134(1):71-80.
  • Neal SL, Karl B. Fields KB. Peripheral Nerve Entrapment and Injury in the Upper Extremity. Am Fam Physician.2010:81(2): 147-155.
  • Hainline, BW, Peripheral Nerve Injury in Sports. CONTINUUM: Lifelong Learning in Neurology. 2014;20(6, Sports Neurology):1605-1628.

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