Radial tunnel syndrome is pressure on a branch of the radial nerve (the posterior interosseous nerve) as it passes under the supinator muscle in the upper forearm. It causes a deep ache rather than numbness, and it often occurs alongside tennis elbow or is mistaken for it. Repetitive forearm rotation and forceful gripping, common in mechanics, assembly work, drywall work and racquet sports, are typical triggers.
Warning signs
- A deep ache in the upper outer forearm, a few finger-widths below the bony point on the outside of the elbow
- Pain that worsens with gripping, lifting or turning the forearm
- An ache that can travel up to the elbow or down the forearm and disturb sleep
- Usually no numbness or tingling, and no measurable weakness on exam
Treatment
The diagnosis is made with specific exam tests, such as pain over the radial tunnel when the middle finger is straightened against resistance. Care usually starts with modifying the gripping and rotating tasks that trigger the pain, a splint at night and during heavy tasks, hand therapy with nerve-gliding exercises, and anti-inflammatory medication. An ultrasound-guided injection can help confirm the diagnosis and relieve symptoms. When these measures are not enough, the nerve can be released through a small incision on the forearm under regional anesthesia.
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Questions patients ask
What is radial tunnel syndrome?
Radial tunnel syndrome is pressure on a branch of the radial nerve (the posterior interosseous nerve) as it passes under the supinator muscle in the upper forearm. It causes a deep ache rather than numbness, and it often occurs alongside tennis elbow or is mistaken for it. Repetitive forearm rotation and forceful gripping, common in mechanics, assembly work, drywall work and racquet sports, are typical triggers.
What are the warning signs of radial tunnel syndrome?
A deep ache in the upper outer forearm, a few finger-widths below the bony point on the outside of the elbow. Pain that worsens with gripping, lifting or turning the forearm. An ache that can travel up to the elbow or down the forearm and disturb sleep. Usually no numbness or tingling, and no measurable weakness on exam.
How is radial tunnel syndrome treated?
The diagnosis is made with specific exam tests, such as pain over the radial tunnel when the middle finger is straightened against resistance. Care usually starts with modifying the gripping and rotating tasks that trigger the pain, a splint at night and during heavy tasks, hand therapy with nerve-gliding exercises, and anti-inflammatory medication. An ultrasound-guided injection can help confirm the diagnosis and relieve symptoms. When these measures are not enough, the nerve can be released through a small incision on the forearm under regional anesthesia.
Who treats radial tunnel syndrome near Southlake and Dallas-Fort Worth?
Dr. Pedro Loredo, a board-certified hand surgeon (General Surgery, American Board of Surgery; Hand Surgery, American Board of Plastic Surgery) at Loredo Hand Care Institute, 431 E State Hwy 114, Suite 380, Southlake, TX. New patients are seen within days. Call (972) 939-4974. Se habla español.
En español: ¿Dolor de antebrazo que no es codo de tenista?
El síndrome del túnel radial es la presión sobre una rama del nervio radial (el nervio interóseo posterior) cuando pasa por debajo del músculo supinador en la parte alta del antebrazo. Causa un dolor profundo más que adormecimiento, y con frecuencia aparece junto con el codo de tenista o se confunde con él. Girar el antebrazo de forma repetida y agarrar con fuerza, algo común en mecánicos, trabajo de ensamblaje, instalación de tablaroca y deportes de raqueta, son desencadenantes típicos.
Señales de alerta
- Un dolor profundo en la parte alta y externa del antebrazo, unos dedos por debajo del hueso de la parte externa del codo
- Dolor que empeora al agarrar, cargar o girar el antebrazo
- Un dolor que puede subir al codo o bajar por el antebrazo y no dejar dormir
- Normalmente sin adormecimiento ni hormigueo, y sin debilidad medible en el examen
Tratamiento
El diagnóstico se hace con pruebas específicas en el examen, como dolor sobre el túnel radial al estirar el dedo medio contra resistencia. El manejo suele empezar modificando las tareas de agarre y giro que provocan el dolor, con una férula de noche y durante tareas pesadas, terapia de mano con ejercicios de deslizamiento del nervio y medicamentos antiinflamatorios. Una inyección guiada por ultrasonido puede ayudar a confirmar el diagnóstico y aliviar los síntomas. Cuando estas medidas no bastan, el nervio puede liberarse por una incisión pequeña en el antebrazo con anestesia regional.
If this sounds like your hand
Call Loredo Hand Care Institute or start your forms online. New patients are seen within days; surgery, when needed, is scheduled at the first available opening. Se habla español.