Compression of the Radial Nerve

Does the back of your hand experience ‘pins and needles’ or a numbing sensation? Did you wake up one morning after night out and you hand decided to not work properly? Does your wrist uncontrollably drop when you try to use it? Or does your little finger constantly stick out and you are unable to bring it in? You may have a radial nerve compression injury!

The radial nerve is a nerve that originates from your spine in the neck at C5-C8. It travels all the way from your neck down the back of your arm down to the back of your hand and fingers. This nerve supplies sensation and motor control to enable your hand and arm to work effectively.

This nerve has a specific pathway through the arm and it goes through different canals which can easily be compressed. When these different areas are compressed the most common symptoms occurs which are pain, numbness or ‘pins and needles.’ Depending on where the nerve is compressed the type of compression injury is determined. The different injuries are mentioned below:

Radial Nerve Palsy

Radial Nerve Palsy also known as ‘Saturday night palsy’ or ‘crutch palsy’ is when the radial nerve gets compressed at the armpit. Generally, the most common causes of radial nerve palsy include compression from using crutches (crutch palsy) or from falling asleep with the arm hanging over a chair (Saturday night palsy). It can also be caused from fractures occurring at the humerus which is the bone in the upper arm. Generally, this results in the most common sign of ‘wrist drop’. Wrist drop occurs due to weakness or the lack of innervation to the muscles of the hand which allow for wrist and finger extension (pulling the hand up).

Common symptoms include:

  • Pain
  • Weakness in muscles of the arm, forearm and hand
  • Wrist drop
  • Decrease in sensation in the muscles of the back of the arm, forearm and hand

Radial Tunnel Syndrome:

As the radial nerve journeys down the arm, it splits in two at the elbow. One nerve, called the superficial radial nerve, supplies sensation whilst the other nerve, the posterior interosseus nerve supplies motor control and input. With radial tunnel syndrome the radial nerve, specifically the posterior interosseus nerve, gets compressed in a canal near the elbow. This canal is called the arcade of Fröhse, which is a fibrous arch near a muscle called the supinator. The supinator is responsible for allowing a ‘palm up’ or ‘supinated’ position. When the arm is overused, particularly with repetitive pushing/pulling or gripping movements the radial nerve can become compressed. Over time these repetitive movement causes radial tunnel syndrome.

The common symptoms of radial nerve syndrome include a dull aching pain at the top of the forearm towards the outside of the elbow or the hand. Radial tunnel syndrome causes fatigue and weakness in the forearm and weakness at the wrist. Sometimes these symptoms are confused with the injury known as Tennis elbow.

Wartenburg’s Syndrome:

Wartenburg’s syndrome is caused when the radial nerve, specifically the superficial radial nerve, that supplies sensation to the hand is compressed. This nerve runs rather close to the skin at the base of the wrist and due to this, the nerve is at risk for compression when external forces such as tight jewellery, watches or handcuffs are applied. The injury generally relates to pins and needles, numbness or reduced sensation on the back of the hand mainly on the thumb side.

If you have any of the following symptoms, please don’t hesitate to contact us. It is vital the nerve compression injuries are assessed and treated properly to ensure there is no permanent damage. Our Specialists at Specialists On Hand can help with assessing and treating your injury. We can create personalised treatment regime to allow you to get back to doing the things that you enjoy doing the most! These include:

  • Pain management
  • Anti-inflammatory management
  • Activity modification and ergonomic education
  • Soft tissue massage and myofascial release
  • Static and dynamic orthotic regimes
  • Individualised muscle and nerve exercises programs
  • Neurostimulation using Inter-X and TENS machines.