Radial Tunnel Syndrome (RTS)

Radial tunnel syndrome (RTS) causes chronic pain resulting from compression of the radial nerve in the forearm. The radial nerve starts in the armpit and travels down the outside of the arm to the hand. Compression of the radial nerve may affect the ability to move the arm, wrist, hand, and fingers.

 

Radial tunnel syndrome (RTS) causes chronic pain resulting from compression of the radial nerve in the forearm. The radial nerve starts in the armpit and travels down the outside of the arm to the hand. Compression of the radial nerve may affect the ability of your muscles to move the arm, wrist, hand, and fingers.

Doctors have differing opinions on whether RTS actually exists. It is difficult to diagnose because the symptoms and location of pain are not consistent from case to case and because RTS rarely causes problems with movement.

Symptoms of RTS vary from person to person but usually include a dull ache or pain at the top of the forearm. The pain may be worse at night or when you straighten your arm, wrist, or middle finger.

See your doctor if conservative treatment doesn’t relieve your arm pain.

RTS is usually caused by compression of the radial nerve. This can happen anywhere along the length of the nerve, but happens most often in the radial tunnel. The radial tunnel is a narrow space formed by your muscles, tendons, and bones on the top and outside of the arm bone near the elbow.

Compression of the nerve can be caused by:

• Overuse and repetitive movements, such as gripping, bending, and pinching
• Injury, such as a blow or broken bone
• Diseases, such as diabetes or thyroid problems
• Swelling in the arm
• Inflammation in the nerve
• Improper use of crutches

There isn’t a single test that can tell your healthcare provider that you have radial tunnel syndrome. To find out what’s causing your pain, your healthcare provider will examine your arm, feel for tenderness in certain places, and ask you to move it in specific ways. You may also need tests to check for nerve damage or problems with your bones, muscles, or tendons. These tests include:

• Ultrasound
• Magnetic resonance imaging (MRI)
• Electromyography (EMG)
• Nerve conduction velocity (NCV)

The goal of treatment is relieving your pain so you can get back to your daily tasks. Your treatment will be based on your symptoms and the results of the examination and any tests.

Conservative treatments that you can do at home include:

• Resting the arm and hand 
• Using a wrist brace or splint to reduce movement in the forearm
• Taking nonsteroidal anti-inflammatory medicine (aspirin, naproxen, ibuprofen) to reduce pain and swelling
• Using ice or cold packs to reduce pain and inflammation

Other nonsurgical treatments may include steroid injections, physical therapy, ultrasound massage, and changes in activity.

If nonsurgical treatments do not help, surgery may be recommended to reduce or remove the compression on the nerve. There are many different ways this can be done. Your surgeon will recommend a solution based on your specific problem. It may take up to 9 months to fully recover from surgery.

It may not be possible to prevent some injuries. But you can reduce your chances of getting radial tunnel syndrome from other causes by:

• Taking breaks when doing repetitive tasks and resting your arm and hand
• Following your diabetes or thyroid treatment plan
• Using your crutches correctly