Radial Tunnel Syndrome

The radial nerve runs from the neck, along the upper arm and forearm, providing sensation and motor function to the hand. At the elbow, it passes through a tunnel comprised of bone, muscle and tendons. Injury, tumors or inflammation can compress the nerve, resulting in radial tunnel syndrome, which is characterized by pain and weakness at the top of the forearm or back of the hand, especially when straightening out the arm. The radial nerve can be decompressed through a surgical procedure called radial tunnel release.

The surgery is recommended when conservative options fail over a period of 3 months, and in severe cases where the wrist becomes extremely weak and extending the fingers is difficult.

Radial tunnel release is usually performed under partial general anesthesia so that nerve responses can be tested during the procedure. An incision is made either on the outer side or inner region of your elbow to expose the radial nerve. It is traced above and below the elbow to identify all areas of compression. The supinator muscle that encloses the radial tunnel is incised at the areas of compression in the form of splits to make more room for the nerve to pass through the tunnel. All precautions are taken to avoid nerve damage. The tunnel remains enlarged as new tissue grows and fills in the splits.

Following surgery your elbow, forearm and wrist are placed in a splint. Exercises, massage, ice packs and stretching are introduced after one week to improve range of motion. After six weeks, exercises to strengthen the elbow and wrist as well as improve fine motor skills are included. Full recovery usually occurs in 6 to 8 months.

As with all surgical procedures, radial tunnel release may be involved with certain complications such as nerve injury, mild pain, infection, incomplete recovery of function and scar formation.