With the arrival of Summer, we have seen an uptick in patients seeking help for pain in their wrist, forearm, and elbow as they pick up tennis or golf. With this article, we wanted to recap radial tunnel syndrome, how it causes pain, and what can be done to help alleviate the issue. 

What is Radial Tunnel Syndrome?

The radial tunnel is located on the outside of the elbow, where the radial nerve runs through connective tissue before branching out and continuing down into the wrist. Radial tunnel syndrome is a condition that involves the radial nerve and results in the pinching or irritation of the nerve. Repetitive use of forearm muscles, particularly the supinator muscle, can cause this irritation. People with jobs that involve a lot of repetitive wrist movements, such as electricians and those who play sports like golf or tennis, are at greater risk of developing radial tunnel syndrome.

The symptoms of radial tunnel syndrome can include numbness, tingling, weakness, or pain in the elbow, back of the forearm, and possibly into the hand and wrist. It is also common for people with radial tunnel syndrome to experience pain at night or increased pain in the morning.

Assessments and Tests for Radial Tunnel Syndrome

There are several tests that we use to identify and diagnose radial tunnel syndrome:

• Resisted Supination Test: the chiropractor instructs the patient to turn their palm up towards the ceiling against resistance. If pain or symptoms are replicated, it could indicate that the radial nerve is being compressed or pinched by the supinator muscle near the elbow.

• Radial Nerve Tension Test: the practitioner rotates the patient's arm internally and raises the arm back and out without allowing the shoulder to elevate, all while keeping the elbow locked. Any reproduction of the patient's symptoms indicates a radial nerve issue.

• Radial Nerve Compression Test: the chiropractor compresses the patient's radial nerve at the forearm, pressure is held on the nerve for 15 to 20 seconds. If the patient experiences any tingling, numbness, or pain, it's considered a positive test result.

• Middle Finger Extension Test: the middle finger is extended against resistance and held for 10 to 20 seconds. Reproduction of symptoms or pain indicates compression of the radial nerve by the finger extensors.

Myofascial Release for Radial Tunnel Syndrome

There are many soft tissue manipulation techniques that can be used to treat Radial Tunnel Syndrome. One such technique is myofascial release, which involves releasing muscle tension and improving the mobility of the nerve within the connective tissue tunnel, this helps to increase blood flow to the affected areas, promoting healing and reducing inflammation. This helps to reduce pressure on the radial nerve, allowing it to function normally and reducing the symptoms of radial tunnel syndrome. Myofascial release is a safe and non-invasive technique that can be used as part of a comprehensive treatment plan for radial tunnel syndrome.

Three exercises to help alleviate wrist, forearm, and elbow pain:

• Supinator muscle stretch: Start with the palm of your affected arm facing down towards the floor. Use your other hand to grab your affected hand from above. Use the top hand to rotate your affected thumb down toward the ground. Hold for 5 to 10 seconds. Perform a contract-relax stretch by rotating the lower hand back up towards the ceiling, resisting with the top hand. Hold for 5 seconds, then relax and stretch further, repeat for three rounds.

• Radial nerve floss: make a fist with your thumb wrapped inside your fingers. Turn your wrist and arm internally with your thumb turning towards your body. Raise your arm to the outside while looking towards the back of your hand. Do this 10 to 20 times, stopping when you feel tension or tightness, lowering the arm back down to your side and repeating

• Finger extensor stretch: Curl your fingers as if you are making a tight fist and place your knuckles on a surface like a table. Try to push your wrists down towards the surface while keeping your fingers curled. Repeat this 10 to 20 times.

Incorporating these exercises into your daily routine can help prevent and alleviate wrist, forearm, and elbow pain. Remember to take breaks and stretch throughout the day, especially if you spend a lot of time using a computer or performing repetitive tasks.

Overall, there are many ways we as a clinic can help to relieve your pain as well as steps you can take on your own. If you have any questions or want to know if our treatment is right for you, give us a call or book an appointment online!