Radial Nerve Injuries

Clearwater, Tampa, St. Petersburg, Florida

A radial nerve injury involves damage to the nerve that allows sensation and movement in part of the arm.

The radial nerve attaches to the skin and muscles of certain areas of the arm, forearm and hand. It is responsible for muscle movement and sensation in these areas. Someone with an injury to the radial nerve loses function in these areas.

The radial nerve extends to the upper arm off the brachial plexus, and courses through the muscles of the brachialis and brachioradialis, just anterior to the lateral epicondyle. The distal aspect of the humerus that articulates with the radius forearm bone is referred to as the capitellum. In this area, the radial nerve divides into a deep motor nerve (posterior interosseous nerve) and a superficial branch, which is sensory.

The posterior interosseous nerve traverses through the heads of the supinator muscle. In this muscle, approximately 35 percent of individuals will have what is known as the arcade of Frohse, which is a fibrous arch. It is here in the posterior compartment of the forearm that the posterior interosseous branch of the radial nerve can become entrapped, resulting in elbow pain or non-specific arm pain.

Since the posterior interosseous nerve is purely a motor branch, it may be entrapped either at the fibrous arch of Frohse due to injury, or thickening of the posterior compartment or supinator muscle. Traumatic injury such as fractures or dislocation or masses may also compromise this nerve.

In most cases, the radial nerve is damaged by trauma, repeated use of the nerve, or by the nerve being compressed by other structures. The injury may be permanent.

What are the Causes and Risks of a Radial Nerve Injury?

Radial nerve injury can be caused by a number of activities, including:

• The improper use of crutches, usually when a person rests his or her weight on the armpits rather than the hands
• Hanging the arms over the back of a chair for too long or lying on an arm for too long.
• A bone fracture involving the upper arm bone, or humerus
• Certain repeated motions of the arm, known as a repetitive stress injury.

A radial nerve injury may be permanent, causing lifelong weakness and numbness, and sometimes chronic pain. In some people, the muscles can shrink and cause the arm to become deformed over time. In other people, some or all of the arm’s function may be regained over time.

Repetitive stress injuries to this nerve can be seen in occupations that utilize these muscle frequently, such as violinists, conductors, even vigorous house cleaning can lead to this posterior interosseous nerve injury.

Athletes who repetitively pronate and supinate or forcefully extend the forearms (which can occur with swimming and basketball players – especially those who illegally palm the ball) are also susceptible to this form of injury.

Radial nerve injuries can be evaluated by electrodiagnostic testing (EMG/NCS) and may also be visualized through careful clinical examination or magnetic resonance imaging (MRI) scanning.

Because radial nerve injuries may present as elbow pain, it may often be confused with lateral epicondylitis or diffuse nonspecific arm pain. Because of this, it may be misdiagnosed and persist for prolonged periods because of incorrect diagnosis or inadequate treatment. With all chronic nonspecific elbow or arm pain syndromes, a specialist or highly skilled and trained clinician is necessary to help make this diagnosis.

Treatment radial nerve injuries include physical medicine modalities, restriction of the repetitive activity that is exacerbating it, and in some case injection therapy. As a last resort, surgical intervention may be appropriate.

If you continue to suffer with a radial nerve injury and your current treatment plan leaves you wanting more options, perhaps a fresh set of experienced eyes can change your outlook. Since 1990, Dennis M. Lox, M.D. has applied his personal interests in sports medicine, cutting-edge regenerative medicine and chronic pain management to helping patients increase their quality of life. Contact us for an appointment at 727-462-5582.

All statements, information or opinions provided by this website are provided for educational purposes only. We do not diagnose nor treat through this website or by telephone. As you consider any treatment, discuss them with your physician.