What is the radial nerve?
The radial nerve runs down the underside of your arm
and controls movement of the triceps muscle, which is located at the back of
the upper arm. The radial nerve is responsible for extending the wrist and
fingers. It also controls sensation in part of the hand.
Injury to the radial nerve may result in radial
neuropathy, also called radial nerve palsy. Radial nerve injury may
be due to physical trauma, infection, or even exposure to toxins. It often
causes numbness and tingling or burning pain. It can also be painless. The
condition may cause weakness or difficulty moving your wrist, hand, or fingers.
In many cases, this condition will improve if the underlying
cause is treated.
Causes of radial nerve injury
Injury to the radial nerve has a variety of
possible causes. These include:
- fracturing your humerus, a bone
in the upper arm
- sleeping with your upper arm in
an awkward position
- pressure from leaning your arm
over the back of a chair
- using crutches improperly
- falling on or receiving a blow to
- long-term constriction of your
The most common causes of radial nerve injury
are breaking your arm, overusing your arm, and sports and work accidents. Depending
on the level of injury, you may experience a complete laceration of the radial
nerve. This occurs when the nerve is severed. It can cause symptoms that are similar
to more minor injuries. A nerve laceration usually requires surgical repair.
Certain actions, when repeated often enough, can
lead to radial nerve damage. Movements that involve both grasping and swinging
movements, such as swinging a hammer, can lead to nerve damage over time. As
the radial nerve moves back and forth over the bones of your wrist and forearm,
there’s potential for the nerve to become trapped, pinched, or strained from these
Lead poisoning can also lead to long-term
nerve damage. Over time, the lead toxin can cause damage to the nervous system
as a whole.
Certain health conditions that affect your
whole body may damage one nerve. Kidney disease and diabetes may cause
inflammation, fluid retention, and other symptoms that can, in turn, lead to
nerve compression. This could affect the radial nerve or other nerves in your
Symptoms of an injury to
the radial nerve
A radial nerve injury usually causes symptoms
in the back of your hand, near your thumb, and in your index and middle
Symptoms may include a sharp or burning pain,
as well as unusual sensations in your thumb and fingers. It’s common to
experience numbness, tingling, and trouble straightening your arm. You may also
find that you can’t extend or straighten your wrist and fingers. This is called
“wrist drop” or “finger drop,” and it doesn’t occur in all cases.
Testing for and diagnosing
a radial nerve injury
If you think you’ve injured your radial
nerve, your doctor will start by asking you about your symptoms and when they
began. This may help pinpoint what caused the injury.
Your doctor will also do a physical exam.
They will look at your affected arm, hand, and wrist, and compare it to your
healthy arm, hand, and wrist. They may ask you to extend and rotate your arm to
see if the injury affects your range of motion. Your doctor will also ask you
to extend your wrist and fingers, checking for any weakness or loss of muscle
Your doctor may order tests to rule out other
causes of your symptoms. For example, you may have blood tests to check your
blood sugar and vitamin levels, as well as your kidney and thyroid function. These
tests check for signs of other conditions associated with nerve damage, such as
diabetes, vitamin deficiencies, or diseases of the kidney and liver. A CT
scan or MRI can also look for diseases within your head, neck, or
shoulders that may result in pressure on your radial nerve.
Your doctor may also consider electromyography
(EMG) and nerve conduction tests. An EMG measures the electrical activity
in your muscle. A nerve conduction test measures the speed at which impulses
travel along your nerves. These tests can help determine if you are
experiencing a problem in your nerve or in your muscle. They may also show
whether the radial nerve is damaged.
In very rare cases, your doctor may request a
nerve biopsy. This involves taking a small sample of the nerve and examining it
to determine what is causing the damage.
The goal of
treatment for radial nerve injury is to relieve symptoms while maintaining movement
of your wrist and hand. The best treatment depends on the underlying cause. In
some cases, symptoms go away slowly on their own without intervention. Your
doctor may prescribe medication or other therapies to help manage your
There are several different first-line
treatment options available. These include:
- analgesic or anti-inflammatory medications
- antiseizure medications or tricyclic antidepressants
(prescribed to treat pain)
- steroid injections
- anesthetic creams or patches
- braces or splints
- physical therapy to help build and maintain muscle strength
choose transcutaneous electrical nerve stimulation (TENS) to
treat nerve damage. This therapy involves placing several adhesive electrodes
on the skin near the affected area. The electrodes deliver a gentle electric
current at varying speeds.
Physical therapy to build and maintain muscle
strength can help to heal and improve nerve function. Massage treatment is
another option. Massage can break up scar tissue and make the radial nerve more
Analgesic or anti-inflammatory medication can
help relieve the pain of a radial nerve injury. It may also help the injury
heal faster. A single cortisone shot in the affected area can relieve pain. Anesthetic
creams or patches can also be used to relieve pain, while still allowing
It’s also common to use a brace
or splint to immobilize the nerve. This might not sound like the most
convenient option, but it may prevent you from reinjuring the nerve while it’s
Less traditional treatment
methods, such as acupuncture and chiropractic adjustments, are also an option.
Keep in mind that evidence about whether some of these treatments work is
Most people with a radial nerve injury will
recover within three months of starting treatment if the nerve is not torn or
lacerated. But some cases ultimately require surgery. If your radial nerve is
entrapped, surgery can relieve pressure on the nerve. If there is a mass, such
as a benign tumor, on your radial nerve, you may need surgery to remove it.
The goal of surgery is to repair any damage
to the nerve. Occasionally, when it is thought that the nerve will not heal,
tendon transfers can be performed to restore function to the extremity. After
surgery, you will need to wear a brace or splint to allow the injury or tendon
transfer to heal. Your doctor will refer you to a physical therapist for
rehabilitation to restore range of motion and strength.
How can I prevent radial nerve injury?
You can prevent most radial nerve injuries if
you avoid putting prolonged pressure on your upper arm. Avoid behaviors that
can lead to nerve damage, such as repetitive motions or remaining in cramped
positions while sitting or sleeping. If you work in an occupation that requires
repetitive motions, take steps to protect yourself by taking breaks and
switching between tasks that require different movements.
Recovery time and outlook
The long-term prognosis for a radial nerve
injury varies greatly depending on the cause and severity of the injury. In most
cases, a full recovery is possible. First-line treatment methods will generally
heal most radial nerve injuries within 12 weeks.
If your nerve damage is the result of an
underlying medical condition, such as diabetes or alcoholism, talk to your
doctor about how to manage your symptoms.
People who are younger when the injury occurs
and people who have additional nerve damage injuries tend
to recover the most quickly. If surgery is
needed, a full recovery can take from six to eight months.