Radial Nerve Injury — Symptoms, Causes & Treatment

Radial nerve injury is a condition that occurs when the radial nerve, which supplies sensation to the back of the arm and hand, is damaged. This type of injury can be caused by a number of factors, including trauma, compression, or a medical condition such as diabetes.

The symptoms of a radial nerve injury may vary depending on how severe the injury is. Although few symptoms include:

• Numbness or tingling in the back of the hand and fingers.
• Hand and wrist may feel weak, making it difficult to grip objects or perform everyday tasks.
• Inability to extend the wrist or fingers.
• Pain or discomfort in the forearm, elbow, wrist, or hand may be present, especially when moving the affected limb.
• Wrist drop, the wrist is unable to maintain an extended position.
• Difficulty with fine motor movements, such as buttoning a shirt or typing on a keyboard, may be present.

There are various causes for radial nerve injury, some of which are mentioned below:

• Radial nerve injury can occur as a result of direct trauma to the nerve, such as a fracture or dislocation of the arm or wrist.
• Compression or entrapment of the radial nerve can cause injury. This can happen when the nerve is compressed by surrounding structures, such as a tight cast, wrist splint, or crutches.
• Prolonged pressure on the radial nerve can also cause injury. This can happen when a person leans on their elbow for an extended period of time or sleeps in an awkward position that compresses the nerve.
• Certain medical conditions, such as diabetes or autoimmune disorders, can damage the nerves and cause radial nerve injury.
• In some cases, radial nerve injury can occur as a complication of surgery, particularly in surgeries that involve the arm, elbow, or wrist.

Pathology:
The pathology of radial nerve injury can vary depending on the location and severity of the damage. Mild injuries may result in temporary symptoms, while more severe injuries can lead to permanent disability or loss of function. In some cases, the nerve may regenerate over time, while in other cases, surgical intervention may be required to repair or replace the damaged nerve.

Physical examination: A physical examination is typically the first step in diagnosing a radial nerve injury. The doctor will assess the affected area for signs of weakness, numbness, or tingling.

Imaging tests: X-rays, MRI, or CT scans may be ordered to help diagnose the underlying cause of the nerve injury, such as a bone fracture or a herniated disc.

Nerve conduction study: A nerve conduction study involves placing electrodes on the skin to stimulate the radial nerve and measure how quickly signals travel through the nerve. This test can help to determine the extent of nerve damage.

Electromyography (EMG): An EMG involves inserting a needle electrode into the muscle to assess the electrical activity and function of the muscle and nerve. This test can help to determine the severity of the nerve injury and the degree of muscle involvement.

Ultrasound: Ultrasound can be used to visualize the radial nerve and surrounding structures to look for signs of compression or entrapment.

Blood tests: Blood tests may be ordered to assess for underlying medical conditions that may be contributing to the nerve injury, such as diabetes or autoimmune disorders.

Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs), Corticosteroids, Antidepressants, Anticonvulsants, Muscle relaxants, etc.

Note: Medication should not be taken without a doctor’s prescription.

Surgery:
Radial nerve injury can be caused by trauma or compression, and it can lead to weakness or paralysis of the muscles that extend the wrist and fingers, as well as loss of sensation in the back of the hand and forearm. Surgery may be necessary in cases where the nerve is severely damaged or compressed and other treatments have not been effective.
There are several types of surgeries that can be performed for radial nerve injury, including:

• Nerve decompression surgery.
• Nerve grafting.
• Nerve transfer.
• Tendon transfer.

Cryotherapy:
Cryotherapy or cold therapy can help to reduce inflammation and swelling in the affected area. The physiotherapist may use an ice pack or a cold towel to apply cold to the affected area.

Thermotherapy:
Thermotherapy or heat therapy can help to improve circulation and reduce muscle tension in the affected area. The physiotherapist may use a hot pack or a warm towel to apply heat to the affected area.

Transcutaneous electrical nerve stimulation (TENS):
TENS is a non-invasive modality that uses electrical impulses to help manage pain and reduce muscle spasms. Electrodes are placed on the skin over the affected area, and a small electrical current is delivered to stimulate the nerves.

Ultrasound:
Ultrasound uses high-frequency sound waves to help promote healing and reduce inflammation in the affected area. The physiotherapist may apply a special gel to the skin and use a handheld device to deliver the ultrasound waves.

Massage therapy:
Massage therapy can help to promote relaxation, reduce pain, and improve circulation in the affected area. The physiotherapist may use techniques such as effleurage, petrissage, or myofascial release to help manage symptoms and improve function. Range-of-motion exercises: Range-of-motion exercises can help to improve flexibility and mobility in the affected limb. These exercises may include stretching and gentle movements of the fingers, wrist, and elbow.

Strengthening exercises:
Strengthening exercises can help to improve muscle function and prevent muscle wasting. The physiotherapist may recommend exercises such as wrist curls, finger extensions, or elbow extensions to improve strength in the affected limb.

Nerve gliding exercises:
Nerve gliding exercises can help to improve the mobility of the radial nerve and reduce symptoms such as tingling or numbness. These exercises involve moving the affected limb in specific ways to gently stretch the nerve.

Splinting:
Splinting may be used to immobilize the affected limb and reduce stress on the radial nerve. A splint can also help to maintain a proper wrist and hand position and prevent contractures.

Massage therapy:
Massage therapy can help to improve circulation, reduce muscle tension, and promote healing in the affected area. A massage therapist may use gentle techniques such as effleurage or petrissage to promote relaxation and reduce pain.

Patients should understand the cause and nature of their radial nerve injury, as well as the expected timeline for recovery. This can help them to manage their expectations and develop a positive attitude toward recovery. Patients should avoid activities or positions that may aggravate their radial nerve injury. For example, they should avoid repetitive motions, lifting heavy objects, or placing prolonged pressure on the affected limb.