So - what do you know about Radial Tunnel Syndrom?

In My Humble Opinion
1

You are (most likely) not my doctor.

The best minds in medical science believe I have radial tunnel syndrome. It’s like carpal tunnel syndrome, but higher on the forearm, just below the elbow. I earned my symptoms back in October, digging 120’ of trench for my hot tub. I started seeing my orthopedic about it in December, when it wasn’t getting better. He has since referred me to a hand/arm specialist.

Basically, if I carry something with my arm bent - like a coffee cup - it tightens up and hurts when I release. If I try to grab something quickly, like catching something I dropped, it hurts like hell. If I do thousands of other light things while twisting the arm, it hurts a bit.
Sometimes, like right now, it hurts to type.

But it isn’t the classic presentation. Both my ortho, and the hand/arm specialist he sent me to, poked at a spot on elbow, expressing surprise that I have no tenderness there. X-rays show no damage. MRI shows some inflammation , but no tears or other damage.
I had an EMG/Nerve Conductivity test done this morning, which was really, really fun. Or painful. One of those.
I’ll get my official results on that next Monday, but the doctor who ran the test said they looked fairly normal.

I’ve been doing Occupational Therapy for three months. I improved a bit initially, but plateaued fairly quickly. My strength is fine, and my range of motion is fine. It just…hurts. I had a cortisone injection last week, with minimal improvement.

I’ve been told that if I feel pain, I’m actually extending the injury. So this is one where I’m not supposed to “tough it out.”

I’m curious if anyone else has gone through this and can comment on how long it took to heal. I know these things can be slow and annoying, and I can be patient. There is a surgical option, but it’s more intrusive than carpal tunnel syndrome, because there are a lot of muscles in the way. Recovery time is much longer, apparently.

So I turn to the Dope, to keep me sane and give me hope! What do you know?

2

I had Radial Nerve Entrapment back in 2004. I had pain whenever I reached or tried to support something with a bent arm. The most vivid one that I recollect is once when I was working on a water heater. I had an iron pipe I was using as an extension for a breaker bar (replacing the anode). I laid it on top of the tank, it rolled off and as I tried to catch it, low, in a bent arm position, I couldn’t.

Orthopedic doc gave me cortisone, OT, exercise. Nothing worked. Went to arm specialist, did nerve tests, MRI’s X-rays, everything. Negative, everything negative. This went on for about a year. Then, the specialist said he suspected Radial Nerve Entrapment but wasn’t sure. He saw/heard (my recollection is fuzzy on this) some cases in the past, didn’t really have a test for it, but was pretty sure. The only way to know was to cut. It was definately exploratory, but he had high confidence on it and I was ready for anything.

I now have a 4" scar on the underside of my forearm from the elbow down and NO pain. The nerve was being compressed by the muscle, it is sandwiched between two muscles at that point. See picture at right in link.

http://en.wikipedia.org/wiki/Posterior_interosseous_nerve

This is apparently a tough diagnosis. Good luck.

3

Thanks, luvrbcs.
Sounds very similar to what I’m going through, except I’m only four months post injury, and three months into therapy. At some level, it’s nice to hear someone talk about the same type of problem, similar descriptions and symptoms.

Can you write a little about your rehab after surgery? I hope I don’t end up there, but the doctor has broached the subject already. I can tell my therapist isn’t any happier with my progress than I am, which makes me worry we’re going down the wrong path.

4

Rehab was nothing to it, just wound care and then therapy, same therapy as earlier. Really, nothing to write about.

With my problem, surgery was the only option, nothing else would have freed up the nerve.

Good luck, I know what you are going through and wish you well.

5

I don’t know what to tell you, but I have had issues with ulnar and median nerve compression with symptoms like numbness in my hands. Mostly ulnar nerve, but occasionally the median nerve too.

I have overpriced, high deductible insurance. But I’ve seen a physical therapist, orthopedist, a few general practitioners, some chiropractors and an ergonomics expert. Nobody has correct/useful advice. They keep saying ‘cubital tunnel syndrome’, which isn’t it because it doesn’t match my symptoms.

After experimenting, I think my anterior scalenes in my neck may be the problem. I started stretching them daily about 2 weeks ago and the numbness has gotten a lot better.

The point is that, the cause of your issue could be further up your arm. For me I think the issues in my hands are occurring due to tight muscles in my neck. If the scalene stretches keep improving my condition I will do that. But if not I will try to find a decent orthopedist to work with.