Radial Tunnel Syndrome

Nerve Compression Conditions Radial Tunnel Syndrome

Radial tunnel syndrome is a rare compression neuropathy of the upper limb. The most common compression neuropathies are carpal tunnel syndrome from a median nerve compression at the wrist and a cubital tunnel from a compression of the ulnar nerve at the elbow.  

The exact causes of Radial Tunnel Syndrome are not always clear. Repetitive motions that involve the forearm, such as extending the wrist, gripping and twisting activities, as well as sustaining pinch positions, are often associated with the development of this condition. It is commonly seen in people who engage in activities like tennis, typing, carpentry, and painting.

The radial tunnel is a theoretical space where the radial nerve crosses over the back of the forearm. It is thought that in this ‘tunnel’ that is comprised of multiple tendons, muscles and ligaments, there can be compression on the radial nerve. The radial nerve is a major nerve that runs down the back of the arm and controls the straightening movements of the wrist, hand, and fingers, as well as providing sensory information to parts of the forearm and hand.

This compression typically results in forearm pain and pain that spreads down to the back of the wrist. This pain can be sharp, aching or burning. There can also be numbness and tingling sensations on the back of the forearm into the hand, as well as weakness in the wrist and hand.

Anatomically, the nerve moves from the back to the front of the forearm and then dives under the supinator muscle, which has a rigid arch. It is thought that the tightness of the muscles and the rigid fibrous arch compress the nerve, resulting in continuous pain. There is also a suggestion that there is a common association between radial tunnel syndrome and lateral epicondylitis or tennis elbow.

There is another condition very similar to radial tunnel syndrome but is less painful, and this is called posterior interosseous nerve (PIN) syndrome. This is the same conceptual problem, with the compression on the distal (lower) part of the radial nerve that forms the posterior intraosseous nerve supplying the muscles that straighten or extend the wrist, fingers, and thumb. In this PIN syndrome, one will also present with weakness of the extensor muscles.


To diagnose Radial Tunnel Syndrome, a thorough evaluation with a comprehensive medical history and physical examination is required. An MRI or ultrasound can help exclude other conditions and confirm the presence of nerve compression.


We will always try to treat radial tunnel syndrome conservatively, usually with a combination of physio, rest (with or without the use of a splint), activity modification and anti-inflammatories or muscle relaxants or even a corticosteroid injection. If the symptoms do not improve or resolve over three to six months, then surgery is likely required. 

A posterior surgical procedure is done where the distal part of the radial nerve is explored, and neurolysis or decompression of the nerve is done, releasing the structures in this anatomical space that are compressing the radial nerve.

Generally, radial tunnel syndrome is treated conservatively, and most patients get better naturally.

Please feel free to consult us if you have any of the above symptoms.


1Can radial tunnel syndrome cause pain?
The radial nerve becomes trapped through the radial tunnel, which can make simple motions painful and difficult to do.
2How will I know I suffer from radial tunnel syndrome?
  1. How will I know I suffer from radial tunnel syndrome?

An individual with radial tunnel syndrome exhibits the following symptoms:

  • Pain in the upper part of the forearm
  • Burning forearm pain
  • Pain when rotating the forearm
3How do you know you’ve damaged the radial nerve?

Severe damage to the radial nerve results in the following:

  • Poor coordination and weakness in the fingers
  • An issue with bending the wrist backwards

Please read the above text for more in-depth information to help answer these questions. It's important to consult with our qualified healthcare professionals to ensure the appropriate diagnosis and treatment plan for your specific situation.