Radial neuropathy occurs when there is damage to the radial nerve, which travels down the arm and controls movement of the triceps muscle at the back of the upper arm. It also controls the ability to bend the wrist backward and helps with the movement and sensation of the wrist and hand.
Mononeuropathy means a single nerve is damaged. With mononeuropathy, usually the nerve damage is caused locally. However, body-wide disorders may damage just one nerve.
Improper use of crutches
Broken upper arm bone
Long-term or repeated constriction of the wrist (for example, from wearing a tight watch strap)
Pressure caused by hanging the arm over the back of a chair (for example, falling asleep in that position)
Pressure to the upper arm from arm positions during sleep or coma
Pinching of the nerve during deep sleep, such as when a person is intoxicated
Long-term pressure on the nerve, usually caused by swelling or injury of nearby body structures
In some cases, no cause can be found.
If other nerves are also affected, the health care provider should look for a medical problem that can affect nerves. Medical conditions such as diabetes and kidney disease can damage nerves.
The following symptoms may occur:
Hand or forearm ("back" of the hand)
"Thumb side" (radial surface) of the hand
Fingers nearest to the thumb (2nd and 3rd fingers)
Difficulty straightening the arm at the elbow
Difficulty bending the hand back at the wrist, or even holding the hand
Numbness, decreased sensation, tingling, or burning sensation
Signs and tests
The doctor or nurse will examine you and ask questions about your symptoms and medical history. You will be asked what you were doing before the pain started.
The goal of treatment is to allow you to use the hand and arm as much as possible. Your doctor or nurse should find and treat the cause, if possible. In some cases, no treatment is needed and you will recover slowly on your own.
Surgery to repair the nerve or remove something that is pressing on the nerve may help.
Medical causes such as diabetes and kidney disease should be treated.
Anticonvulsant medicines (phenytoin, carbamazepine, gabapentin, and pregabalin) or tricyclic antidepressants (amitriptyline) to reduce stabbing pain
Steroid (prednisone) injections around the nerve to reduce swelling may help some patients.
Other treatments include:
Braces, splints, or other devices to help you use the hand in severe cases
Physical therapy to help maintain muscle strength
Occupational therapy and vocational therapy or counseling to suggest changes at the worksite may be needed.
If the cause of the nerve dysfunction can be found and successfully treated, there is a good chance that you will fully recover. In some cases, there may be partial or complete loss of movement or sensation.
Nerve pain may be uncomfortable and may last for a long period of time. If this occurs, see a pain specialist to ensure you have access to all pain treatment options.
Mild to severe deformity of the hand
Partial or complete loss of feeling in the hand
Partial or complete loss of wrist or hand movement
Recurrent or unnoticed injury to the hand
Calling your health care provider
Call your health care provider if you have had an injury to the arm, and you develop numbness, tingling, or weakness.
Luc Jasmin, MD, PhD, Department of Neurosurgery at Cedars-Sinai Medical Center, Los Angeles, and Department of Anatomy at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.