Elbow Radial Tunnel Syndrome


Radial tunnel syndrome is a condition that affects the elbow, causing pain and discomfort in the forearm and hand. This condition is often seen in athletes and people who engage in repetitive motions involving the elbow. Let’s look at the causes and symptoms of radial tunnel syndrome and provide you with various treatment options to help you return to your active lifestyle.


The elbow is a hinge joint formed by the upper arm bone (humerus) and the forearm bones (radius and ulna). The radial nerve runs along the radius and controls the muscles in the forearm and hand. The radial nerve passes through a narrow tunnel, called the radial tunnel, which is formed by muscles, tendons, and other soft tissues.


Radial tunnel syndrome is a relatively uncommon condition that occurs when the radial nerve, which controls the muscles that extend the wrist and fingers, becomes compressed or irritated within the radial tunnel. This tunnel is a narrow passageway near the elbow through which the radial nerve passes. The compression of the nerve can lead to pain, weakness, and discomfort in the forearm, wrist, and hand.

Several factors can contribute to the development of radial tunnel syndrome:

  • Repetitive motions: Prolonged or repetitive use of the forearm, wrist, and fingers can cause the muscles and tendons surrounding the radial nerve to become inflamed or swollen, leading to nerve compression. Occupations or activities that involve forceful, repetitive gripping or twisting movements, such as carpentry, typing, or playing musical instruments, can increase the risk of radial tunnel syndrome.
  • Direct trauma: An injury to the elbow, such as a direct blow or a fracture, can cause swelling, inflammation, or damage to the radial tunnel, leading to nerve compression.
  • Anatomic abnormalities: Some individuals may have structural abnormalities, such as a narrow radial tunnel, ganglion cysts, or irregularly shaped muscles, which can cause the radial nerve to become compressed more easily.
  • Overuse in sports: Athletes who engage in sports that use frequent and forceful elbow movements, such as tennis, baseball, or weightlifting, are at a higher risk of developing radial tunnel syndrome due to the repetitive stress placed on the radial nerve.


Radial tunnel syndrome presents a range of symptoms that can vary in intensity and duration. These symptoms typically result from the compression or irritation of the radial nerve within the radial tunnel near the elbow.

Common symptoms of radial tunnel syndrome include:

  • Dull, aching pain: The outer part of the elbow and forearm may experience a persistent, dull, aching pain. This pain may worsen during activities that require wrist and finger extension or forearm rotation, such as gripping or lifting objects.
  • Tenderness: The radial tunnel area, located just below the elbow on the outer side of the forearm, may be tender to the touch. Pressing on this area may cause pain or discomfort.
  • Weakness or fatigue: Individuals with radial tunnel syndrome may notice a feeling of weakness or fatigue in the forearm and hand, particularly when performing activities that need forceful gripping or twisting motions. This weakness may make it difficult to carry out daily tasks or take part in sports or hobbies involving the affected arm.
  • Numbness or tingling: Some people with radial tunnel syndrome may experience numbness or tingling sensations in the forearm and hand, especially in the thumb and fingers. These sensations may be intermittent or persistent and can be worsened by activities that place stress on the radial nerve.
  • Worsening of pain during specific activities: Activities that involve wrist and finger extension or forearm rotation, such as turning a doorknob, using a screwdriver, or playing certain sports, can worsen the pain of radial tunnel syndrome. This pain may persist even after the activity is done, making it challenging to continue with daily tasks or recreational pursuits.

It is important to note that the symptoms of radial tunnel syndrome can be like those of other conditions, such as tennis elbow or carpal tunnel syndrome. A thorough evaluation by your doctor, including a physical examination and diagnostic tests, may be necessary to accurately diagnose radial tunnel syndrome and develop an appropriate treatment plan.


Diagnosing radial tunnel syndrome can be challenging, as its symptoms often overlap with other conditions, such as tennis elbow or carpal tunnel syndrome. A thorough physical examination and a detailed medical history are essential for accurate diagnosis. Imaging studies, such as X-rays or MRIs (Magnetic Resonance Imaging), and nerve conduction studies may also be performed to rule out other conditions and confirm the diagnosis.

Treatment (Overview)

Treatment options for radial tunnel syndrome depend on the severity of the symptoms and the underlying cause. Both non-surgical and surgical treatments are available and can be tailored to meet each patient’s specific needs.

Non-surgical Treatments

Conservative treatments are often the first line of defense for managing radial tunnel syndrome symptoms. These may include:

  • Activity modification: Avoiding activities that worsen symptoms or cause further nerve compression can help ease pain and promote healing.
  • Rest and ice: Resting the affected arm and applying ice packs can help reduce inflammation and pain.
  • Anti-inflammatory medications: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin), aspirin, or naproxen sodium (Aleve), can help manage pain and inflammation.
  • Physical therapy: A physical therapist can design a personalized program to help improve strength, flexibility, and range of motion in the elbow, forearm, and hand. Techniques such as ultrasound, electrical stimulation, and manual therapy may also be used to reduce pain and promote healing.
  • Bracing or splinting: Wearing a brace or splint can help immobilize the elbow and reduce stress on the radial nerve.
  • Corticosteroid injections: In some cases, corticosteroid injections can help lower pain and inflammation.

Surgical Procedures/Treatments

Surgical intervention may be considered if conservative treatments fail to relieve or worsen symptoms. Surgical options for radial tunnel syndrome include:

  • Radial tunnel release: This procedure involves making an incision in the forearm to release pressure on the radial nerve by cutting the tight structures surrounding it. The surgeon may also remove any scar tissue, cysts, or other obstructions that may be compressing the nerve.
  • Nerve decompression: In some cases, nerve decompression surgery may be performed to relieve pressure on the radial nerve. This involves releasing the tight structures surrounding the nerve or removing any other obstructions, such as scar tissue or cysts.

Prevent Elbow Radial Tunnel Syndrome

To prevent or reduce the risk of developing elbow radial tunnel syndrome, consider the following measures:

  • Maintain proper ergonomics: Ensure your workspace is set up ergonomically to minimize stress on your arms and hands. Adjust the height of your chair, desk, and computer monitor to promote a neutral posture.
  • Avoid overuse: Avoid activities that use repetitive gripping, pinching, or twisting motions, especially if they cause discomfort in your forearm or elbow. Regularly take breaks from activities that involve repetitive motions or place excessive stress on your forearm and elbow. During breaks, stretch and move your arm and hand to reduce tension and promote blood flow. Additionally, gradually increase the intensity and duration of new activities to allow your body to adapt to them.
  • Practice proper techniques: When engaging in activities that involve using your arms, such as sports or manual labor, use proper techniques to reduce strain on your elbow and forearm muscles.
  • Strengthen your muscles: Engage in regular exercises to strengthen your forearm and upper arm muscles. This can help provide better support to the elbow joint and reduce the risk of overuse injuries.
  • Stretch regularly: Incorporate stretching exercises for your forearm, wrist, and elbow into your daily routine to maintain flexibility and reduce muscle tightness.
  • Use protective gear: When participating in sports or activities that can cause direct impact to the elbow, wear appropriate protective gear, such as elbow pads, to reduce the risk of injury. Choose tools and equipment designed to reduce strain on your forearm and elbow, such as those with padded handles or ergonomic grips. Use both hands when lifting or carrying heavy objects.
  • Consult with a professional: If you have concerns about activities that may contribute to radial tunnel syndrome, consult with your doctor, physical therapist, or sports coach for guidance on prevention strategies.

By following these preventive measures, you can reduce the risk of developing radial tunnel syndrome and maintain the overall health of your elbow and arm.

Next Steps

If you suspect you may have radial tunnel syndrome, please find help as soon as possible. The trusted experts at Dr. Peter Howard, M.D., can give you the help you need. Reach out today to set up an appointment.