What is radial nerve palsy?

The radial nerve is one of the three main nerves in the arm. It travels from the armpit down the back of the arm to the hand. It provides sensation over the back of the wrist and hand, as well as movement and strength over the elbow, wrist and fingers (i.e. straightening of the elbow and fingers, backward bending movement of the wrist). Radial nerve palsy is a condition that involves pressure, stretching or damage of the radial nerve, resulting in numbness or tingling and/or weakness in the elbow, wrist and hand.

There are several causes for radial nerve palsy, including:

  • Long-term pressure on the nerve (e.g. sleeping with the upper arm in an awkward position, improper use of crutches).
  • Direct injury to the nerve (e.g. traumatic injury, sustaining a fracture in the upper arm close to the nerve).
  • Nerve compression caused by swelling or injury or nearby body structures.
  • Medical illness that causes nerve damage.

How do I know if I have radial nerve palsy?

Signs and symptoms of radial nerve palsy may include:

  • Numbness, tingling and/or pain over the back of the wrist and hand.
  • Difficulty or weakness in straightening the elbow.
  • Difficulty or weakness in lifting the wrist and bending it backwards and/or straightening of the thumb and fingers.
  • Loss of strength and dexterity over the fingers, making it difficult to grasp and manipulate objects.

How is radial nerve palsy diagnosed?

Your specialist Doctor will obtain your health history and perform a physical examination. Your Doctor may also order medical diagnostic tests (e.g. nerve conduction studies, electromyography studies, ultrasound scans, MRI scans) to help with the diagnosis.

How is radial nerve palsy treated?

It is important to seek early treatment for radial nerve palsy to prevent permanent damage to the nerve and corresponding muscles of the elbow, wrist and hand. Treatment options for radial nerve palsy depend on the severity and duration of the disease and include both surgical and non-surgical interventions.

Hand Therapy

Your specialist Doctor may refer you to our Hand Therapist, who will be able to provide the following services:

  • Advice and education pertaining to your condition
  • Wax therapy
  • Ultrasound therapy
  • Advice on lifestyle and activity modifications so as to eliminate or minimise daily activities or or upper limb postures which may further aggravate the condition
  • Provide a customised wrist splint to help support the wrist in a position that is bent slightly backwards so that you are able to use your hand functionally to perform your daily activities
  • Nerve and tendon gliding exercises to help the radial nerve move better
  • Appropriate exercises to improve elbow, wrist and hand movements
  • Neuromuscular electrical stimulation (NMES)
  • Personalised home exercise program

Non-surgical Treatment

Your Doctor may suggest other non-surgical interventions such as oral medications (e.g. anti-inflammatory drugs, vitamin B supplements) to help reduce any existing inflammation and improve nerve function.

Surgical Treatment

Surgical interventions may be recommended in the following situations:

  • The symptoms of radial nerve palsy do not improve over time with non-surgical interventions.
  • Radial nerve palsy has been persistent for prolonged periods of time (i.e. more than six months) and/or has been diagnosed to be severe in nature.
  • The muscles of the hand, wrist and elbow that are controlled by the radial nerve show signs of wasting and hand weakness becomes more pronounced.

Recovery from radial nerve surgery can take anywhere from several weeks to several months. Hand therapy is often required after surgery to help regain the movement, strength and function of the affected hand, wrist and elbow.