Causes and Treatment of Radial Nerve Injury

The radial nerve runs down the arm to the fingertips. If it’s injured, radial nerve pain usually occurs when your palm is pressed against something and your wrist is bent back.

It is usually sharp, radiating, or burning pain. This usually occurs on the back of the hand, around the thumb, and on the middle and index fingers. Often, the pain is accompanied by an inability to fully straighten the arm or finger.

Along the way to the fingertips, the radial nerve sends messages to the muscles of the arm and hand to trigger movement. It receives sensory information and sends it back to the spinal cord and brain, allowing you to feel sensations. Sensory and motor (motor) symptoms may vary depending on where the nerve damage occurs.

This article discusses the different sites of radial nerve injury and the symptoms that can occur at each site. It also covers how these injuries typically occur, what the prognosis is, and how to treat them.

armpit injury

The radial nerve branches off from the brachial plexus, which is a network of nerves at the root of the neck. It then moves under the arm near the armpit (armpit). Improper use of crutches is a common cause of radial nerve compression at this time.

Symptoms may include the following:

  • You may have arm weakness, especially when you push something away. This is because the radial nerve is responsible for controlling the triceps muscle located at the back of the arm.
  • There may also be an inability to bend the wrist back, resulting in “wrist sagging.”
  • The finger extensor muscles may also weaken, making it difficult to fully open your hand.
  • You may experience tingling and numbness from the back of your arm to your hand. This can also be felt along the sides and back of the thumb.

Walking safely with crutches

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Spiral groove damage

Starting in the armpit, the radial nerve travels down the arm and wraps around the humerus (the large bone between the shoulder and elbow). It’s in a channel called a helical groove. Nerves can be compressed within this groove.

Symptoms of a spinal sulcus injury include:

  • You cannot bend your wrists back and straighten your fingers.
  • you may notice brachioradialis The muscles of the forearm. This muscle helps you flex your elbows and turn your hands so your palms face up.

Fractures of the humerus of the upper arm may result in radial damage in the helical groove. It can also occur in a condition called “Saturday Night Palsy.” This is due to falling asleep with arms draped over the back of the chair.

Posterior interosseous nerve injury

Just before the elbow, part of the radial nerve branches to the back interosseous nerve. This is responsible for straightening the muscles below the elbow.

Unlike other branches of the radial nerve, the posterior interosseous nerve has no sensory receptors and is only responsible for muscle movement. Thus, the injury is characterized by muscle weakness but no abnormal sensations.

Symptoms include:

  • An inability to reach a finger is usually a telltale sign.
  • This nerve injury can be very painful, especially when the finger is stretched.

superficial radial neuropathy

The radial nerve passes through the elbow and continues down to the back of the hand, where it provides purely sensory functions.

At that time, nerves are most vulnerable to injury at the wrist. This can happen when the wrist is bound or the handcuffs are too tight.

Symptoms include:

  • The pattern of numbness from the wrist to the back of the thumb is usually the worst.
  • It may also be accompanied by a “pins and needles” feeling or tingling in the upper or lower back of the hand.

Prognosis and Treatment

When radial nerve injury is diagnosed, treatment is usually conservative and includes:

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  • A wrist splint or brace that provides support to stabilize the wrist and maintain function
  • Pain management with nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or Advil (ibuprofen)
  • Physical therapy helps restore movement through exercise
  • Nerve blocks are performed when the pain is severe. This uses a local anesthetic injected near the nerve to relieve pain.

Recovery time can vary from a few weeks to six months. If your pain and disability do not improve, your healthcare provider may order tests. These can include nerve conduction studies, which test for nerve damage, or electromyography (EMG), which looks at electrical activity in muscles.

If the nerve is: You may need surgery:

  • Trapped, such as radial tunnel syndrome, requiring surgical release
  • being compressed by a growth that needs to be removed, such as a tumor
  • torn, requiring repair or rebuilding. This repair may involve nerve grafting, in which new nerves are added to damaged nerves. It may also involve nerve transfer, in which another nerve is rerouted to the injured nerve.


To treat radial nerve injuries, your doctor may recommend splints or over-the-counter pain relievers. In some cases, you may need physical therapy or nerve blocks, injections to relieve pain. Surgery may be needed if the nerve is caught, torn, or compressed by a growth.


Radial nerve injuries can occur in different parts of the arm and cause different symptoms depending on the location. They can occur in the area from near the armpit (axillary) to around the wrist (superficial radial neuropathy).

Injuries near the armpit can cause arm weakness, especially at the back of the arm. Spinal groove injuries can make it difficult to bend the wrist back or open the hand.

Injury to the posterior interosseous nerve can make it impossible to stretch the fingers. Injuries to the wrist can cause numbness in the thumb or a tingling sensation in the hand.

Treatment for radial nerve injuries may include wrist splints, over-the-counter pain relievers, physical therapy, or surgery. Injuries can take a few weeks or up to six months to heal.

Anatomy of the radial nerve

Frequently Asked Questions

  • What type of healthcare provider treats radial neuralgia?

    Your primary care doctor or neurologist will usually evaluate and treat radial nerve pain. If you need surgery, you will see a hand surgeon.

    A hand surgeon can be an orthopedic surgeon, a neurosurgeon, an orthopedic surgeon, or a general surgeon specializing in hand surgery.

    If your radial nerve is damaged by a fracture, you may be treated by an orthopedic surgeon (orthopaedic specialist). You may also see a physical therapist as part of your treatment.

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  • How long does it take for the nerve to heal after the radial tunnel is released?

    For most people, full recovery after radial tunnel release is expected to take about 6 to 8 months. However, it may take longer if the nerve has been extensively damaged before surgery.

  • Can the injection damage the radial nerve?

    Yes, it is possible to damage the radial nerve with injections – but it is rare. Radial nerve injury has been reported following a number of procedures, including venipuncture and intramuscular injection.

  • Radial neuralgia how to sleep?

    To avoid triggering your radial nerve pain when you try to fall asleep:

    • Do not lie on your injured arm or sleep with your head on your injured arm.
    • Keep your elbows straight or bent less than 90 degrees.
    • If by your side, place a pillow in front of you to support your arm and keep your wrists and fingers flat.
    • Try sleeping on your back with your arms by your sides, possibly with pillow support.

    Also, asking your healthcare provider if wearing a wrist or elbow splint at night may help reduce your pain.