Radial Nerve Injury: Causes, Symptoms, Diagnosis, Treatment and Prevention

Radial nerve injury can be brought on by physical trauma, infections, and exposure to toxins. Damage to the radial nerve can cause radial neuropathy, commonly referred to as radial nerve palsy.

The radial nerve runs along the underside of your arm and controls the triceps muscle, which is located at the back of your upper arm. The radial nerve is responsible for wrist and finger elongation. It also controls feeling in a part of the hand.

Numbness and tingling or scorching sensation are common signs of radial injury. Maybe it won't hurt at all. The condition may cause your wrist, hand, or fingers to weaken or become difficult to move. When the underlying cause is treated, this condition frequently gets better.

Causes Of  Radial Nerve Injury

Radial nerve damage can result from a variety of causes. Among them are:

• Fracture of the humerus, the upper arm bone
• Sleeping with your arm in an unusual way
• Bending over a chair
• Falling or being hit by an object
• Chronic wrist constriction

The most common causes of radial nerve injury are accidents at work or in sports, breaking your arm, and overusing your arm. Depending on the extent of the damage, you may experience a complete laceration of the radial nerve. 

When the nerve is severed, this occurs. It could show up with symptoms similar to less severe wounds. A nerve laceration usually requires surgery to treat. Certain actions, if repeated often enough, may cause damage to the radial nerve. Neural damage can develop over time from motions that involve both gripping and swinging, such as swinging a hammer. 

These movements can cause the radial nerve to become pinched, stretched, or imprisoned since it passes over the wrist and forearm bones. Lead poisoning can also result in long-term nerve damage. Over time, the nervous system as a whole could be harmed by lead poisoning.

Certain whole-body medical conditions can cause damage to one nerve. Inflammation, fluid retention, and other symptoms can compress nerves in people with diabetes and kidney disease. The radial nerve and other nerves in your body could be affected by this.

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Symptoms Of Radial Nerve Injury 

Radial nerve injury usually manifests as symptoms in the thumb, index, and middle fingers in addition to the back of the hand.

Possible symptoms include:

• Unusual sensations in your fingers and thumb, as well as severe pain.
• Tingling
• Numbness
• Difficulty straightening your arm. 
• Wrists and fingers get stiff. This is sometimes called "wrist drop" or "finger drop," but it's not always the case.

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Diagnosis Of Radial Nerve Injury 

Initially, your physician will inquire about the nature of your symptoms, when they began, and whether you think you may have injured your radial nerve. This might help identify the cause of the injury.

Your doctor will also perform a physical examination. We'll evaluate your affected arm, hand, and wrist and compare it to its healthy counterpart. They could ask you to rotate and extend your arm to see if the injury affects how much range of motion you have. Your doctor will ask you to extend your wrist and fingers and will also be checking for any indications of weakness or atrophy in your muscles.

Your doctor may recommend tests to rule out other potential causes of your symptoms. Blood tests may be carried out, for example, to evaluate vitamin levels, blood sugar, thyroid, and renal function. 

These tests search for signs of additional conditions such as vitamin deficiencies, diabetes, or issues with the kidneys, liver, or kidneys that are connected to nerve damage. To look for diseases in your neck, head, or shoulders that can pressure your radial nerve, you can also get an MRI or CT scan.

Your doctor might also take into account nerve conduction testing and electromyography (EMG). An electromyography (EMG) measures the electrical activity of your muscles. A nerve conduction test determines the speed at which impulses travel through your nerves. 

These tests can help determine whether the problem you're experiencing is related to a muscle or nerve. They could also show signs of radial nerve damage.

A nerve biopsy may be requested by your doctor in extremely rare cases. A little piece of the nerve must be removed and studied to determine what is causing the injury.

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Treatment Of Radial Nerve Injury 

Treatment for radial nerve injuries aims to preserve wrist and hand movement while also relieving associated symptoms. What is the best method of action depends on the underlying cause. Sometimes symptoms fade away gradually on their own without the need for therapy. Your doctor may prescribe medicine or other therapies to help you manage your symptoms.

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Initial medical care

First-line therapeutic options are abundant.

• Tricyclic antidepressants that are used as analgesics or anti-inflammatory medications, or injections of steroids that are used as antiseizure medications
• Splints, creams, shackles, or patches with anesthetic
• Physical therapy to assist in maintaining and growing muscle strength
• Both massage and acupuncture

Transcutaneous electrical nerve stimulation (TENS) is an option for certain individuals seeking treatment for nerve injury. This therapy involves the application of several adhesive electrodes to the skin surrounding the affected area. At varying rates, the electrodes deliver a mild electric current.

Physical therapy that focuses on maintaining and strengthening muscle mass aids in improving neuron function and regeneration. Receiving massage therapy is an additional choice. The radial nerve can become more responsive and scar tissue can be broken up via massage.

Pain from injury to the radial nerve can be reduced by medication that has analgesic or anti-inflammatory characteristics. Furthermore, it may expedite the wound's recovery. An injection of cortisone in the affected area can alleviate pain after just one. Analgesic patches or lotions that don't impede mobility can also help lessen pain.

Splints and braces are also commonly used to immobilise the nerve. Doing this could prevent you from injuring the nerve again as it recovers, even if it might not seem like the most sensible option.

Online braces and splints can be bought.

Acupuncture and chiropractic adjustments are two more non-traditional therapeutic alternatives available. Always keep in mind that the effectiveness of some of these treatments is supported by contradicting data.

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Surgery

Most people who suffer from such injuries will heal in three months if the radial nerve is not lacerated or ruptured. Surgery is, however, eventually required in certain situations. Your radial nerve may become freed from its entrapment through surgery. If a benign tumor or other mass is growing on your radial nerve, surgery may be necessary to remove it.

Surgical repair aims to restore the integrity of the nerve. When it is thought that the nerve will not heal, tendon transplants may occasionally be utilised to restore function to the affected limb. To allow the wound or tendon transfer to heal, you will need to wear a brace or splint after surgery.  To help you restore strength and range of motion, your doctor will advise you to see a physical therapist.

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Prevention Of Radial Nerve Injury 

If you avoid putting constant pressure on your upper arm, you can prevent most radial nerve injuries. Avoid activities like sleeping in cramped areas, doing repeated jobs, and doing anything else that can aggravate your nerves. If you work in a job that requires repeated motions, take safety measures to protect yourself by taking pauses and switching between tasks that require different actions.

Frequently Asked Questions

1. What are the complications of radial nerves?
   • Chronic pain , muscle atrophy,  persistent injury may lead to loss of Function
2. Muscles  which are not affected in radial injury?
   • Triceps, anconeus, brachialis, extensor carpi radialis longus

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