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radial nerve injury

Alternative Names 
radial nerve trauma, radial nerve damage

A radial nerve injury involves damage to the radial nerve, which allows sensation and movement in part of the arm. The radial nerve attaches to the skin and muscles of certain areas of the arm, forearm, and hand. It is responsible for muscle movement and sensation in these areas. Someone with an injury to the radial nerve lose function in these areas.

In most cases, the radial nerve is damaged by trauma, repeated use of the nerve, or by the nerve being compressed by other structures. The injury may be permanent.

What are the signs and symptoms of the injury? 
Symptoms of a radial nerve injury depend on where the nerve injury occurs, but may include:
  • numbness or tingling of the skin on the back of the arm, forearm, and hand
  • pain in the same areas as the numbness or tingling
  • muscle weakness, which usually affects the ability to straighten the elbow, wrist, and fingers
  • muscle shrinkage or wasting, which takes a long time to develop
  • deformities in the hand or forearm, usually due to muscle wasting
Symptoms may also result from the injury that caused the nerve damage.

What are the causes and risks of the injury? 
Radial nerve injury can be caused by a number of activities, including:
  • the improper use of crutches, usually when a person rests his or her weight on the armpits rather than the hands
  • hanging the arms over the back of a chair for too long or lying on an arm for too long. This is sometimes called "Saturday night palsy," because it often happens in those who are very drunk or intoxicated.
  • a bone fracture involving the upper arm bone, or humerus
Rarely, no cause can be found for the nerve damage. In these cases, the injury may come from certain repeated motions of the arm, known as a repetitive stress injury.

A radial nerve injury may be permanent, causing lifelong weakness and numbness, and sometimes chronic pain. In some people, the muscles can shrink and cause the arm to become deformed over time. In other people, some or all of the arm's function may be regained over time.

What can be done to prevent the injury? 
Most cases of radial nerve injury cannot be prevented. Avoiding injury, overuse of the arm, and improper use of crutches can prevent some cases.

How is the injury recognised? 
A radial nerve injury can often be diagnosed with a history and physical examination. Tests may be ordered to help figure out the cause of the nerve injury. An x-ray of the arm is commonly done to look for a break or other bone injury. A test called a nerve conduction velocity (NCV) study may be done to determine the location of the nerve injury. This test involves attaching wires to the skin. Small shocks are used to stimulate the nerve and measure its function.

Blood tests or a nerve biopsy are sometimes needed in unusual cases. A biopsy is a procedure to remove a small piece of tissue from the body. A special tool or needle can be inserted through the skin and into the nerve. A small piece of the nerve can be removed with the tool. The piece can then be sent to the laboratory for further examination and testing.

What are the treatments for the injury? 
When the radial nerve injury is caused by a broken bone, fixing the bone may reverse the nerve injury or make it better. This may involve surgery or the use of a cast. Other treatments may include:
  • analgesics, such as aspirin
  • other medications to help with nerve pain, such as amitriptyline or valproate
  • physiotherapy to help improve arm use and strength
  • occupational therapy to help the person improve his or her ability to perform daily activities
What are the side effects of the treatments? 
Surgery may cause bleeding, infection, or allergic reaction to anaesthesia. Aspirin and other analgesics may cause stomach upset, allergic reactions, or kidney damage. Other side effects depend on the specific medication used.

What happens after treatment for the injury? 
Treatment for a radial nerve injury may or may not be able to reverse the lost function in the person's arm. Someone who does not recover fully often benefits from long-term physiotherapy and occupational therapy. Deformity of the hand and muscle shrinkage can occur in severe cases. Some people may recover completely and need no further treatment.

The doctor can help people monitor the injury by measuring the strength and sensation in the affected areas. Some of the medications used to treat pain may also need monitoring, which can include blood tests. Any new or worsening symptoms should be reported to the doctor.

Author: James Broomfield, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 10/05/2005
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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