WHAT YOU SHOULD KNOW
The muscle portion of the radial nerve passes the outside of the elbow and runs down the forearm. There is a thick band in the forearm muscle that can put pressure on the nerve. This is worse in patients who use those muscles frequently and when the muscle has become tight. See also Elbow Tendinopathy.
MEDICAL HISTORY
Sharp pain at the side of the elbow and aching pain in the forearm are the main symptoms that are usually made worse by gripping or trying to lift anything. When advanced, it can even be difficult to straighten the elbow.
EXAMINATION
The outside of the elbow and the upper forearm are tender to applied pressure. Cocking the wrist or fingers back against resistance is painful. Stretching the muscle or straightening the elbow can be difficult.
ADDITIONAL TESTS
None are needed. Electrical nerve tests will routinely be normal in this form of muscular nerve compression as opposed to carpal tunnel and cubital tunnel syndromes.
TREATMENT OPTIONS
| NON-OPERATIVE | SURGICAL RELEASE | |
| CONSISTS OF | Stretching, muscle conditioning and ergonomic training | Stretching, muscle conditioning and ergonomic training |
| FEATURES | Makes the muscle group more elastic with less pressure on nerve | Short incision, outpatient, immediate use for light activities |
| ADVANTAGES | Avoids surgery | Definitive solution to problem |
| DISADVANTAGES | Only works on muscle tissue, if band is too thick will not be successful | Temporary period of weakness where arm cannot be used for heavy activity |
RECOVERY
Light everyday activities are allowed immediately. Sutures are removed in the office at 2 weeks. Rehabilitation begins soon after surgery with the same stretching exercises done during the non-operative treatment program. Strengthening comes next along with endurance as the patient prepares to return to heavy activities. Powerful use of the arm doesn’t usually occur until several months after surgery as the healing tissues become more mature.
