The symptoms described above, as well as signs during the physical examination with your doctor, will determine the diagnosis. There are no clear tests to diagnose radial tunnel syndrome. Electromyography (EMG) and nerve conduction studies (NCS) are often normal in radial tunnel syndrome. These studies can still be useful to rule out other diagnoses. A magnetic resonance image (MRI) might be helpful. This can sometimes identify a reason the nerve is being pinched. It also can identify other muscle, ligament, tendon, bone, artery, or cartilage sources of pain.
Injections around the nerve can be helpful to diagnose and treat the problem. These injections typically include a numbing medication. Temporary pain relief aids the diagnosis. It shows that a medication in the area can decrease the pain. Steroid injections can decrease inflammation in the area in some cases.
Potential treatment options include:Non-Surgical Treatments
- Non-steroidal anti-inflammatory drugs
- Wrist splinting
- Change in activities
- Ice or heat
- Avoiding forearm straps
- Injections of anti-inflammatory medications such as steroids
- Physical therapy
Patients with a suspected diagnosis who fail months or years of nonsurgical treatments are candidates for surgery. There are many surgical techniques to treat radial tunnel syndrome, and there can be significant differences in surgical outcomes. A common way is to make a cut between the forearm muscles to open the space for the nerve to pass through. The surgeon will remove all sites of compression on the nerve. This is an outpatient surgery. Some surgeons will also treat tennis elbow, which can occur at the same time as radial tunnel syndrome, during the surgery. Recovery might take three to six months and benefit from therapy to allow muscles and nerves to recover and prevent scarring. Risks of surgery include general risks of anesthesia, injury to the nerve, persistent pain, scarring, and weakness.
Studies have shown only modest improvements for patients after surgery. About 60-80% of patients have good outcomes with surgery. However, many patients have reported some persistent symptoms.