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Radial Nerve Palsy

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The radial nerve is a nerve that begins in the neck moving down to the upper arm and runs down to the wrist and fingers. The nerve helps one control the way their triceps in the upper arm moves and controls the backward bending of the wrist. The nerve is also responsible for the movement and feeling in the hand. The radial nerve palsy is the condition affecting the radial nerve.

What is Radial Nerve Palsy?

Imagine you are trying to push something heavy away from yourself. Your wrist bends back and the arms straighten up. These actions are controlled by the radial nerve. Any injury or damage to the radial nerve will result in the inability of wrist to extend and hangs flaccidly. This condition is called as radial nerve palsy or wrist drop.

Symptoms of Radial Nerve Palsy

The muscles of the forearm contract and pull the tendons back. This helps the wrist pull up. If thesenerves, muscles or tendons are damaged or injured, it causes a wrist drop. The symptoms of radial nerve palsy depend on the location of the damaged nerve. These symptoms are left near the thumb, in the pointer, middle fingers and the back of the hand. These signs include:

  • A sharp pain
  • Burning sensation or pain
  • Inability to move the wrist and fingers
  • Problems straightening the arm
  • Wrist hanging flaccidly
  • Weak hand grip

Causes of Radial Nerve Palsy

Radial nerve palsy may occur due to the following conditions:

  • Stab wound to the chest or right under the clavicle
  • Fracture of the humerus
  • Lead poisoning as lead has toxic effects on the radial nerve
  • Injury to the nerve due to prolonged use of crutches or leaning on the elbows for an extended time
  • Long term constriction of the wrist due to tight bracelet, bangle or watch strap

Diagnosing a Radial Nerve Palsy

The doctor will examine the arm, hand and wrist to check for problems straightening the arm at the elbow, problems lifting the wrist or fingers, loss of muscle in the forearm, weakness of the wrist and fingers, wrist drop or finger drop. In order to confirm, diagnostic tests are conducted such as:

  • EMG
  • MRI of the head, neck and shoulder
  • Nerve conduction tests
  • Ultrasound of the elbow

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Treatment for Radial Nerve Palsy

The treatment depends on the underlying cause of the condition. The treatment includes:

  • Prescription pain medications
  • Use of anti-seizure medications
  • Steroid injections
  • Anesthetic creams
  • Use of braces and splints for the wrist
  • hysical therapy to help the muscles strengthen themselves
  • Massage to ease the pain
  • Transcutaneous electrical nerve stimulation for treating nerve damage

In most cases, radial nerve palsy gets better within 3 months of treatment. However, if the condition persists, surgery is the only option to treat wrist drop. The surgery will help relieve pressure on the nerve as well as help improve any loss of sensation or movement. A brace or splint may be placed to heal the wrist after surgery.

Radial nerve palsy can be prevented by avoiding putting extra pressure on the upper arm. Also, avoid sleeping in a cramped position and carrying out repetitive motions. If you cannot point your fingers towards the ceiling with the back of your hand facing the ceiling, then you may have to visit a doctor for further diagnosis.

Written by: Saptakee sengupta
Date last updated: April 05, 2015

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