Radial neuropathy

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Radial neuropathy
Illustration of the radial nerve
Synonyms	Radial nerve palsy, Saturday night palsy
Pronounce	N/A
Specialty	N/A
Symptoms	Wrist drop, numbness in the back of the hand and fingers
Complications	Muscle atrophy, chronic pain
Onset	Sudden or gradual
Duration	Varies, can be temporary or permanent
Types	N/A
Causes	Compression, trauma, fracture of the humerus
Risks	Alcohol intoxication, prolonged immobilization, improper use of crutches
Diagnosis	Physical examination, nerve conduction study, electromyography
Differential diagnosis	Cervical radiculopathy, brachial plexopathy, peripheral neuropathy
Prevention	N/A
Treatment	Physical therapy, splinting, surgery
Medication	N/A
Prognosis	Generally good with treatment, but depends on cause and severity
Frequency	Common
Deaths	N/A

Radial neuropathy is a condition characterized by damage to the radial nerve, which can result in symptoms such as weakness, numbness, and difficulty in controlling the muscles of the arm and hand. The radial nerve is one of the major peripheral nerves of the upper limb, originating from the brachial plexus.

Anatomy

Anterior view of the humerus, showing the path of the radial nerve.

The radial nerve arises from the posterior cord of the brachial plexus and contains fibers from the C5 to T1 spinal nerves. It travels down the arm, passing through the radial groove of the humerus, and innervates the posterior compartment of the arm and forearm. The nerve provides motor innervation to the triceps brachii, anconeus, and the extensor muscles of the forearm. It also supplies sensory innervation to the posterior aspect of the arm and forearm, as well as parts of the hand.

Causes

Radial neuropathy can be caused by various factors, including:

• Compression: Prolonged pressure on the radial nerve, often referred to as "Saturday night palsy," can occur when the arm is compressed against a hard surface.
• Fractures: A fracture of the humerus can damage the radial nerve as it runs along the radial groove.
• Entrapment: The nerve can become entrapped in the radial tunnel, leading to pain and weakness.
• Systemic conditions: Diseases such as diabetes mellitus can lead to neuropathy affecting the radial nerve.

Symptoms

Symptoms of radial neuropathy may include:

• Weakness: Difficulty in extending the wrist and fingers, leading to a condition known as "wrist drop."
• Numbness: Loss of sensation in the posterior arm, forearm, and parts of the hand.
• Pain: Discomfort or pain in the affected areas.

Diagnosis

Diagnosis of radial neuropathy involves a combination of clinical examination and diagnostic tests. A thorough neurological examination can reveal characteristic signs such as wrist drop and sensory deficits. Electromyography (EMG) and nerve conduction studies can help localize the site of nerve damage and assess the severity of the neuropathy.

Treatment

Treatment of radial neuropathy depends on the underlying cause. Conservative management includes:

• Rest and immobilization: Avoiding activities that exacerbate symptoms.
• Physical therapy: Exercises to maintain muscle strength and prevent contractures.
• Splinting: Wrist splints can help support the wrist and improve function.

In cases where conservative treatment is ineffective, surgical intervention may be necessary to relieve nerve compression or repair nerve damage.

Prognosis

The prognosis for radial neuropathy varies depending on the cause and severity of the nerve damage. Many patients experience significant improvement with appropriate treatment, although recovery can take several weeks to months.

See also

• Brachial plexus
• Peripheral neuropathy
• Wrist drop

Anatomy of the hand, showing areas affected by radial nerve damage.

External media

{{#ev:youtube|Radial_Nerve_-_Anatomy,_Innervation_&_Distribution_-_Human_Anatomy_Kenhub_1.webm|left|thumb|Video explaining the anatomy and distribution of the radial nerve.}}