Explanation of Diagnosis

Radial Tunnel Syndrome occurs when the radial nerve is compressed as it passes through the radial tunnel in the forearm, leading to pain, weakness, and discomfort along the outside of the elbow and forearm. Unlike tennis elbow (lateral epicondylitis), this condition does not cause swelling and is more related to nerve irritation than tendon damage. Symptoms may worsen with repetitive gripping, twisting motions, or wrist extension.

Specific Work Modifications

• Avoid repetitive gripping, twisting, or forceful wrist extension (e.g., turning screwdrivers, typing, or using tools).
• Modify tasks by using ergonomic tools and wrist supports.
• Take frequent breaks to rest the arm and prevent nerve irritation.
• Use a forearm strap or brace to reduce nerve compression.
• Adjust workstation to reduce repetitive forearm strain (e.g., ergonomic keyboard and mouse).

Specific Activity Modifications

• Avoid repetitive wrist extension, gripping, or twisting movements (e.g., tennis, golf, weightlifting, or playing an instrument).
• Modify workouts by reducing wrist-heavy movements and focusing on lower body or core strength.
• Use a brace or compression sleeve for support during activities.
• Gradually reintroduce activities once pain decreases, focusing on proper form.

Recommended Supplements

• Vitamin B6 (50-100 mg daily) – Supports nerve health and function.
• Alpha-lipoic acid (600 mg daily) – May help with nerve regeneration.
• Magnesium (300-400 mg daily) – Aids in muscle relaxation and nerve recovery.
• Omega-3 fatty acids (1000 mg daily) – Reduces nerve inflammation.
• Turmeric (500 mg twice daily) – Helps with pain and inflammation.

Recommended Nutrition and Hydration

Diet Recommendations:

• Anti-inflammatory foods: Fatty fish (salmon, sardines), berries, nuts, turmeric, and leafy greens.
• Nerve-supporting foods: Avocados, eggs, dark chocolate, almonds, and whole grains (rich in B vitamins).
• Limit processed foods and excessive sugar, which can increase inflammation.

Hydration Tips:

• Drink at least 2–3 liters of water daily to support nerve and muscle function.
• Avoid excessive caffeine and alcohol, which can dehydrate tissues and slow healing.

Home Exercise Prescription

Perform 2-3 times daily to relieve nerve compression and improve mobility:

1. Radial Nerve Glide (Nerve Flossing)

1. • Extend your arm straight out to the side with your palm facing down.
   • Bend the wrist downward and tilt your head away from the affected arm.
   • Slowly return to the starting position.
   • 10 reps, 2-3 times daily.

2. Wrist Flexor Stretch

1. • Extend the affected arm with the palm up.
   • Use the opposite hand to gently pull fingers back.
   • Hold 20-30 seconds, repeat 3 times.

3. Forearm Supination/Pronation Exercise

1. • Hold a light weight (1-2 lbs) with your elbow bent at 90°.
   • Slowly rotate your palm up and down.
   • 10 reps, 2-3 times daily.

4. Grip Strength Exercise (if pain allows)

1. • Squeeze a soft stress ball for 5 seconds, 10-15 reps, 2 times daily.

5. Isometric Wrist Extension

1. • Place your hand on a table, palm down.
   • Press lightly against the table without moving the wrist.
   • Hold for 5 seconds, 10 reps.

Avoid forceful wrist movements or gripping exercises until symptoms improve.

Helpful Books

1. "Why Do I Hurt? A Patient’s Guide to Overcoming Chronic Pain" – Adriaan Louw
2. "The Pain-Free Program: A Proven Method to Relieve Back, Neck, Shoulder, and Joint Pain" – Anthony Carey

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.