It’s not easy to diagnose a pinched radial nerve, primarily because it presents just like tennis elbow, an inflammation of the tendons that attach the forearm muscles to the elbow. The causes are also similar, namely a repetitive motion twisting the elbow or stressful gripping or turning with the hand. A blow to the outside of the elbow can also cause a radial nerve injury. Remedies range from simple exercise to surgery for extreme cases.
Analgesics are any class of drug that relieves pain. To lessen the pain associated with a pinched radial nerve, any over-the-counter pain medication will do, but to help reduce swelling in the radial tunnel that is causing the compression, a non-steroidal anti-inflammatory (NSAID) like ibuprofen is recommended.
There is debate about whether ice or heat is best for radial nerve injury. Ice reduces swelling, but heat relaxes and expands muscle tissue. Immediately following the onset of symptoms, ice is the better alternative. The radial nerve is trapped somewhere in the radial tunnel causing pain.
It’s impossible to tell what’s causing the compression without expensive medical scans, but it is most likely from a slightly torn tendon or muscle fiber that has become swollen as a result. When muscle fibers tear, the capillaries that serve the muscle with blood also rupture, flooding the area with blood and other fluid, which in turn causes localized swelling.
Ice reduces swelling and constricts blood flow in the broken capillaries. A handy acronym to remember is RICE, or "rest," "ice," "compression," "elevation," according to medical author William C. Shiel Jr., MD, FACP, FACR, who practices rheumatology in south Orange County, California.
Rest is the best medicine. Try to identify what caused the problem, be it a work or recreational activity, and avoid that activity until the symptoms lessen. Immobilize the elbow as best you can with an Ace bandage or even a forearm splint from the drugstore. It may not completely restrict movement, but it will serve as a reminder to treat your elbow gingerly. Analgesics, even over-the-counter doses, can lessen the pain enough that you could forget about the problem and worsen the injury.
Self-directed nerve gliding exercises can help loosen a compressed area in the radial tunnel and pull the nerve free of obstruction. It’s better not to tax the elbow with rehabilitative exercises until you’ve given the joint plenty of rest.
Using home remedies makes you the judge of your progress, so if you can go through the day with just minimal pain without the aid of NSAIDs, it could be time to start stretching the area, according to orthopedist Nathan Wei, MD, FACP, FACR. Dr. Wei, a rheumatologist and director of the Arthritis and Osteoporosis Center of Maryland, suggests using basic, low-impact gliding exercises.
Drop your arms to your sides with the palms facing behind you. Gently lower the shoulder on the affected arm. Don’t lean, just reach down with your hand and let the shoulder drop. Slowly bend the wrist until your palm is facing upward, fingers pointing behind you. Increase the stretch if you are ready by tilting the head in the opposite direction, bringing the opposite ear closer to the opposite elbow. Return to the neutral position and repeat the exercise 10 times per set with rest in between.