Radial nerve palsy, also known as Saturday night palsy or dropped wrist, is a condition that affects the radial nerve and if damage to this nerve occurs, weakness, numbness and an inability to control the muscles served by this nerve may result. The radial nerve runs from the upper arm to the wrist and fingers. This nerve controls movement and sensation in the arm and hand and extension of the elbow, wrist and fingers.

Baptist Health is known for advanced, superior care in diagnosing and treating radial nerve palsy. Our 24/7 inpatient neurology and neurosurgery services, as well as our outpatient services, Home Health, physical and occupational therapy services are available to help treat people with radial nerve palsy.

You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms of Radial Nerve Palsy

Radial nerve palsy symptoms include:

• Numbness from the triceps down to the fingers
• Problems extending the wrist or fingers
• Pinching and grasping problems
• Weakness or inability to control muscles from the triceps down to the fingers
• Wrist drop (also known as wrist drop wrist syndrome) – when the wrist hangs limply and the patient cannot lift it 

Radial Nerve Palsy Diagnosis

To diagnose radial nerve palsy, a physician will perform a physical examination to evaluate radial nerve pain, weakness, numbness and other symptoms in the arm, hand and dropped wrist.

We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition.

Tests & Exams for Radial Nerve Pain

Diagnostic procedures may include:

Electromyogram (EMG): This test measures the electrical activity of a muscle in response to stimulation, as well as the nature and speed of the conduction of electrical impulses along a nerve. It can confirm the presence of nerve damage and assess its severity.

Imaging studies: The physician may order an X-ray, ultrasound or MRI to check for broken bones, cysts and other masses in the arm.

Nerve conduction studies: These tests measure how well individual nerves can send an electrical signal from the spinal cord to the muscles. A physician places a shock-emitting electrode directly over the nerve to be studied, and a recording electrode over the muscles supplied by that nerve. The shock-emitting electrode sends repeated, brief electrical pulses to the nerve, and the recording electrode records the time it takes for the muscle to contract in response to the electrical pulse

Radial Nerve Palsy Causes

Radial nerve palsy can be caused by pressure injuries caused by awkward body positions for long periods of time, such as while working or sleeping; bruises that put pressure on the radial nerve; growths such as tumors or cysts; and devices such as tight watches pressing on the wrist or crutches pressing under the arm.

Fractures or dislocations as well as cuts on the wrist or arm can also damage or separate the radial nerve. In rare cases, radial nerve palsy is caused by infection or inflammation.

Most of these causes cannot be controlled by behavior or lifestyle changes. However, proper ergonomics and posture at work and pillows to correct awkward sleeping positions may help.

Risk Factors

Risk factors that may contribute to radial nerve palsy include:

Gender: Radial nerve palsy is more common in men than women.

Occupational risks: Jobs that require repetitive motion and awkward postures or working positions may increase the risk of radial nerve palsy.

Other injuries: Broken bones, joint dislocations, significant bruises and injuries requiring the use of crutches can increase a person’s risk for radial nerve palsy.

Prevention

Most cases of radial nerve palsy cannot be prevented, but proper ergonomics and work postures and pillows to correct awkward sleeping positions may help.

Radial Nerve Palsy Prognosis and Treatment

This condition may go away over time as accompanying injuries heal, cysts or tumors are removed, or awkward postures are corrected. But, some people may always experience varying degrees of radial nerve palsy.

Treatment and Recovery

Treatment for radial nerve palsy varies between individuals. Some people may experience a complete resolution of symptoms over time, while other people may have more lingering symptoms.

Treatment of radial nerve palsy may include:

Medication

Your physician may recommend prescription or over-the-counter medication to decrease pain associated with radial nerve palsy.

Physical Therapy

Your physician or physical therapist may prescribe exercises to strengthen your muscles and increase your range of motion.

Splint or Cast

A splint or cast can support the wrist and hand while the radial nerve heals.

Radial Nerve Surgery

In certain cases, your physician may recommend surgery to remove a cyst, tumor or broken bone pressing on the nerve or repair the nerve itself.

Transcutaneous Electrical Nerve Stimulation (TENS)

This therapy applies a gentle electric current to the muscles and may help reduce pain.

Recovery

Recovery time depends on what type of injury, the severity of the injury, and how quickly the injury is treated. Recovery time can vary significantly between individuals and ranges anywhere from days to weeks, months, or even years for some people. Determining the underlying cause is critical for the recovery process. In some cases, the nerve damage can become permanent if not treated in an appropriate time frame.

Complications

Many patients with radial nerve palsy will see complete recovery or symptom relief after treatment. In some cases, complications may occur, including:

Partial or complete loss of feeling in the hand: If the radial nerve doesn’t heal completely, numbness may be permanent.

Partial or complete loss of wrist or hand movement: If the radial nerve doesn’t heal completely, weakness may be permanent.

Mild-to-severe deformities of the hand: Ongoing radial nerve problems can cause joint and muscle stiffening or muscle atrophy.

Recurrent or unnoticed injuries to the wrist or hand: If the wrist or hand are numb, a person may not notice an injury.

Why Choose Baptist Health for Your Health Care Provider

Baptist Health is committed to providing high-quality, patient-centered care backed by decades of medical expertise. Our team of skilled physicians, advanced practice clinicians, and healthcare professionals offer a wide range of services, from primary care to specialized treatments. With a focus on clinical excellence, compassionate care, and innovation, we strive to meet the diverse needs of our patients and communities.

FAQ

Can you fully recover from radial nerve palsy?

Recovery from radial nerve palsy varies between individuals. Addressing the underlying cause quickly will increase the chances of a better recovery. Some people recover fully, while other people may experience symptoms throughout the rest of their life. Recovery may take days, weeks, months, or even years for some people.

What happens if your radial nerve is damaged?

If your radial nerve is damaged, you may feel numbness, tingling, or burning pain. Some people experience no pain at all. Damage to the radial nerve may cause weakness or difficulty in moving your wrist, hand, or fingers.

How to rehab radial nerve palsy?

There are several methods for rehabilitation of the radial nerve. The most common methods include:

• Stretching and strengthening the muscles of the forearm
• Exercises that help the radial nerve slide through the tunnel at the elbow
• Physical therapy
• Wearing a brace, splint, or cast that stabilizes the wrist and allows the radial nerve to heal
• Pain medication
• Using transcutaneous electrical nerve stimulation (TENS), which applies a gentle electric current to the affected area and may help to reduce pain

What muscles can recover from radial nerve palsy?

• Brachioradialis
• ECRL (extensor carpi radialis longus)
• ECRB (extensor carpi radialis brevis)
• Extensor indicis (last muscle to regain function)