Radial Nerve Palsy

Radial nerve palsy causes the wrist to droop and cannot be lifted

Case Sharing

In mid-June, 31-year-old Mr. Cheung went to see a doctor because his right wrist was drooping and weak, he also was unable to control his hand strength. After waking up early in the morning, the patient found that his wrist was unable to bend, and was weak and drooping, his hand could not be lifted, and the back of his hand felt numb. However, the fingers, upper and lower arms are still strong and there is no pain. The patient did not have any signs of hand or shoulder injuries. It was understood that Mr. Cheung recently changed to a harder pillow and used it for days. He then woke up on the fourth day which resulted in this problem. After doing a detailed nerve reflex and muscle strength examination, he was diagnosed with nerve palsy.

Case Analysis

The radial nerve branches from the C5,6 spinal nerves of the neck through the humerus (inside of the arm) to the hands and fingers to control the hand muscles. For example, when the radial nerve is compressed somewhere in the hand, it will produce radial nerve palsy. The symptoms include drooping wrists, numbness of the back of the hand, and the inability to stretch the wrists and fingers upwards. The reason may be that Mr. Cheung used a harder pillow, which caused compression of the cervical vertebral nerves, or that he was sleeping on his arms for a long time, and the upper arms of the arms could be compressed.

Interestingly, there have been some cases where patients usually sleep on top of their arms  after a night, or sleep on a chair with arm dangling down. In the process, they suffer from radial nerve palsy due to improper compression of their arms. So it is also called “Saturday night Palsy".

Treatment

After muscle strength and nerve reflex tests to find which area is compressed on the radial nerve, and use electrode therapy and ultrasound to relax the muscles and increase blood circulation. In addition to the tests, there will also be an examination to check  whether the positions of cervical vertebrae C5,6 is subluxated, and perform manual correction. After receiving the treatment, the patient was able to lift his wrist the next morning and returned to normal.

Other hand nerve compression

In addition to the radial nerve of the hand, there are other nerves that are also susceptible to compression and produce symptoms, such as Carpal Tunnel Syndrome and Cubital Tunnel Syndrome.

Carpal Tunnel Syndrome

When the Median Nerve passes through the carpal bone and transverse ligament of the wrist, it is compressed by excessive force or strain on the wrist, causing numbness and pain in the palm, thumb, index finger, middle finger and ring finger. In severe cases, the thumb is weak and causes muscle atrophy. Most patients are caused by excessive repetitive wrist movements, such as playing the piano for a long time, playing the computer, using a mouse, etc.

Cubital Tunnel Syndrome

The ulnar nerve forms a tube through the medial malleolus and aponeurosis of the elbow. The ulnar nerve is very close to the surface of the elbow, so it is easily compressed. Symptoms include numbness or needle tingling in the little finger and ring finger, muscle atrophy of the back of the hand and fingers in severe cases, and the little finger and ring finger cannot be extended.