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24 m a s s a g e & b o d y wo r k m ay/ j u n e 2 0 24 CLINICAL EXPLORATIONS By Whitney Lowe Radial Tunnel Syndrome Spotting the Impersonator Radial tunnel syndrome (RTS) is a perplexing and often misunderstood condition. Because it is not common, it can go unrecognized. Unfortunately, attempts at treating it can worsen the condition if that treatment is not specific to RTS. Like many conditions, this is one in which a greater understanding will improve your clinical decisions and provide your clients with better education and care. RTS can challenge even the most experienced massage therapists. It is frequently mistaken for other conditions, especially lateral epicondylitis (LE), commonly known as tennis elbow. This mistaken identity is why the cornerstone to effective treatment begins with your assessment. Distinguishing this painful condition with symptoms that mimic others is a prerequisite to getting these clients out of pain and back into activities. Let's take an in-depth exploration of RTS. ANATOMICAL OVERVIEW RTS is a nerve compression pathology affecting the radial nerve in the forearm. The radial nerve is one of three main nerve branches that run the entire length of the upper extremities. Compression pathologies of the radial nerve are less common because the radial nerve's path has fewer vulnerable compression locations. However, the nerve is susceptible in the lateral elbow region, where RTS occurs. The other two nerve branches are the ulnar and median nerve branches and have more common pathologies. For example, the median nerve is affected by carpal tunnel syndrome. There are also numerous locations along Two divisions of the supinator muscle. Image courtesy of Complete Anatomy. 1 Two divisions of the supinator TECHNIQUE KEY POINT • Massage and soft-tissue therapy play particularly beneficial roles in treating radial tunnel syndrome. It is essential to address the entire arm comprehensively, so massage treatment should focus on the upper extremity and cervical regions.