Handcuff injury
what is it?
Wartenberg's Syndrome is described as the entrapment of the superficial branch of the Radial nerve at the wrist on the thumb side. 
Symptoms are sensory only meaning there is no motor involvement affecting muscle strength. Typically the patient reports pain over the thumb side of the forearm and paresthesia (pins and needles and numbness) over the back of the hand. 

It is sometimes referred to as Hand Cuff syndrome because tight objects, including watches and bracelets, around the wrist will press the nerve against the Radius bone underneath it. 

Less common causes include repetitive movements of the forearm muscles that alternate between palm the side up and palm side down, like turning a key. In this case there is no immediate compression on the nerve but friction from muscles contracting repeatedly can irritate the nerve.
Handcuff injury
Causes and symptoms

Wartenberg’s Syndrome is caused by external pressure onto the Dorsal (sensory) branch of the Radial Nerve as it enters the wrist. Here are some reasons known to cause this type of compression:
  • Performing tasks that require repetitive wrist motion and tight grips 
  • Wearing tight wrist jewellery such as watches and bracelets or bands
  • Previous injury or fractures or scar at the wrist
  • Ganglion pressing on the nerve

  • Pain following the radial nerve distribution down the forearm and into the hand into the 1st web space of the thumb
  • Numbness along the radial side of the forearm along the nerve distribution
  • Pain may be burning, aching and radiating into the 1st web space
  • Pain when rolling the hand to have the palm side facing down as it stretches the nerve
  • Symptoms are aggravated by rapid, repetitive wrist movements
  • No motor symptoms but grip may feel weak secondary to pain
Handcuff injury
Treatment at Hand Kinetics
Treatment is aimed at reducing pressure on the nerve from external aggravating factors. This could be as simple as asking you to remove watches or bands from around your wrist.

Once these things have been removed, the nerve has room to heal. However, healing can be slowed by performing certain wrist actions which make the internal muscles slide repeatedly across the nerve continuing to irritate it. 

An activity analysis will help to pinpoint the muscle actions which may be causing a pinch on the nerve especially when external factors, such as wearing a watch, do not apply to you.

The irritated nerve often benefits from gentle massage of the forearm muscles and Kinesio taping for space correction.

Gentle radial nerve gliding exercises and in some cases desensitisation to various touch stimulus can also help.

Wearing a resting wrist support/splint made at Hand Kinetics to prevent the wrist from rotating to end range is also very beneficial as it will prevent over stretching the nerve and prevent the muscles from pinching it.

Hand Kinetics Telephone: 0044 28 417 72301



Find us on FaceBook