The radial nerve is a major peripheral nerve extending from the neck down the arm, providing both movement and sensory function to the upper limb. It controls the muscles that straighten, or extend, the elbow, wrist, thumb, and fingers. When this nerve becomes compressed or irritated, nerve tension or entrapment can occur. Specialized movements called “nerve glides” or “nerve flossing” are used to improve the nerve’s mobility and reduce irritation within the surrounding tissues. This approach encourages the nerve to slide freely through its sheath, which can alleviate discomfort and restore normal function.
Understanding Radial Nerve Tension
Radial nerve tension causes symptoms that indicate whether gliding exercises are appropriate. Readers often report pain, numbness, or a tingling sensation running along the back of the arm and forearm, sometimes extending into the back of the hand and the thumb side. This discomfort is often described as a deep ache near the elbow or a sharp, burning pain along the nerve’s distribution.
Common activities that aggravate these symptoms include repetitive wrist extension, gripping, or forearm rotation, such as typing or using a screwdriver. Entrapment can occur from prolonged pressure, such as sleeping in an awkward position or repetitive motions during work or sports. The radial nerve is vulnerable to compression where it passes through the radial tunnel near the elbow, which can lead to radial tunnel syndrome.
Step-by-Step Radial Nerve Glides
Radial nerve glides are controlled movements designed to encourage the nerve to slide smoothly through surrounding structures. A foundational glide begins with the affected arm hanging relaxed at the side, with the shoulder blade gently depressed.
The first step is to tuck the thumb into the palm and make a gentle fist, then flex the wrist so the palm faces upward. Next, slowly rotate the arm inward so the thumb points toward the body, and extend the elbow straight out to the side. This combination creates initial tension. The movement then becomes a gentle, dynamic back-and-forth motion, often using the head to drive the glide.
Progressive Flossing Technique
A progressive technique involves gently tilting the head away from the affected arm to increase tension. This is done while the arm is uncoiled by extending the wrist and rotating the arm outward. The nerve is then “flossed” by returning the head to the center while rotating the arm inward and flexing the wrist again. A simpler “waiter’s tip” variation involves starting with the arm out to the side, palm up, and tilting the head away from the outstretched arm.
Proper Technique and Safety Guidelines
The distinction between a nerve “stretch” and a nerve “glide” is important for safe practice. A glide involves elongating the nerve bed at one end while simultaneously shortening it at the other, causing the nerve to move without excessive tension. The sensation should be a mild, comfortable pull or tension, and never a sharp, painful stretch.
Movements must be performed slowly and with control, often holding the position for only a few seconds before releasing. A recommendation is to perform 5 to 10 repetitions, several times throughout the day. The most important rule is to immediately stop the movement if it causes an increase in symptoms, such as numbness, tingling, or sharp pain. The goal is to promote nerve mobility, not to provoke or irritate the nerve.
When Self-Care Is Not Enough
While nerve glides are effective for managing mild tension, certain symptoms indicate a need for professional medical evaluation. If pain worsens despite consistent exercise or if symptoms do not improve after several weeks, consult a healthcare provider. Increasing weakness in the forearm, wrist, or hand is a warning sign that the compression may be more severe.
The appearance of “wrist drop”—the inability to lift or extend the wrist and fingers—signals a serious loss of motor function due to severe radial nerve compression. If symptoms result from a recent traumatic injury, such as a fall or fracture, immediate medical attention is necessary. A physical therapist, neurologist, or orthopedic specialist can provide an accurate diagnosis and determine if treatment beyond self-care, such as advanced therapy or surgery, is required.