Wartenberg’s Syndrome: Radial Nerve Entrapment at the Wrist
Wartenberg’s syndrome (cheiralgia paresthetica) causes tingling, burning or numbness over the back and side of your hand. Early recognition and straightforward treatments help you return to daily activities with confidence.
Definition and Overview
Wartenberg’s syndrome occurs when the superficial branch of the radial nerve is trapped near the wrist or forearm. It affects sensation only—there is no muscle weakness. Symptoms typically include tingling, burning or numbness over the thumb side of the back of your hand and in the web space between thumb and forefinger.
Causes and Risk Factors
Entrapment most often follows:
- Repetitive wrist rotation (for example, turning a screwdriver or frequent pronation/supination)
- Prolonged pressure from tight watches, wristbands or handcuffs
- Direct injury such as a wrist fracture or surgery in the area
- Rare anatomical variations where the nerve passes beneath a split tendon
Anyone can develop Wartenberg’s syndrome, but it is more common in women and usually affects adults aged 20–70.
Signs and Symptoms
- Burning, aching or shooting pain over the radial (thumb-side) wrist and back of the hand
- Tingling or numbness in the thumb, index and middle fingers
- Sensitivity to light touch or pressure on the forearm or wrist
- Symptoms worsen with wrist movement or tight straps
Diagnosis
Your specialist will:
- Take a detailed history of your symptoms and activities
- Examine the back and side of your wrist for tenderness and altered sensation
- Perform a Tinel’s test—gently tapping the nerve to reproduce symptoms
- Use nerve conduction studies or ultrasound scans in complex or persistent cases
Treatment Options
Non-Surgical Management
- Rest and modify activities that aggravate symptoms
- Wear a wrist splint or soft brace to limit rotation and reduce pressure
- Take paracetamol or ibuprofen to ease discomfort
- Consider a corticosteroid injection around the nerve if inflammation persists
Surgical Referral
Surgery to release the nerve is uncommon and considered when:
- Symptoms continue despite 3–6 months of conservative care
- Scar tissue or a tight fascial band clearly compresses the nerve
- Daily life and work are significantly disrupted
Preventing Recurrence
- Choose looser wrist straps and avoid tight clothing or handcuffs
- Take regular breaks from repetitive wrist tasks (typing, tool work)
- Perform gentle nerve-gliding exercises as taught by your therapist
- Attend follow-up appointments promptly if symptoms return
Clinical Pearls / Key Points
- Wartenberg’s syndrome affects only sensation—hand strength and movement remain normal.
- Symptoms localise to the dorsoradial hand and thumb web space.
- Simple measures—rest, splints, NSAIDs—usually bring relief within weeks.
- Surgical decompression is reserved for rare, persistent cases.
Patient FAQs
How long before I feel better?
Most people improve within a few weeks to months of rest, splinting and anti-inflammatory treatment.
Will my sensation fully return?
Yes—when managed early, full recovery of feeling is expected, though mild tingling may briefly persist.
Can I keep working or driving?
Yes—maintain a neutral wrist position, use your splint as advised, and take regular breaks to avoid strain.
Call-to-Action
For exercise videos, printable guides and referral to our hand therapy team, visit www.TheArmDoc.co.uk/hand-therapy. To book a consultation with a hand specialist, phone 020 3384 5588 or email Info@TheArmDoc.co.uk.
Evidence & Guidelines
• Based on best practice for peripheral nerve entrapment and guidance from NICE on neuropathies.
Disclaimer
This leaflet provides general information and does not replace personalised advice. Always discuss your concerns and treatment choices with your healthcare team.