Diagnosing Arm Pain: When Nerve Compression Mimics Tendon Injury
Persistent arm pain that doesn’t respond to standard treatments often frustrates both patients and healthcare providers. Many people suffering from arm pain receive diagnoses of tendonitis or repetitive strain injuries, yet their symptoms fail to improve despite rest, physical therapy, and anti-inflammatory medications. The culprit in many of these cases is nerve compression at sites that are frequently overlooked during initial evaluations. At Macomb Hand Surgery with offices in both Macomb & Oakland County, board-certified hand surgeon Dr. Uzma Rehman specializes in identifying nerve entrapment conditions that masquerade as tendon injuries, providing accurate diagnoses that lead to effective treatment.
Understanding the difference between nerve compression and tendon injury helps patients advocate for appropriate evaluation when standard treatments fail. While both conditions cause arm pain, they require fundamentally different treatment approaches, making accurate diagnosis essential for resolution.
Why Nerve Compression Is Often Misdiagnosed as Tendonitis
Nerve compression and tendon injuries share many overlapping symptoms, including arm pain, weakness, and difficulty with certain movements. Both conditions can develop from repetitive activities, and both may worsen with use and improve with rest. This symptom overlap leads many healthcare providers to assume tendonitis when nerve compression is actually responsible. According to research in orthopedic journals, nerve entrapment syndromes are frequently misdiagnosed, with some patients suffering for months or years before receiving correct diagnoses.
The arm contains multiple nerves traveling through anatomical tunnels and tight spaces where compression can occur. Unlike carpal tunnel syndrome, which most people recognize, other nerve entrapment sites remain relatively unknown to the general public and even some healthcare providers. An arm pain specialist with expertise in peripheral nerve conditions recognizes the subtle distinctions that differentiate nerve compression from tendon pathology.
Board-certified hand surgeon Dr. Uzma Rehman with offices in both Macomb & Oakland County has extensive training in diagnosing nerve compression syndromes that other providers may miss.
Radial Tunnel Syndrome and Arm Pain
Radial tunnel syndrome occurs when the radial nerve becomes compressed as it passes through a tunnel formed by muscles and bones in the forearm, just below the elbow. The condition causes arm pain on the outer forearm that closely mimics lateral epicondylitis, commonly called tennis elbow. Many patients diagnosed with resistant tennis elbow actually have radial tunnel syndrome, explaining why their symptoms don’t respond to treatments targeting tendon inflammation.
Key differences help arm pain specialists distinguish radial tunnel syndrome from tennis elbow. Radial tunnel pain typically occurs slightly lower on the forearm than tennis elbow pain and worsens with specific movements that stretch or compress the radial nerve. Patients may experience weakness in wrist or finger extension and sometimes report symptoms extending into the hand.
At Macomb Hand Surgery with offices in both Macomb & Oakland County, Dr. Uzma Rehman performs detailed examinations that identify radial tunnel syndrome and differentiate it from tendon conditions requiring different treatment approaches.
Cubital Tunnel Syndrome Causing Arm Pain
Cubital tunnel syndrome involves compression of the ulnar nerve at the elbow, where it passes through a bony channel on the inner side of the joint. This condition causes arm pain along the inner elbow and forearm, often accompanied by numbness and tingling in the ring and small fingers. Patients frequently notice symptoms worsening when the elbow remains bent, such as during sleep or while holding a phone.
The ulnar nerve’s superficial position at the elbow makes it vulnerable to compression from leaning on hard surfaces, repetitive elbow bending, or anatomical variations that narrow the cubital tunnel. According to the American Academy of Orthopaedic Surgeons, cubital tunnel syndrome is the second most common nerve compression syndrome after carpal tunnel, yet many patients go undiagnosed because symptoms are attributed to other causes.
Board-certified hand surgeon and and arm pain specialist Dr. Uzma Rehman with offices in both Macomb & Oakland County diagnoses cubital tunnel syndrome through careful clinical examination and nerve conduction studies that confirm ulnar nerve dysfunction.
Pronator Syndrome and Forearm Pain
Pronator syndrome occurs when the median nerve becomes compressed in the forearm as it passes through or near the pronator teres muscle. Unlike carpal tunnel syndrome, which compresses the same nerve at the wrist, pronator syndrome causes arm pain in the forearm along with numbness in the thumb, index, and middle fingers. The condition often develops in people who perform repetitive gripping and twisting motions.
Distinguishing pronator syndrome from carpal tunnel syndrome requires expertise, as both conditions affect the median nerve and produce overlapping symptoms. However, pronator syndrome causes forearm aching that carpal tunnel typically doesn’t, and symptoms may worsen with specific forearm rotation movements. An arm pain specialist considers both conditions when evaluating patients with median nerve symptoms.
At Macomb Hand Surgery with offices in both Macomb & Oakland County, and arm pain specialist Dr. Uzma Rehman differentiates between pronator syndrome and other median nerve compression sites to ensure appropriate treatment targeting the actual compression location.
Getting the Right Diagnosis for Your Arm Pain
Accurate diagnosis of arm pain requires thorough evaluation by a specialist experienced with both tendon injuries and nerve compression syndromes. The diagnostic process includes detailed history taking, physical examination with specific provocative tests for various nerve compression sites, and often electrodiagnostic studies that measure nerve function. These nerve conduction studies and electromyography tests can confirm nerve compression and identify the specific location.
Patients whose arm pain hasn’t responded to treatment for presumed tendonitis should consider evaluation by an arm pain specialist who can assess for nerve compression. Key warning signs suggesting nerve involvement include numbness or tingling, symptoms that follow specific nerve distribution patterns, weakness in muscles supplied by particular nerves, and pain that worsens with positions that stretch or compress nerves.
Board-certified hand surgeon and arm pain specialist Dr. Uzma Rehman with offices in both Macomb & Oakland County provides comprehensive evaluation for patients with unexplained or treatment-resistant arm pain, identifying nerve compression that may have been previously overlooked.
Treatment Options for Nerve Compression
Treatment for nerve compression differs substantially from tendon injury treatment, which is why accurate diagnosis matters so much. Conservative approaches include activity modification to avoid positions that compress the affected nerve, splinting to maintain nerve-friendly positioning especially at night, and physical therapy focusing on nerve gliding exercises rather than tendon rehabilitation.
When conservative measures fail to provide relief, surgical decompression releases the structures compressing the nerve, allowing it to function normally. These procedures have high success rates when performed by experienced surgeons on appropriately selected patients. Recovery involves protecting the surgical site while gradually returning to normal activities as the nerve heals.
Arm Pain Specialist | Oakland County
Arm pain that doesn’t respond to standard tendonitis treatments may actually result from nerve compression at sites that are frequently overlooked during initial evaluations. Conditions like radial tunnel syndrome, cubital tunnel syndrome, and pronator syndrome mimic tendon injuries but require different treatment approaches. Accurate diagnosis by a qualified arm pain specialist opens the path to effective treatment and symptom resolution.
At Macomb Hand Surgery with offices in both Macomb & Oakland County, board-certified hand surgeon and arm pain specialist Dr. Uzma Rehman provides expert evaluation for patients with persistent arm pain, identifying nerve compression syndromes that other providers may miss. If your arm pain hasn’t improved despite treatment, schedule an appointment to discover whether nerve compression might be the true cause of your symptoms.
