Brachioradialis pain causes tightness and pain in the forearm which may extend into the back of your hand, thumb and index finger.
Typically caused by overexertion, brachioradialis muscle pain causes problems with gripping, twisting and lifting movements such as drinking a cup of tea, using a screwdriver or a corkscrew.
The brachioradialis muscle runs down the back of the forearm and works with the biceps to flex (bend) the elbow. Biceps does most of the work when the forearm is supinated (palm facing upwards) but brachioradialis takes the lead when the forearm is pronated (palm facing downwards).
Brachioradialis also helps to twist the forearm and is a key stabiliser of the elbow and wrist.
Brachioradialis pain is often confused with tennis elbow and radial tunnel syndrome but they are each caused by different things and present slightly differently. Let’s find out more.
Brachioradialis runs from the outer side of the humerus, just above the elbow (lateral supracondylar ridge), down the back of the forearm (dorsal aspect) to the bony lump just below the thumb side of the wrist (radial styloid).
Brachioradialis works in a few different ways depending on the position of the arm and hand and what movements are being performed.
The main functions of the brachioradialis muscle are:
Common causes of brachioradialis pain are:
Overloading brachioradialis leads to tearing and inflammation in the muscle fibres and can result in trigger point formation i.e. small knots in the muscle.
Brachioradialis pain is a common cause of lateral elbow pain. The two most common symptoms of brachioradialis pain are forearm pain and tightness, and the affected area may be tender to touch.
Brachioradialis pain may be felt in the elbow (outer side), along the forearm and/or into the back of the hand, thumb and index finger.
There may be a sharp, shooting pain through the forearm at the time of injury or when doing certain activities, and a background ache at rest.
Typical activities that cause pain in the brachioradialis muscle include:
Over time, you may develop weakness in the forearm and may notice your grip strength gradually decreasing with brachioradialis pain.
You doctor can usually diagnose brachioradialis pain. They will start by asking you about your symptoms, how and when they started, your normal daily activities and any sports that you play and your general health.
They will then examine you, looking at the range of motion and strength in your shoulder, elbow, wrist and hand. They will prefer various special tests to check the different structures in and around the elbow and forearm. Pain with resisted elbow flexion in a pronated position usually indicate brachioradialis pain. They may also send you for scans to look for bone and soft tissue damage e.g. x-rays, CT or MRI scans.
Brachioradialis pain is often misdiagnosed as tennis elbow or radial tunnel syndrome, both of which cause outer elbow pain so careful diagnosis is essential. They are all overuse injuries and are aggravated by gripping and twisting movements but there are subtle differences between them.
Pain from tennis elbow is typically centred around the lateral epicondyle on the outer elbow and may travel down the back of the forearm. It is caused by repetitive strain and overuse through the common extensor tendon.
Tennis elbow pain usually presents as an aching or burning sensation. The common extensor tendon is tender to touch and pain is usually worse with twisting and gripping movements. There may be weakness in the forearm and decreased grip strength. Sleep is often affected due to pain. Pain with resisted wrist extension or middle finger extension is indicative of tennis elbow.
Find out more about the common causes, symptoms, diagnosis and treatment options in the Tennis Elbow section.
With radial tunnel syndrome there is a problem with one of the nerves in the forearm rather than a muscle. Radial tunnel syndrome typically causes a nagging ache or burning pain on the outer forearm caused by pressure on the radial nerve.
Pain from radial tunnel syndrome tends to be worse with gripping and twisting movements and is often associated with weakness in the forearm and wrist.
Unlike brachioradialis pain and tennis elbow, radial tunnel syndrome never causes elbow pain – RTS pain is usually felt at least 3cm below the elbow. Pain with resisted supination often indicates radial tunnel syndrome.
You can find out more about the common causes, symptoms, diagnosis & treatment in the Radial Tunnel Syndrome section.
Here's a quick guide to help you tell the difference between brachioradialis pain, tennis elbow and radial tunnel syndrome.
Brachioradialis pain can usually be treated at home with a combination of RICE, medication and exercises:
RICE is the best place to start with any overuse or acute injury and involves a combination of:
rest is a really important part of brachioradialis pain treatment. With acute injuries, you should make sure to protect and rest the arm for the first 48-72 hours to prevent the risk of further injury.
With overuse injuries, it is important to rest from any aggravating activities until the pain starts to subside to give the muscle fibres time to heal and to allow any inflammation to settle. Failure to do so will delay the healing process, much like picking at a scab.
Regularly applying an ice pack to the forearm will help to reduce pain in the brachioradialis muscle and inflammation which in turn helps speed up the healing process.
Wrap some ice cubes or an ice pack in a towel and place them over the affected area of your forearm for 10-15 minutes at a time. Wait at least 2 hours between applications to allow the temperature to normalise – failure to do so can lead to an ice burn or even increased swelling.
The main goal of ice is to cause vasoconstriction – narrowing of the blood vessels to reduce the amount of swelling. If you leave an ice pack on too long, it actually causes the blood vessels to dilate resulting in increased blood flow and inflammation.
Wearing a tubigrip compression bandage can help to reduce swelling and provide support for the forearm if it is feeling weak. Tubigrip should be worn double thickness from the elbow to the hand – simply cut a small hole for your thumb to fit through. Make sure to take the tubigrip off overnight.
Resting with the forearm raised above the level of your heart helps to reduce any swelling in the forearm associated with brachioradialis pain. Make sure your hand is elevated as well – you want any excess fluid to drain towards the arm pit where it can be reabsorbed by the lymphatic system rather than pooling in your hand.
Elevation is usually only necessary when the brachioradialis pain is due to direct trauma to the forearm, rather than overuse, where there may be some bleeding in the soft tissues from the injury.
Cver the counter pain relief e.g. paracetamol/acetaminophen and non-steroidal anti-inflammatories e.g. ibuprofen/Advil can help to manage brachioradialis pain and swelling. Always check with your doctor or pharmacist before starting any medication
Once your brachioradialis pain is starting to settle, you can start working on an exercise program of forearm strengthening and stretching exercises.
Exercises are an important part of brachioradialis pain treatment and isometric Exercises are the best place to start. With isometric exercises, you work on activating the muscle statically. This gets the muscle contracting without shortening or lengthening allowing the muscle to work but without placing any tension through the muscle fibres to reduce the risk of further injury. There are a few different ways to do this isometric brachioradialis exercises:
It is important to keep your wrist and elbow moving with range of motion exercises so they don’t stiffen or tighten up with brachioradialis pain. Think of them as really gentle stretching exercises.
Once you are comfortable doing isometric and range of motion exercises and the pain in your brachioradialis muscle is under control, you can start doing some stretches to regain full flexibility in the muscle. This will help reduce the chance of recurrent problems in the future.
The final stage of rehab with brachioradialis muscle pain is exercises to strengthen the muscle so it can cope with the daily demands you put on it.
You may be used to doing barbell curls with your palms facing upwards, but pronating your forearms makes brachioradialis do a majority of the work rather than your biceps.
Prevention is always better than cure and that goes for brachioradialis pain, so try the following:
Page Last Updated: 11/22/2022
Next Review Due: 11/22/2024