Wrist Drop (Radial Nerve Palsy): Causes, Symptoms, Physiotherapy Treatment & Recovery Guide

Struggling to lift your wrist or extend your fingers? You might be facing wrist drop, a telltale sign of radial nerve palsy—a condition that disrupts hand function and daily independence. 

Often triggered by nerve compression, trauma, or prolonged immobilization, radial nerve injury can lead to weakness, numbness, and difficulty gripping objects. At ReLiva Physiotherapy & Rehab, we specialize in neuro rehabilitation and nerve recovery protocols that restore mobility, strength, and confidence. In this blog, we’ll explore the causes, symptoms, and evidence-based physiotherapy treatments for wrist drop—empowering you with actionable insights and hope for healing.

Understanding Wrist Drop  |  Causes  |  Symptoms  |  Diagnosis  |  Treatment Options  |  Exercises |  Home Care Tips  | Physiotherapy Techniques  |  Recovery Timeline

Understanding Wrist Drop (Radial Nerve Palsy)

Wrist Drop, medically known as Radial Nerve Palsy, is a condition where a person finds it difficult or impossible to lift the wrist or straighten the fingers. This happens when the radial nerve, responsible for controlling the muscles that extend the wrist and fingers, gets injured, stretched or compressed. The hand tends to hang limply from the wrist, giving the characteristic “dropped” appearance.

Early diagnosis and physiotherapy play a major role in preventing stiffness, maintaining muscle strength, and improving recovery outcomes. Wrist drop can develop suddenly after trauma or gradually due to prolonged pressure on the arm. It affects everyday activities such as writing, gripping objects, dressing, or lifting items.

Common Causes of Wrist Drop

Radial nerve runs from the upper arm to the wrist and is responsible for controlling the wrist and finger-extensor muscles. Wrist Drop occurs when this nerve is damaged, compressed, or inflamed along its path to the wrist. This nerve controls several key muscles that allow you to straighten your wrist and fingers. Any interruption in its normal signals while traveling from the brain to the muscles, can lead to weakness or paralysis in the associated movements.

Some of the most common causes of wrist drop are:

1. Traumatic causes due to Injuries

• Humerus fractures—the radial nerve runs in a spiral groove along the upper arm bone in a spiral groove, making it vulnerable during breaks.
• Penetrating or crush injuries to the arm or forearm.
• Dislocation or surgical injury around the elbow or shoulder.

2. Compressive causes

• Prolonged pressure on the arm, e.g. sleeping with the arm over a chair or under the body (“Saturday-night palsy”).
• Tight casts or splints around the upper arm or forearm.
• Improper use of crutches, which can compress the nerve in the armpit (axillary region).

3. Systemic or medical causes: Certain health conditions can damage peripheral nerves over time.

• Diabetic neuropathy — long-term high blood sugar can weaken or injure peripheral nerves.
• Lead poisoning — chronic exposure may cause motor neuropathy leading to wrist weakness.
• Infections or inflammatory conditions such as viral neuritis, vasculitis.

4. Latrogenic (Post-Medical) causes- Nerve injury during surgery, injections, or blood draws near the upper arm.

The severity of Nerve Palsy (wrist drop) can range from temporary nerve compression (neuropraxia), which usually recovers within weeks, to complete nerve damage (neurotmesis), which may need surgical repair.
Understanding the exact cause is crucial because it determines how quickly the nerve can recover and what kind of rehabilitation plan is needed.

Recognising the Symptoms and Early Signs of Wrist Drop

The symptoms of wrist drop depend on the site and severity of nerve injury, but generally include a combination of movement loss, weakness, and sometimes altered sensation.

The first sign of Wrist Drop is usually the inability to lift the wrist or fingers upward, even though hand sensation may feel normal initially. Many people notice difficulty in performing simple tasks like holding a glass, typing, or gripping objects firmly.

1. Motor Symptoms (Movement-Related)

These are the most noticeable and functionally limiting signs:

• Difficulty lifting the wrist upward—a hallmark of radial nerve dysfunction.
• Trouble straightening the fingers or thumb, especially during reach or grip.
• Weak grip strength, making it hard to hold or carry objects securely.
• A visibly “dropped” wrist posture – wrist appears to “hang down” when the arm is extended—classic of radial nerve palsy.

2. Sensory Symptoms

While not always present, some patients experience:

• Numbness or tingling over the back of the hand, especially near the thumb and index fingers.
• Pins-and-needles or burning sensations in the forearm or hand.

3. Other Associated Features

Additional signs of wrist drop may include:

• Mild pain or discomfort, particularly after trauma or prolonged compression.
• Muscle wasting in the forearm in chronic or untreated cases.
• Difficulty with everyday tasks like writing, eating, or buttoning clothes—impacting independence.

If you experience any of these symptoms, especially after an injury or prolonged arm pressure, it’s important to seek physiotherapy and medical assessment early. Early diagnosis improves the chances of full nerve recovery and prevents muscle stiffness.

Prompt physiotherapy, combined with protective splinting, helps preserve joint mobility, prevent muscle stiffness, and support nerve healing. At ReLiva, our wrist experts tailor recovery plans to restore hand function and confidence. To find a convenient center near you or book an appointment for Wrist rehab,

Diagnosis and Evaluation for Radial Nerve Palsy

Accurate diagnosis is essential to identify the level and extent of radial nerve involvement. Diagnosis of wrist drop is mainly clinical, supported by nerve and imaging studies to identify the exact site and type of nerve injury.

At ReLiva, physiotherapists and doctors collaborate to assess muscle strength, nerve response, and overall hand function before planning therapy.

1. Clinical Evaluation:
   • Physical Examination: The physiotherapist checks wrist and finger movement, muscle tone, and reflexes to assess the degree of weakness or paralysis.
   • Sensory Testing: Areas of numbness or tingling are mapped to determine which part of the radial nerve is affected.
   • Range of Motion & Strength Tests: Gentle wrist and hand exercises help evaluate how much control is lost and which muscles need targeted rehabilitation.
2. Nerve Tests: Nerve Conduction Study (NCS) and Electromyography (EMG) measure how well the nerve sends signals to the muscles and help detect the location of the injury.
3. Imaging: X-rays may be taken to check for bone fractures around the humerus or elbow. Ultrasound or MRI can visualize nerve continuity or swelling.
4. Specialist evaluation:  A team approach often gives the best results — usually involving an orthopaedic or neurologist for diagnosis and a physiotherapist for rehabilitation planning.

Early diagnosis helps protect joints from stiffness and guides timely treatment before permanent weakness develops.

Treatment Options for Wrist Drop (Radial Nerve Palsy)

Managing wrist drop begins with understanding the severity and location of the radial nerve injury. Fortunately, most mild or compression-related cases respond well to conservative care and physiotherapy, especially when started early.

Conservative (Non-Surgical) Management

This is the first line of treatment for most people with wrist drop:

• Rest and protection: Avoid activities that strain the affected arm or worsen nerve compression.
• Splints or braces: A wrist-hand splint supports the wrist in an extended position, improving finger function and preventing joint stiffness.
• Physiotherapy: Early, guided exercises help maintain joint mobility and muscle strength. The focus remains on functional recovery through:
  • Guided exercise therapy to maintain joint mobility and rebuild muscle strength.
  • Specialised Techniques like range-of-motion therapy, electrical stimulation, mirror therapy, and grip retraining.
  • Training in safe movement patterns to protect weak muscles and prevent further injury.
• Additional supportive care may include Medications for pain relief or inflammation control and Lifestyle adjustments. (Maintaining good posture, avoiding pressure on the arm during sleep, and eating a nerve-friendly diet rich in vitamin B12).

Surgical Management

Surgery may be considered when:

• There’s no improvement after 3–6 months of physiotherapy and rest.
• Diagnostic tests reveal severe or complete nerve disruption.

Post-surgical physiotherapy is essential to regain movement, rebuild strength, and retrain coordination.

Remember that early diagnosis and structured rehabilitation often lead to full recovery in compression-related wrist drop. Severe injuries may take longer but can still achieve meaningful functional improvement with structured therapy

Physiotherapy and Exercises for Wrist Drop 

Physiotherapy is the cornerstone of wrist drop recovery, helping restore movement, prevent stiffness, and activate weak muscles while the radial nerve heals. At ReLiva, we follow a phased, goal-driven approach tailored to each stage of nerve recovery:

Phase 1: Early Protection & Support for Wrist Recovery

In the initial phase, the focus is on preserving joint mobility and preventing complications:

• Splinting: A dynamic wrist-hand orthosis holds the wrist in extension, enabling functional hand use and preventing contractures.
• Passive & Assisted Exercises: Your therapist gently moves or supports your wrist and fingers to maintain flexibility.
• Electrical Muscle Stimulation: Low-level currents stimulate weak muscles, improving tone and circulation.
• Edema & Skin Care: Elevation, massage, and padding help reduce swelling and protect areas with altered sensation.

Phase 2: Recovery & Re-Education for Wrist Movement

As nerve signals begin to return, therapy shifts toward active engagement:

• Active Range of Motion: Patients begin lifting the wrist and fingers independently.
• Biofeedback & Mirror Therapy: Visual cues and mirror exercises retrain brain-muscle coordination.
• Proprioceptive Training: Activities like ball-rolling or table-tapping improve hand awareness and control.

Phase 3: Strengthening & Functional Training for Wrist Function

This phase builds strength and restores everyday function:

• Resisted Exercises: Using resistance bands or therapy putty to rebuild muscle power.
• Grip & Fine Motor Tasks: Practicing tasks like writing, buttoning, or picking up small objects.
• Stretching Opposing Muscles: Gentle stretches for wrist flexors maintain balance and prevent tightness.
• Functional Retraining: Simulating real-life tasks—typing, eating, lifting—to rebuild confidence and independence.

Phase 4: Home Program & Self-Care for Wrist

Consistency at home accelerates recovery:

• Follow your therapist’s exercise plan daily.
• Avoid heavy lifting or pressure on the affected arm.
• Keep the wrist supported during sleep.
• Track small improvements—every bit of movement signals healing.

Remember that recovery from wrist drop takes time, but with regular physiotherapy and guided exercises, most patients regain strength, coordination, and confidence in hand use.

Ready to reclaim your grip and restore wrist function? 💪 Connect with ReLiva’s expert physiotherapists today for personalized care and proven recovery strategies.

Wrist Drop Home Care Tips and Precautions

While professional physiotherapy remains the cornerstone of recovery, consistent care at home greatly supports nerve healing and functional improvement. At ReLiva we believe and firmly propagate to all our patients that the right habits and precautions can help prevent further injury and maintain flexibility throughout the recovery phase.

Here’s what you can do at home for your wrist:

1. Protect the Affected Arm and Hand
   • Always use your wrist splint as advised by your therapist to keep the hand in a functional position.
   • Avoid direct pressure on the arm—do not sleep with your head or body resting on it.
   • Check your skin daily for redness, dryness, or small cuts, especially if there’s numbness.
2. Maintain Joint Flexibility
   • Perform your home exercise plan regularly—gentle stretching and movement prevent stiffness.
   • Keep the shoulder, elbow, and finger joints moving to avoid contractures while the nerve recovers. 
3. Daily Activities and Ergonomics
   • Use lightweight utensils and adaptive grips to make daily tasks easier.
   • Keep commonly used items within easy reach to avoid over-stretching.
   • When sleeping, place a rolled towel under the wrist for support.
4. Lifestyle and Nutrition
   • Include foods rich in vitamin B12, B6, and omega-3 fatty acids for nerve health.
   • Stay hydrated and maintain good posture during desk or device work.
5. When to Seek Medical Help Again?
   • If you notice increasing weakness, worsening numbness, or pain after therapy, contact your doctor.
   • Seek urgent attention after any new trauma or fall on the affected arm. 

A combination of clinical therapy and disciplined home care ensures the best chance for complete functional recovery and long-term wrist strength.

Physiotherapists at ReLiva Physiotherapy & Rehab follow a systematic intervention involving neurofacilitation, manual therapy, and specific exercises. Early intervention benefits many patients significantly. Basith Zeegi from Chennai relates his experience how physiotherapist Dr. Preethi and her team treated him with ultrasound therapy as well as muscle strengthening exercises to regain control and alleviate wrist pain – a success story of the effectiveness of guided physiotherapy.

.Have hand and wrist pain? Wait no More

Physiotherapy Techniques for Treatment of Wrist Drop

Expert Physiotherapy for wrist drop includes specialised hands-on and technology-assisted techniques to restore movement, strength, and coordination in the wrist and fingers. At ReLiva, the treatment plan is always customised after assessing your nerve function, muscle strength, and recovery stage. It may include a combination of these techniques:

• Neurofacilitation Techniques: Techniques such as PNF (Proprioceptive Neuromuscular Facilitation) and NDT (Neurodevelopmental Treatment) re-educate muscles and rehabilitate nerve control. 
• Electrical Stimulation: Mild electric currents stimulate weak muscles, enhancing nerve repair and movement restoration.
• Splinting or Bracing: Wrist splints hold the hand in a functional position, prevent stiffness, and assist in daily activities.
• Manual Therapy: Gentle mobilisation to maintain joint flexibility and improve circulation.
• Mirror Therapy: Some physiotherapists apply mirror therapy to retrain the brain to recognise and restore hand movement.
• Strengthening and Stretching Exercises: Exercise therapy with gradual, targeted movements is used to rebuild control and prevent stiffness.
• Taping and Splinting may be recommended to hold and support the wrist in the correct position. This also helps reduce strain and aids functional movement.
• Task-Based Functional Training: Therapist will guide practice of everyday activities to improve grip, coordination, and confidence.

Which Exercise is Best for Wrist Recovery?

The right exercises can make a huge difference in wrist drop recovery, but only when they are tailored to your specific condition. At ReLiva, a physiotherapist will first assess your wrist strength, nerve function, and movement thoroughly. A typical wrist drop rehab exercise program will progress in a phased manner (as explained in the section above ‘Physiotherapy and Exercises for Wrist Drop’) 

For any other wrist trouble, physiotherapist will design a customised exercise plan after the assessment for your specific stage and condition.These exercises will usually be for the forearm, hand, finger and wrist muscles. 

Related Reading: Carpal Tunnel Syndrome: Exercises

Related Video: Carpal Tunnel Syndrome: Symptoms, Treatment, Wrist Exercises with Dr Swati (PT) 

Doing random or general exercises may not help and can sometimes slow progress. 

Do not overdo; physiotherapists will check progress and adjust intensity for safe return to function.

At ReLiva Physiotherapy, our experts use targeted techniques to restore strength, flexibility, and control. With ReLiva’s wide network across cities, you can easily find a qualified physiotherapist nearby to guide you with the exact exercises your wrist needs for faster and safer recovery.

How long does a wrist drop take to heal?

Recovery Timeline for Wrist Drop

Recovery from wrist drop depends on the extent and location of nerve injury, as well as how early treatment and physiotherapy are started.

• In many cases caused by compression (neuropraxia), full recovery occurs once the nerve resumes normal function — often within 6 to 8 weeks.
• If the nerve fibers are partially damaged (axonotmesis), recovery takes longer, typically 3 to 6 months, as the nerve needs time to regenerate and reconnect with muscles.
• In cases of complete nerve injury (neurotmesis) — such as after a fracture or deep trauma — the nerve may not heal on its own and could require surgical repair. Recovery after surgery can take 6 to 12 months or more, depending on individual healing.

How to Speed up Wrist Recovery?

Taking into consideration the following factors that influence wrist recovery, usually helps:

• Severity and site of nerve injury
• Age and overall health of the patient
• Early diagnosis and consistent physiotherapy
• Nutritional status and absence of underlying conditions like diabetes
• Regular follow-ups with your doctor and repeat EMG tests help assess nerve regeneration.

Remember: Most people with mild-to-moderate radial nerve palsy regain useful wrist and hand function with structured physiotherapy and proper care.

Starting physiotherapy early and staying consistent makes a big difference. If you or someone you know is experiencing wrist weakness or loss of hand movement, reach out to your nearest ReLiva Physiotherapy Clinic for a professional evaluation and recovery program tailored to your needs.

This post has been reviewed by Dr Pragati Ligade (PT). Physiotherapist Dr Pragati is an experienced musculoskeletal physiotherapist in Bengaluru. She is a specialist in orthopedic manual therapy. With a focus on restoring mobility, reducing pain, and improving functional strength, her personalized approach combines evidence backed techniques, modern modalities and exercise therapy to ensure long-term health and enhanced quality of life.

Scholarly References:

[1] “Wrist Drop”; Alexei DeCastro; Patrick Keefe. PMID: 30422586 

[2] “Bilateral Wrist Drop Due to Lead Poisoning in a Young Woman With Opium Addiction”; Hossein Azadeh, Farhad Gholami, […], and Mostafa Soleymani+2, doi.

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