B Vitamins and Prednisone for Radial Nerve Injury Symptoms
B vitamins (B1, B2, B6) may provide modest benefit for your arm heaviness after radial nerve injury, but prednisone is not recommended for chronic nerve injury symptoms and will not help in your situation.
Why Prednisone Won't Help
Systemic corticosteroids like prednisone are ineffective for chronic nerve injury symptoms. The evidence is clear:
- For radicular pain (nerve-related pain), multiple high-quality trials found that systemic corticosteroids showed no differences compared to placebo in pain relief 1
- Prednisone is only beneficial when started within 72 hours of acute radiculopathy onset, not for chronic symptoms 2
- In the largest trial (n=269), oral prednisone increased adverse events (49% vs 24%), insomnia (26% vs 10%), nervousness (18% vs 8%), and increased appetite (22% vs 10%) without meaningful benefit 1
Your situation involves a chronic partial radial nerve injury with persistent symptoms—this is fundamentally different from acute radiculopathy where steroids might have limited short-term benefit.
Potential Role of B Vitamins
B vitamins may offer modest support, though the evidence is limited:
What the Research Shows
- B vitamin complex (including B1, B2, B6) decreased proinflammatory cytokines and increased anti-inflammatory cytokines after peripheral nerve injury in experimental models 3
- Higher doses of oral vitamin B complex for 4 weeks were more effective than lower doses in reducing neuropathy symptoms in small trials 4
- One small trial showed slight improvement in vibration perception with benfotiamine (B1 derivative) for 8 weeks 4
Important Caveats About B6
Be cautious with vitamin B6 dosing—high levels are neurotoxic and can worsen peripheral neuropathy 5:
- High B6 intake (usually from supplements) can cause predominantly sensory neuropathy of the axonal type 5
- Stick to recommended daily allowances: 1.3 mg/day for adults 1
- The tolerable upper limit is 100 mg/day, above which sensory neuropathy risk increases 1
Practical Recommendation for B Vitamins
If you choose to try B vitamins:
- Use a standard B-complex supplement at recommended daily doses (B1: 1.1-1.3 mg/day, B2: 1.1-1.3 mg/day, B6: 1.3 mg/day) 1
- Never exceed 100 mg/day of B6 to avoid worsening your nerve symptoms 1, 5
- Expect modest benefit at best—no strong evidence supports B vitamins as monotherapy for established nerve injury 4
- Consider a 4-8 week trial; if no improvement, discontinue 4
What You Should Actually Consider
For chronic radial nerve injury symptoms:
- Physical therapy and nerve gliding exercises are more appropriate than medications for chronic nerve injury recovery
- If inflammation from the recent steroid injection is suspected, the injection itself should provide local anti-inflammatory effect
- Avoid systemic prednisone—it carries significant risks (hyperglycemia, gastritis, opportunistic infections, osteoporosis) without benefit for your condition 1
If Prednisone Were Prescribed Despite Evidence
Should you receive prednisone for any reason requiring >3 months of therapy:
- Start calcium 1000-1200 mg/day and vitamin D 600-800 IU/day immediately for bone protection 1
- Consider bisphosphonate therapy if treatment exceeds 3 months 1
- Monitor blood glucose regularly 1
Bottom line: Skip the prednisone entirely. If you want to try B vitamins, use standard doses in a B-complex supplement for 4-8 weeks, but keep expectations modest and never exceed safe B6 limits.