What is Forearm Pain?
The forearms are an integral part of the movement of the hands and arms, so pain in this area can be very disruptive to everyday life. Forearm pain can result from many causes, each requiring a different treatment approach. The forearms are made up of the radius and ulna, which extend the length of the forearm to cross at the wrist joint. The location means that the forearm is inherently involved in a range of daily arm or hand movements.
Forearm pain refers to any type of pain or discomfort in the arm between the wrist and the elbow. Pain in the forearm can result from an injury or inflammation that affects any of the tissues in the forearm, including muscles, bones, blood vessels, tendons, and skin. Forearm pain can happen to anyone and is often related to traumatic or repetitive use injury.
The causes of forearm pain often include sports injuries, overuse injuries, fractures, pinched nerves, or accidents. Forearm pain can also be related to a general infection, such as a cold, which causes body aches, or an infection of the tissues of the forearm itself. In rare cases, forearm pain may be related to a benign growth, such as a cyst, or even a malignant tumor.
Healing from forearm pain depends on the type, location, and cause of the pain. Forearm pain can be treated effectively.
Seek immediate medical attention if you have forearm pain related to a severe fracture, such as a bone sticking out of the skin, or if your forearm pain comes with heavy bleeding, paralysis, or
numbness.
Causes
Pain in the forearms is most likely the result of injury or inflammation of the components in the space of the forearm.
Forearm Structure:
The bones of the forearm include:
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The Radius: This bone begins at the elbow and connects to the wrist on the side of the thumb.
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Ulna: This bone begins at the elbow and connects to the wrist on the little finger side.
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Muscles: The forearm also contains several muscles that work not only to rotate the forearm up (supination) and down (pronation), but also flex and extend the fingers of the hand.
Musculoskeletal Causes:
The musculoskeletal causes of bilateral forearm pain involve issues in how the components of the forearm work together.
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Positional: Repetitive actions such as typing, using crutches, and even walking the dog can cause compression of nerves and blood vessels that branch out throughout the forearm. Repetitive positional injury can lead to bilateral forearm swelling and pain.
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Biomechanics: Forearm problems such as dislocations or sprains can also lead to chronic bilateral forearm pain.
Traumatic Causes:
Traumatic causes of bilateral forearm pain include those that result in injury to components of the forearm.
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Fracture: Anything that causes a direct injury to the forearm - a car crash, traumatic fall, direct hit - can lead to fractured bones in the forearm as well as swelling and pain. These causes can also be associated with visible deformities and bleeding, depending on the severity of the trauma.
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Sprain: A sprain is defined as the twisting or stretching of a ligament or tendon. A ligament is a band of connective tissue that connects bone to bone. A tendon is also a band of connective tissue, but it connects muscle to bone. Activities that cause bending, twisting, sudden movement, or direct impact can result in sprained multiple ligaments in the forearm.
Psychosocial Causes:
Psychosocial causes involve the intersection of social factors (stress, unemployment, etc.) and individual thoughts and behaviors.
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Stress:
stress
associated with daily activities can manifest itself in different parts of the body. The forearms are intrinsically linked to many activities of daily living such as dressing, holding objects, typing, etc.
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Somatization: Somatization expresses mental phenomena like physical symptoms. For example, you may have had thoughts of forearm pain that now manifest as physical pain.
Thoracic Outlet Syndrome:
- The "thoracic outlet" is the space on either side of the base of the neck where nerves, arteries, and veins travel under the collarbone. If they become compressed or damaged, the condition is called thoracic outlet syndrome or TOS.
- The most common causes are trauma, such as a car accident or a fall; and repetition or overuse, such as a sports injury.
Carpal Tunnel Syndrome:
-
Carpal Tunnel Syndrome
is numbness and tingling in the hand and arm caused by compression of the median nerve as it passes through the carpal tunnel. The causes include overuse of the wrist and hand, especially highly repetitive activities such as typing or working.
Brachial Plexopathy:
- The brachial plexus is a network of nerves between the neck and the shoulder, connecting the nerves from the spinal cord to the arm. There is a band on each side of the neck. Any injury that forces the shoulder to stretch and the neck to stretch up and down can damage these nerves and cause brachial plexopathy.
- Sports injuries and car accidents are often involved. Inflammation, tumors, and radiation therapy can also damage the brachial plexus.
Acute Infection of the Forearm Bones (osteomyelitis):
Forearm osteomyelitis is a bacterial or
fungal infection
of the bone, typically caused by Staph Aureus (40-50% of the time).
Forearm Torsion Following Repetitive Injury:
Repetitive strain injuries to the forearm are caused by the constant use of the wrist.
Wrist pain is common. Repetitive movements can damage your wrist. Daily activities like typing, racquet sports, or sewing can cause pain or even
carpal tunnel syndrome.
Sometimes wrist pain does not identify with one process.
Wrist Contusion:
A bruise is damage to the blood vessels that return blood to the heart, causing blood to pool. This explains the blue/purple color of most bruises. Bruises on the wrist are common, often due to minor injuries.
Wrist Sprain:
A wrist sprain is often associated with traumatic events such as falls or sports accidents. However, wrist sprain can also stem from chronic issues like repetitive stress and the normal aging process. Cuffs are so necessary and used so frequently that it can sometimes be difficult to differ.
Severe Wrist Pain:
Severe pain in the arm should be examined by imaging and physical examination by a doctor.
Diagnosis
Diagnosis depends on arm pain. Some causes that need diagnosis include
-
Thoracic outlet syndrome: Diagnosis is based on the patient's history, physical examination, imaging such as an x-ray or
ultrsound
, and sometimes studies of nerve conduction and blood flow.
-
Brachial plexopathy: The diagnosis is made by
electromyography (EMG)
,
computed tomography
,
MRI
, and sometimes angiography.
-
osteomyelitis:
It is difficult to diagnose because the infection can come from a break in the skin in the area or anywhere on the body that is spread by blood.
Treatment
- Exercise is not always enough, and some people may need anti-inflammatory drugs, over-the-counter medications, steroid injections, splints to reduce pain.
- Treatment usually involves rest and physical therapy. Surgery may be needed to remove scar tissue or repair
damaged nerves.
Prevention
These are some prevention tips for forearm pain:
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Use dynamic rest: Avoid activities that engage the elbow and forearm, including hard grip. Use lower body workouts to stay in shape.
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Ice it:Apply ice to the area for 15 minutes 4 to 6 times a day for the first two days.
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Massage: A massage technique called myofascial release can help relieve symptoms. Each muscle is enclosed in a tough fibrous sheath called a fascia, which can tighten and constrict the muscle. Regular massage of the forearm can relax the fascia, allowing the muscle to relax.
As the pain from the forearm tension improves, there are a few simple exercises you can do to rehabilitate your arm and resume your normal activities. Here are some exercises to prevent forearm pain:
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Tennis Ball Squeeze: Squeeze a tennis ball in your hand. Hold the position for several seconds and release. Start with a few repetitions and increase the number when the pain permits. If you feel pain, step back.
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Arm Rotations: Hold your arm straight in front of you parallel to the floor and palm up. Make a fist. Turn your fist as if you were flipping a pancake. Add reps if pain permits. As you get stronger, add weight to your fist by holding a light dumbbell, then a hammer, and possibly a tennis racquet.
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Wrist Extension and Flexion Extension:With your right arm in front of you parallel to the floor and your palm down, bend your wrist down. Hold the position for several seconds. Return to the starting position and repeat.
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Flexion: With your right arm in front of you parallel to the floor and palm up, lift your wrist. Hold the position for several seconds. Return to the starting position and repeat. You can also add a light dumbbell (or even a can of beans) to these exercises as you get stronger.
