Forearm is the region that exists between the wrist and elbow and is made of two major bones called as ulna and radius. Several joints are found between these two long bones. These joints are responsible for giving flexibility to the forearm for performing many actions including straightening and bending. Plenty of ligaments and joints in this region give more support and strength to the forearm.
Apart from the joints and ligaments there are several muscles and tendons in the forearm. Only because of these muscles/tendons flexible movements are possible. There are several muscles like flexors, extensors, pronators and supinators that are responsible for making flexible movements. There are also group of nerves like ulnar nerve, median nerve and radial nerve in this area.
Forearm Pain Causes
Since the forearm is composed of many complicated nerve endings, blood vessels, muscles and joints, any damage or injury to them can cause forearm pain.
Any trauma or injury to the underlying bones, tendons, muscles and joints can cause forearm pain. Forearm is one of the most active parts in the body and hence it is vulnerable to injury and pain. Any serious blow or falls can damage the ulnar and radius muscles.
Any kind of twisting of forearm beyond its capacity can also cause injury. It is the forearm that comes for first line defense when someone attacks you suddenly with sharp weapon. Fracture of bones (ulnar or radius) and sometimes cracks on the bones can occur during accidents or fall.
Using the forearm in excess can build pressure inside causing forearm pain. It may affect the muscles or joints or even both depending on the stress caused. Tensynovitis is one of the common conditions that cause swelling of tendon sheath. Medial epicondylitis is a condition causing inflammation of epicondyle region of the forearm. Similarly excess of strain can affect the tennis elbow leading to swelling of tendons inside.
Arthritis is a condition of inflammation of joints in any part of the body and it can occur with forearm also. Cartilages can slowly get eroded due to arthritis making the inner bones and joints more vulnerable. Rheumatoid arthritis, osteoarthritis and septic arthritis are some types of arthritis affecting the forearm causing moderate to severe pain.
Cervical spine nerves can be put under excess of pressure and strain leading to cervical neuropathy causing forearm pain. This condition is known as pinched nerve which can affect the hands, forearm and even fingers. Forearm pain can occur if the C5, C6 or C7 are affected. Carpal tunnel syndrome can badly affect the wrist and fingers and can cause forearm pain also.
In addition to the above causes, any problems in the underlying blood vessels of the forearm can cause pain in the forearm. Peripheral embolism, limb ischemia and narrowing of brachial artery and inflammation of the lymphatic vessel of the forearm can cause forearm pain. Degeneration of the nerves in the wrist or forearm and MCL tear (tearing of ligaments) due to sharp force on the elbow can seriously affect the forearm causing pain. In rare cases ulna fracture, olecranon fracture and radial fracture may occur on the forearm.
Symptoms of forearm pain can range from moderate to severe depending on the intensity of blow or falls. In addition to forearm pain it can also cause swelling of forearm due to inflammation of muscles/joints and tissues inside. The forearm may become red and tender and in serious cases it can affect the range of movement.
Your doctor may complete the physical examination of the affected forearm and may request for X-ray or other imaging tests like CT scan to get a clear picture about the problem.
Forearm Pain Treatment
Mode of treatment directly varies with that of intensity of damage and injury caused. Mild form of injury can be treated with home remedies and complete rest whereas moderate to severe injury like fracture needs medical approach. For some people physiotherapy becomes the first line treatment apart from medications.
Injuries of forearm that occurs due to overuse and strain can be managed with easy techniques like RICE. Athletes are more vulnerable to get forearm injury and pain and it is quite common for them to overuse that part of the body involving sports activities. Most of the problems like nerve entrapment or tendinositis can be resolved with RICE approach. (Rest, Ice, Compression and Elevation therapy).
R stands for Rest in this context and the person should modify her/his activity to reduce further damage to the forearm. You can approach your therapist to know about the types of movement allowed during forearm injury.
The movement you make should never worsen the injury but hasten up the healing process. Ice therapy is certainly very beneficial to reduce inflammation in any part of the body. Applying ice on the injured region can also reduce pain and prevent further swelling inside. Again you have to consult your therapist before applying ice on the forearm if you had nerve entrapment problem.
Compression is using hot/warm water compress on the area. You would feel better by applying warm water compression and it can also help in reducing swelling. Elevation is keeping the forearm slightly elevated to facilitate blood flow. It also prevents blood clot formation around the injury.
Depending on the intensity of the injury your doctor would prescribe non-steroidal drugs of NSAID group and in severe cases steroids may also be prescribed. Electrical stimulation can be done for reducing inflammation alongside with friction massage therapy. Physical therapy is also a definitive cure for forearm injury which is done to gradually increase the vocational activity of the injured person. Rehab program is ideal for patients to get back to normal routine in short period of time.
In case of bone fracture surgical intervention is necessary. For posterolateral rotator problems and cranon impingement syndrome surgery is the only option available. For some people, the ligaments would get severely damaged due to accidents or fall during which surgery is to be done for repairing it and removing loose particles from the joint.
Strengthening exercises can be done only after the patient has totally recovered from injury and symptoms of pain have completely disappeared. Occupational therapy is given to gain flexibility of the muscles and tissues. And the patient should be careful during the recovery phase and proceed with caution to prevent any further damage. Make sure that you are with the right therapist during this phase since any rehab exercises should not give additional stress to the damaged forearm. Your therapist will slowly increase the flexibility and strengthening exercise taking into care that no additional pressure is put on the injured area.
For those affected with nerve entrapment problem neurologist should be consulted. He would use electromyography and similar tests to study the nerve condition. Mild forearm pain can be managed with simple home remedies like ice or compression and over the counter painkillers.
For moderate pain you need to consult your doctor and follow the instructions of your therapist alongside with medications. For serious cases surgery may be done for repairing and occupational therapy would be given after the patient reaches recovery phase.