Your forearm is the area from your elbow to the wrist and consists of two bones lying side by side:
- Radius laterally (side of the thumb)
- Ulna medially (side of the little finger)
Additionally, numerous blood vessels, nerves, and about 20 muscles help in wrist and forearm and finger movements, hand positions, and grip and fine motor coordination (such as writing, drawing, buttoning and unbuttoning, and typing).
20 possible causes of forearm pain
Naturally, forearm pain in this area can be very disruptive in daily activities and can affect your quality of life. Forearm pain when you pick up something may be due to several reasons, such as muscle soreness, weak muscles, or injuries.
- Sports injuries: Sprains in the muscles that run across the forearm, ligament strain during flicking movements of the wrist while handling a tennis racquet, golf stick, or direct trauma can often cause serious pain. The pain is often aggravated while picking things up.
- Overuse injury: Tennis elbow, golfers’ elbow, forearm splints, and carpal tunnel syndrome are often the terms for different types of overuse injury in the forearm. Every muscle in the body is attached to the bone with a tendon. Due to repetitive motion at the joints during sports, the tendons sustain microtrauma. This can cause inflammation (tenosynovitis) and constant or episodic pain in the forearm.
- Fractures: Road traffic accidents, falls, and direct trauma can cause either or both forearms bone to crack, causing pain. In old age, reduced bone porosity causes fractures even after minor trauma. Hence, every potential fall or trauma should be evaluated.
- Dislocations: An elbow dislocation is often seen in young children due to trauma or when a child is held by the elbows. It is a painful condition with or without obvious deformity and needs urgent medical attention.
- Ulnar nerve palsy: The ulnar nerve runs along the medial part of the forearm and supplies the forearm muscles along with the little finger, half the ring finger, and the skin around it. The nerve is thick, and it passes just beneath the medial epicondyle (inner tuberosity of the elbow). Compression of the ulnar nerve in this area due to poor posture and bone injury can cause pain in the forearm and deformity called claw hand.
- Radial nerve entrapment: The radial nerve travels along with the central and medial parts of the forearm. Bone fractures or severe muscle trauma may cause its compression, leading to radial never entrapment, swelling, and pain.
- Infection: A pustule or an abscess in the forearm area due to an infected sweat gland (often due to excess sweating) or a deeper abscess formation in the muscle or soft tissue is seen in those with compromised immunity (human immunodeficiency virus infection, diabetes mellitus, autoimmune disorders). This can cause throbbing pain in the forearm. Moreover, because the forearm consists of a closed packed space, any swelling needs to be rapidly relieved to avoid a complication called “compartment syndrome.”
- Compartment syndrome: Seen in cases of forearm burns, trauma, untreated fractures, and severe infection in the forearm. In this condition, pressure builds up inside the closed forearm compartment that compromises the blood supply to the tissues in the area and can cause irreversible damage and even gangrene of the forearm and hands.
- Damaged blood vessels: A blocked (or a narrowed) artery due to atherosclerotic plaques, a blood clot, or an aneurysm (ballooning of an artery) of the forearm artery can affect the blood supply and cause severe pain. This is an emergency and requires immediate attention by a surgeon.
- Arthritis: Elbow joint wear and tear due to age (osteoarthritis) or diseases, such as rheumatoid arthritis, psoriatic arthritis, or gout, may cause pain, with or without aggravation on the movement of the wrist.
- Olecranon bursitis: Olecranon process is the bony tip of the elbow. Inflammation of the olecranon bursa (a thin, fluid-filled sac) over this area is called olecranon bursitis and is seen in people who constantly lean on tables with pressure over the elbow tip. There is swelling all over the forearm with limited mobility at the elbow.
- Ergonomic injuries: Poor posture while working at a computer, using chairs without armrests and poor muscle tone due to lack of exercise and stretching can cause vague pain in the forearm.
- Tumors: Rarely, forearm pain may be related to a benign growth, such as a cyst or malignant tumor.
- Drugs: Statins (cholesterol control), zidovudine (anti-human immunodeficiency virus drug), colchicine (for gout), and glucocorticoid can cause myopathy (muscle weakness) and forearm pain.
- Systemic disorders: Nonspecific causes of forearm pain includes diabetes mellitus, thyroid disorders, any of the multiple autoimmune diseases, viral myositis, and flu.
- Motor neuron diseases: Chronic motor neuron diseases, such as amyotrophic lateral sclerosis and progressive muscular palsy, are rare causes of forearm pain.
- Multiple sclerosis (MS): A systemic disease with complicated etiology, MS results from damage to the myelin layer over the nerves. An acute flare of MS can cause severe, shooting pains in the upper arm.
- Osteomyelitis: Infection in the bones can cause fever, muscle pain, and swelling. It is typically caused by staphylococcus aureus.
- Fibromyalgia: Though patients of fibromyalgia complain of generalized fatigue and body pain, forearm pain is particularly severe in most cases.
- Radiating pain: Pain in the chest, armpit (axilla), shoulder, or neck may sometimes radiate to the elbows, causing forearm pain.
When should I be worried about forearm pain?
Any history of trauma (possible fracture), deformity (fracture or dislocation), inability to move the arm, open wound, tingling, and numbness, muscle paralysis, and a high fever are danger signs. You should not delay a doctor’s visit.
Any profuse bleeding or history of blunt trauma (tires passing over) should not be neglected. In the elderly, every mild to moderate trauma should be taken seriously.
How to manage forearm pain
The cases of forearm pain resulting from overuse or minor trauma and infections can be managed with adequate rest, splinting, nonsteroidal anti-inflammatory drugs, and ice fomentation. If there is no relief in 24 hours despite these measures, consult your doctor.
Fractures and dislocation may require operative interventions and plasters. Tendon swelling may require intralesional steroid injections. Nerve injuries often recover with rest, decompression, and physiotherapy.
- An ergonomically designed workplace is a solution for many forearm pain cases.
- Stretching and warm-up before sports is a must.
- Physiotherapy plays a key role to avoid the recurrence of such episodes.
- A massage technique called myofascial release often helps in cases of fibromyalgia. This can be learned from a physiotherapist and then practiced at home.
- Exercises, such as squeezing a tennis ball in your hand, holding the position for several seconds, and releasing it many times a day, can help avoid wrist area issues.
- Adding an upper body workout to your exercise schedule can help tone your muscles and prevent muscle aches.
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NASM. The 9 best arm exercises for definition & strength. https://blog.nasm.org/workout-plans/9-best-arm-exercises
Mayo Clinic. Wrist and forearm stretches for the workplace [Video]. https://www.mayoclinic.org/healthy-lifestyle/adult-health/multimedia/forearm-stretches/vid-20084698
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