We use our forearms in nearly every activity and movement we perform throughout the day, from simple, common activities such as eating, using a keyboard/texting, cooking, carrying groceries or purses/backpacks, to more specific activities such as walking, sports, artistic endeavors, gardening, and performing forearm maneuvers in various occupations.
Hand, wrist and forearm pain are all typical symptoms of life in the fast lane. We evolved for hundreds of millions of years walking barefoot on the earth, receiving plentiful sunlight in our eyes and under our skin, breathing clean air and living radiation free – no wifi, no cellular, no electric and no magnetic pollution interfering with our sensitive electrical bodies. Today, the vast majority of us are sunlight and vitamin D deficient, electron deficient, and loaded up with heavy metals, pesticides and countless other industrial pollutants. What could go wrong?
The problem for us is that no matter what the rest of the body is doing, the arms are involved. While the legs are relaxed and resting through our meals, internet time and even reading the newspaper, the arms are busy at work. So it truly adds insult to injury when the forearm is in pain because all those many everyday common tasks become a daily nightmare. When the forearm hurts, all systems are down.
What forearms are made of: The anatomy of the forearm
The forearm contains two long bones, the ulna and the radius, which form a radioulnar joint at both ends: the elbow and the wrist.
The primary motion of the forearm is rotation: the ability to turn our palms up and down. The ulna remains still while the radius rotates around it. This is the motion used to turn a screwdriver or twist in a light bulb.
Forearm fractures can affect the ability to rotate your arm, as well as bend and straighten the wrist and elbow.
The three forearm compartments contain the flexor compartment which includes the finger, thumb, and wrist flexors; the extensor compartment containing the finger, thumb, and ulnar wrist extensor; and the posterior compartment containing the mobile wad of Henry, a group of three forearm muscles: the brachioradialis and the ECRL and ECRB.
Muscles on the palm side of the forearms are known as the flexor muscles and are responsible for curling the fingers toward the palm. The flexors accomplish all the grasping, lifting, holding, and cupping motions. The flexor muscles are also responsible for bending the wrists toward the palm as well.
The extensor muscles are found on the opposite side of the forearms and are responsible for bending the wrists toward the back of the hand. They shorten as the wrist bends toward the back of the hand. When we use a computer and rest our wrists on the desk or on a wrist rest, the wrist bends toward the back of the hand and the extensor muscles contract.
The nerves of the arm and hand perform a substantial two-fold role: commanding the intricate movements of the arms down to the dexterous fingers, while also receiving the vast amounts of sensory information supplied by the sensory nerves of the hands and fingers.
Several major nerves continue from the arm into the forearm, including the radial, median, and ulnar nerves. These nerves control the forearm muscles that move the hands and fingers through tendons that pass through the wrist.
Different nerve networks control the front and back of the forearm. Skin in the posterior forearm and extensor muscles of the hand and fingers are supplied by the branches of the radial nerve. Along the anterior of the forearm, the median and ulnar nerves supply nerve signals to the skin and to the flexor muscles of the hand and fingers.
Causes of forearm pain
Due to their constant use in almost all physical activities and movements, the forearms can become injured at home, on the job or during sports. Arm pain can be caused by a wide variety of problems, ranging from joint injuries, sports injuries, overuse conditions, fractures, and compressed nerves.
Forearm pain may also be related to a general infection, such as the common cold that causes body aches, or to an infection of the tissues of the forearm itself, or in many cases, trauma, such as falling.
Depending on the cause, arm pain can start suddenly or develop over time.
As mentioned, technology has not been easy on our forearms. Current research suggests that intensive use of mouse and keyboard among professional computer users has been identified as a risk factor for pain in various regions of the upper extremity including the forearm. But, is intensive use really the problem? Why are some afflicted and others are not? Keep reading and you’ll find some answers, because these are the questions that most interest us at Deep Recovery.
Repetitive-motion disorders are increasing and can develop over time, such as from continually using machinery or some sports, such as serving in tennis or volleyball.
Competitive and weekend warrior athletes sustain a wide variety of soft tissue, bone, ligament, and tendon and nerve damage to their upper extremities. These types of injuries are directly related to trauma or repetitive stress, and account for a significant amount of ‘down time’ for recovery, particularly those sports in which the arm is utilized for throwing, catching or swinging.
Common causes of forearm pain
Fractures: Forearm fractures affect our ability to rotate our arm, as well as bend and straighten the wrist and elbow. Due to the strong force required to break the radius or ulna in the middle of the bone, it’s common for adults to break both bones during a forearm injury.
Strains and Sprains: Pulled muscles or tendons in the forearm can occur from one-time overuse, such as an extended period of typing, or using a screwdriver. Athletes in contact sports, such as football, hockey, and boxing, have the biggest chance of strains. Even in non-contact sports like tennis, golf, or rowing, doing the same motions over and over can lead to strains of the hand and forearm.
Wrist and thumb sprains are also common, particularly in sports like skiing, where it’s not unusual to fall and land on an outstretched palm.
Carpal tunnel syndrome: Improved ergonomics has helped decrease the occurrence of Carpal Tunnel which is marked by a numbness and tingling in the hand and arm caused by a pinched nerve in the wrist. Or is it simply caused by inflammation related to poor sleep and/or electron deficiency?
Spine conditions: In some cases, forearm pain originates from a condition in your neck or spine. The C6 dermatome covers the top of the shoulders and runs down the side of the arm and into the thumb side of the hand. C7 controls the triceps (the large muscle on the back of the arm that allows for straightening of the elbow). C8 controls the hands.
Pinched nerve or nerve injury: The brachial plexus is the network of nerves that sends signals from your spine to your shoulder, arm and hand. A brachial plexus injury occurs when these nerves are stretched, compressed, or damaged.
Minor brachial plexus injuries, known as stingers or burners, are common in contact sports, such as football.
Pronator Sydrome: A compression of the median nerve by muscles in the forearm, especially the pronator muscle.
Thoracic Outlet Syndrome: TOS is a group of disorders that occur when blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) are compressed. This can cause pain in your shoulders and neck and numbness in your fingers.
Common causes of thoracic outlet syndrome include physical trauma from an auto accident, repetitive injuries from job- or sports-related activities, certain anatomical defects (such as having an extra rib), and pregnancy. Sometimes doctors are unable to determine the cause of thoracic outlet syndrome.
Tendinitis/Tendinopathy/Tendon damage: Tendons connect muscles in your forearm to the bones in your wrist and elbow. Damage to these tendons — called tendinitis or tendinopathy — often occurs with overuse of your forearm muscles.
Tendon injury and inflammation causes forearm pain near your elbow or wrist joints, where the tendon attaches to the bone. These conditions may also cause swelling, decreased movement and weakness. You’ve probably heard of ‘tennis elbow’ this is probably the most commonly recognized form of tendinitis but the proper medical term for it is Lateral Epicondylitis – fancy name your MD will use to give the impression he knows how to help you. Most likely he doesn’t.
Tendon injuries are tradionally treated with activity modification, rest, ice and pain relieving medications. Physical therapy is also often prescribed for ultrasound and electrical stimulation, and strengthening exercises. Tendon injuries that do not improve with traditional treatments are often escalated by MDs to medication injection, or even surgery without trying myofascial release, grounding, light therapy, TENS or other physical therapy. Don’t let this happen to you! Be sure to read our tendinitis treatment guide.
Tenosynovitis: Tenosynovitis is a painful inflammatory condition that limits mobility. This is where the synovium (a lining of the protective sheath that covers tendons) becomes inflamed. The hands, wrists, and feet are often affected. Common causes are injury, repetitive use, and infection. Symptoms include pain, swelling, and difficulty moving the affected joint. Treatment includes pain relievers, ice, and joint immobilization.
Radioulnar articulation injuries: Injuries to proximal radioulnar articulation and distal radioulnar articulation are common in athletes. These are two joints between the two bones of the forearm. Injuries to the distal radioulnar articulation often result from falls onto an outstretched hand.
Compartment Syndrome: A painful and dangerous condition caused by pressure buildup from internal bleeding or swelling of tissues. Compartment syndrome can occur from traumatic, non-traumatic and minimally traumatic events.
Treatments and therapies for forearm pain
Since the forearm is used in almost every form of regular activity, forearm pain can be a very real disruption to daily life.
R.I.C.E.: Rest, ice, compression and elevation are the most traditional treatments and therapy for most forearm pain, regardless of the cause.
Activity reduction: Nothing gives your nonstop forearms relief better and faster than stopping and reducing activities until the forearm feels better. Yeah, most of us don’t have the luxury of stopping, and that’s what I told myself for years. But, at some point chronic pain can become so severe it’s totally disabling. Ever hear the saying “an ounce of prevention is worth a pound of cure?” It’s true.
Massage: Massage is excellent for myofascial release, relaxing and facilitating recovery of tired, sore or injured forearms. Even if the forearms themselves are too inflamed for massage, massaging the shoulders and upper back can go a long way in providing forearm pain relief. Many people find the technique shown below a lifesaver.
Here’s how the Deep Recovery tools can be used for forearm massage:
Please have a look, too, at how our tools and techniques are used to release the rest of the body and obtain long lasting results.
Splints: Splints provide support for the injured muscles, tendons and bones that are involved with most causes of forearm pain, whether the symptoms are inflammation, weakness, numbness, or just pain. They’re also dangerous when overused because they induce muscle atrophy and for this reason you should be skeptical about using a splint for chronic conditions.
Grounding: new research is showing that electron deficiency is highly correlated with inflammation and that this process can be reversed through electrical body grounding also known as earthing. Try grounding yourself while you work and sleep.
Light Therapy: Photo-biostimulation is a non-invasive therapy using light or near infrared light energy that causes tissues in the body to exhibit specific complex biochemical responses, essentially healing the injured tissues. Both lasers and LEDs are in use by physiotherapists, physical therapists and sports medicine specialists to treat a wide variety of acute and chronic musculoskeletal injuries and pain.
Other health professionals such as dentists, rheumatologists, veterinarians and dermatologists use variations of light therapy to treat conditions ranging from edema, burns, and dermatitis, to relieving pain and treatment of chronic inflammation and autoimmune diseases. Other specialists are applying the therapy to effect nerve regeneration.
This would probably be a good place to point out the connection between sunlight, vitamin D, sleep and healing. It’s really simple – if you aren’t getting the kind of sunlight our ancestors got, you’re probably vitamin D deficient and not sleeping easily and deeply. If your sleep isn’t great, your body is not healing fast enough to keep up with the insults you throw at it. The best way forward is to get a lot more sun, but that’s impractical for most of us, so second best is to take Vitamin D3 (with cofactors vitamin A and K).
Contrast Bath Therapy/ Hot/Cold Immersion Therapy: For fast-acting relief from forearm pain, this treatment is very effective. Hot/Cold Immersion Therapy is a form of treatment where a limb or the entire body is immersed in warm/hot water followed by the immediate immersion of the limb or body in ice water. This procedure is repeated several times, alternating hot and cold and it stimulates a dramatic increase in circulation.
DMSO: Considered by many to be the most powerful anti-inflammatory known to man, DMSO has saved the careers of numerous professional athletes – watch the 60 minutes documentary:
Acupuncture: Acupuncture can provide relief from pain and inflammation in the forearms.
TENS: Many people find relief from transcutaneous electrical nerve stimulation, or a TENS unit. These are available over-the-counter, and are used frequently in physical therapy clinics.
Exercise: Exercise as medicine is slowly gaining momentum, as more and more people discover how effective daily exercise routines are, as well as using exercise as therapy for injuries.
The following exercises are designed to relieve forearm pain, and stretch the forearm muscles, which improves recovery from injuries to the forearms:
Pendulum: Stand w/ legs beyond your hips, knees bent. Lean forward, tighten your abs as you do this to protect your low back, and let one arm dangle in front of you. Slowly, rotate in one direction for 5 rotations; 5 rotations the other direction; side to side; front to back.
Wings: Stand, legs hip width apart. Swing both arms forward, then backward and rotate the arms as you slowly swing front to back. Perform for one minute.
Palm Pull: Extend one arm straight out in front of you, bent at wrist, fingers upward; with the other hand, slowly and gently pull the hand back toward you, hold, then, down and toward you.
Yoga Hands: Slowly massage the air in front of you, stretching and flexing fingers and thumbs; then, play the piano or make spider movements with your fingers and thumbs; then, lead your orchestra, slowly flexing the wrists and stretching the forearms.
Preventing forearm injuries and pain
The right exercise can promote forearm health. An exercise routine for the entire body with emphasis on the forearms and hands increases strength, flexibility, stamina and joint range of motion. And the wrong exercise, weightlifting without adequate massage and stretching, for example, can also cause serious pain.
During frequent breaks from your work station, or other sitting jobs, get up and walk around and swing your arms. Stretch your forearms, massage your hands, perform gentle shoulder rolls, either sitting or standing. Take micro-breaks from your static work positions by pinching your shoulder blades together, expanding your ribcage and taking several deep breaths.