Pain in the forearm is relative common in western
industrialized societies, because the widespread use of computers means that
the forearm is exposed to constant stress. The symptoms appear in
different forms, often they occur as a result of movement, but sometimes also
during periods of rest. The symptom of forearm pain is usually explained
by tennis elbow, tendinitis or carpal tunnel syndrome ,
but the symptoms are often more far-reaching - so the forearm should not be
considered in isolation in the diagnosis.
causes
The forearm consists of two long bones, the ulna
and the radius, which are connected by a ligament (ligamentum annulare radii)
and a firm connective tissue structure (membrana interossea
antebrachii). Adjacent joints are on the one hand the wrist, which
connects the forearm with the hand, and the elbow joint, which forms the
connection to the upper arm. Depending on the cause, complaints in or on
the forearm vary in severity and severity, for example in the form of pressing,
pulling or stabbing pain that either occurs suddenly (acutely), for example
after injuries, or takes a chronic course (for example with osteoarthritis) and
sometimes with swelling, restricted mobility, symptoms of paralysis or sensory
disorders.
In many cases, the pain in the forearm occurs as a
result of movement, for example when lifting objects, by turning movements when
opening a bottle, often also while working on the PC or when using the mouse -
for some people, however, the symptoms also show up in the Hibernation.
Complaints and
symptoms
Forearm pain is a general symptom that can have
many different causes such as bone and joint problems, muscle problems, nerve
irritation or nerve damage or circulatory disorders.
In many cases the forearm is overstrained (for
example through monotonous movements, sport or computer work), which can lead
to muscle or connective tissue tension, tears and strains and thus cause
pain. In this context, tendinitis is often the trigger for the symptoms
that arise from excessive stress or constant overloading of the muscles,
tendons and ligaments. The reasons for this are mostly poor posture,
incorrect sports techniques or unergonomic PC workstations as well as other
activities that place monotonous mechanical stress on the wrist and forearm
(e.g. hairdressers, masseurs or bakers).
In addition to tendinitis, acute or chronic
overloading of the hands and forearms can also lead to the so-called golfer's
elbow, tennis elbow or mouse arm (RSI syndrome or repetitive strain injury),
which is sometimes accompanied by severe pain and limited mobility of the arms
and hands.
Tennis elbows and golfers' elbows are characterized
by inflammatory or degenerative changes in the elbow area and result in a
restricted usability of the affected arm. Tennis and golf players are
often affected due to the movement patterns of both sports, but in most cases
incorrect postures (e.g. when doing housework or sleeping) or sports techniques
and workloads (manual activities or intensive PC work) are the triggers.
The RSI syndrome or Repetitive Strain Injury
(translated: injury through repeated stress) occurs as a result of long-term,
repetitively fast, monotonous movement sequences, whereby this primarily refers
to non-stop activity on the keyboard or computer mouse - hence the term
"mouse arm". Depending on the individual predisposition and the
posture requirements at the workplace, the mouse arm can affect nerves,
tendons, muscles, joints or connective tissue, typical symptoms are pain, abnormal
sensations and a loss of strength in the affected hands or arms, the mobility
of which can be severely restricted.
Bruises or fractures caused by falls or accidents
often cause very severe forearm pain. In the case of a forearm fracture,
for example, either the ulna or the radius (sometimes both at the same time) is
usually separated by external influences. In most cases this happens as a
result of a fall (for example during sports), in which the person concerned
tries to cushion himself on the outstretched hand, whereby a large part of his
own body weight is shifted to the narrow forearm bones, which cannot withstand
the pressure and ultimately give in. Also severe bone diseases like osteoporosis can lead to a forearm fracture and thus
severe forearm pain, which usually lasts for a long time, as movements are
initially restricted and painful after a few weeks in a cast.
Nerve irritation can also affect the radial nerve,
which is the only one of the three supplying forearm nerves that runs backwards
in the armpit and there, roughly at the level of the outer edge of the shoulder
blade, has to pass a narrow point between the so-called "external
rotators" of the arm. Here it can be assumed that overuse of the
forearm, for example by unnaturally turning the arm and shoulder inward during
PC work or using the mouse, causes the muscles to tense and the radial nerve to
be pinched off. irritate. In addition, the third supplying nerve of the
forearm - the ulnar nerve - can be pinched off, for example by propping up the
elbow, and its course can lead to discomfort on the inside of the arm or
to elbow pain .
Diagnosis and
therapy
Before the forearm pain can be treated, a doctor
must first clearly pinpoint where the pain is occurring and what the underlying
cause of the complaints is. It should always be ensured that the forearm
is not viewed in isolation - because in the case of the very frequent tension
in muscles and connective tissue, for example, there is usually a close
connection with a misuse of the upper arm and shoulder. The diagnosis is
usually based on a detailed anamnesis (previous illnesses, sporting and
occupational stress, etc.) and the clarification of the symptoms by palpation
of the painful areas and movement tests. Imaging methods such as x-rays
and laboratory tests are also used to provide support or if anything is
unclear.
For forearm fractures, treatment depends on where
the bone is broken and whether other body structures are affected. In the
case of a broken shaft, surgical intervention is usually necessary, in which
the break is screwed to a plate. Even more displaced elbow and spoke
fractures near the wrist are usually surgically stabilized, especially if the
joint surface is affected. In the case of fractures that are only slightly
displaced, conservative treatment is sufficient in most cases - the fracture is
first re-established under local or brief anesthesia, then the arm is
stabilized with a plaster splint. After a few days, the patient is usually
given an all-round plaster cast instead of the splint,
In the case of tendinitis, it is primarily
important to protect the affected area. Stabilizing bandages or support
bandages are usually used for this. Cooling compresses help with swelling
or redness, and pain reliever and anti-inflammatory creams or, if necessary,
tablets can alleviate the symptoms. In severe cases, an experienced doctor can
also inject cortisone into the inflamed area. In the case of chronic
tendinitis that does not respond to conventional measures, surgery is carried
out in rare cases - the narrowed area on the tendon sheath is split open and
thus relieved.
Even with tennis elbows, golfers' elbows and mouse
elbows, therapy is initially conservative, i.e. non-surgical. Depending on
the case, physical applications in the form of cold treatments or heat therapy,
stretching exercises, massages or local ultrasound and microwave treatment are
suitable as initial measures for pain relief. In addition, special
bandages with pads that shift the tension of the tendons from the elbow to the
periphery have proven effective. In addition, ointment dressings and medication
(for example pain relievers or cortisone injections) can also be used
here. If this treatments is unsuccessful, the next step is usually to try
to relieve the symptoms with the help of a forearm cast.
If the forearm pain is caused by damage to the
nerves, such as the carpal tunnel syndrome, an operation can be avoided in the
early stages in many cases by using wrist splints or anti-inflammatory
cortisone in the form of tablets or injections into the carpal tunnel to
alleviate the symptoms. It should been noted, however, that treatment with
cortisone should only be carried out over a short period of time. If the
disease is more advanced or if the symptoms persist despite these measures, an
operation can be considered. In this case, the ligament structure that forms
the "roof" of the carpal tunnel is split, relieving the nerves.
Basically, it should be borne in mind that forearm
complaints as a result of excessive strain, poor posture, etc. can only be
alleviated in the long term if the circumstances causing them are
changed. This can be implemented relatively quickly and easily, for
example when working on the PC, by optimizing the workplace (correct height of
screen monitors, supports for the heels of the hand and forearms, larger mouse,
etc.) and generally avoiding unfavorable postures or movements.
Naturopathy
In addition to conventional medicine, various naturopathic methods can also
be considered in the treatment of forearm pain. Herbal
medicine, for example, offers preparations with arnica or combination preparations
made from essential oils such as bergamot, lavender, orange and lemon oil,
which may have a soothing effect, for severe pain in tendons, ligaments and
muscles. Homeopathy also offers numerous remedies for pain or painful
conditions such as arnica or hypericum - here, however, an appropriate expert
should be consulted in order to individually coordinate the appropriate remedy
and the correct dosage.
For forearm pain caused by tension, massages
or progressive muscle relaxation also help in many
cases . In addition, acupuncture is often recommended for a tennis
elbow or golfer's elbow, for example, as it serves to relieve pain and can stop
the inflammatory process - provided that the activity causing the pain (such as
playing tennis) is stopped. Since the forearm should not be viewed in
isolation for a reliable diagnosis and effective therapy, osteopathy or Rolfing are often usedmeaningful treatment
approaches. Here, the forearm is considered in its relationship to the
entire arm and shoulder, which is essential in order to give those affected
instructions for the time after the therapy, for example with regard to pain
prevention or avoiding postural damage. (No)
