The Forearm

Forearm pain in all its forms can be particularly disabling affecting all aspects of your life from dressing to playing sport and working.

At walker and Hall we know through personal experience how painful these conditions can be and fortunately how well they can respond to physiotherapy treatment.

The most common types of forearm conditions we treat are

Repetitive Strain Injury (RSI)
Referred pain

If your condition is not listed above please contact us

We have extensive experience in treating these conditions and managing your recovery.

To see how Walker and Hall can help you please click on the links below:

Repetitive Strain Injury of the Forearm (also known as RSI)

Repetitive Strain Injury (RSI) is a condition where the soft tissue structures of the upper limbs i.e., ligaments, tendons, muscles and nerves are damaged due to repetitive activity. Pain, swelling and other symptoms in the forearms are the result.

There are two main types of RSI:

Type 1 RSI – this includes conditions that can easily be diagnosed such as carpal tunnel syndrome (compression at the wrist and pain), tendonitis (inflammation of a tendon) and tenosynovitis (inflammation of a tendon sheath). These conditions can occur as a result of or be made worse by repetitive activities, however they may also occur separately without any connection to RSI.

Type 2 RSI – in this case the conditions are not easily diagnosed and often there are not any specific symptoms but rather a general feeling of pain and discomfort in the upper limbs that is difficult to reproduce on examination.

Type 1 RSI responds very well to physiotherapy treatment.

The causes of repetitive strain injury

Frequent and repetitive movements of the upper limbs e.g., the use of a computer, typing or clicking the mouse or both, playing on a games console, playing a musical instrument, working in a factory – factory workers often perform repetitive tasks for long periods of time, builders and sportsmen and women.

In fact any activity that involves repetitive movements and especially the use of small hand controls where the buttons close together e.g., computers and games consoles.

Poor posture – the adoption of a poor posture whilst performing the repetitive movement is thought to contribute / aggravate RSI

Excessive force – repetitive activities using a lot of force and not having enough breaks from the activities are thought to contribute / aggravate RSI

The signs and symptoms of repetitive strain injury

In our experience we are now seeing people of all ages with RSI. The main symptoms we treat are:

Pain, dull aching and throbbing in the wrist and forearms – these tend to develop gradually over a period of time. Initially they occur when you perform the specific activity and ease when you stop. However with time they become more constant and more severe whenever the repetitive activity is repeated. These symptoms can range from mild to severe.

Swelling and tightness in the affected area – as the soft tissue structures become inflamed due to repetitive movement, they will swell. This leads to the sensation of tightness in the forearms and wrist.

Pins, needles and numbness – if there is a lot of swelling in the forearms and wrists then the nerves can become compressed, this produces symptoms such as pins, needles and numbness.

How Walker and Hall can help you

A thorough musculoskeletal examination is required to determine the extent of the RSI and exactly which structures are involved. This is essential if the optimum recovery is to be achieved.

Following the diagnosis a treatment plan is devised and discussed with you.

The types of physiotherapy treatment used at Walker and Hall for RSI of the upper limbs include

  • Advice i.e., wherever possible try to reduce or stop the activity that is causing the symptoms, however bear in mind that this can be particularly difficult if it is your job. If possible talk to your employer and see if a change to your work pattern can be accommodated.
  • Pain relieving techniques e.g., gentle joint mobilizing techniques, electrical therapy e.g., ultrasound and interferential therapy and soft tissue massage to reduce pain and muscle spasm
  • Joint, nerve and soft tissue mobilizing techniques i.e., stretching and soft tissue release techniques.
  • Home exercise programme – this is important to continue the improvement gained with the treatment and maintain strength and flexibility of the joints and associated soft tissues.
  • Anti-inflammatory advice – anti-inflammatory medication may also significantly hasten the healing process by reducing the pain and swelling associated with inflammation. To check whether you are able to tolerate non-steroidal anti-inflammatory medication (NSAID) contact your General Practitioner or local pharmacist

Referred Pain

Not all pain experienced in the forearm is necessarily coming from a problem within the forearm. Occasionally pain felt in the forearm can be referred or caused by a problem in another area of the body such as the neck or spine. This is called referred pain.

What is Referred Pain?

Referred pain occurs when pain is experienced in an area away from the actual injury or problem. This is not uncommon, examples being sciatica, where pain is felt down the leg whilst the problem is in the back, and a heart attack, where the pain is felt in the shoulder, arms and neck.

What structures can refer pain into the forearm

The following structures have the ability to refer pain into the forearm

  • The cervical and upper thoracic spines (from the 3rd cervical vertebra to the 4th thoracic vertebra – C3 to T4). Any problems affecting the intervertebral discs, ligaments, nerves and muscles of this area of the spine can mimic an elbow problem.
  • The shoulder joint (gleno-humeral joint) and the acromioclavicular joint
  • The elbow joint (radio-humeral joint, humero-ulnar joint and the superior radio-ulnar joint)
  • The muscles of the rotator cuff
  • The muscles of the upper arm i.e., biceps and triceps muscles
  • The muscles of the forearm

How can Walker and Hall help you distinguish between forearm pain and referred pain

At Walker and Hall you will receive a thorough musculoskeletal examination which will examine all the structures that could possibly be responsible for the pain in your forearm.

It is only following such an accurate examination and diagnosis that a treatment plan can be devised to address your problems.

You will be involved in all stages of your treatment given every opportunity to ask questions.