Pain in the forearm is a specific sensation caused by damage to the bones, soft tissues or nerve structures of the forearm. It can be acute, dull, local, widespread, periodic, constant, pulling, pressing, burning, shooting, aching. Sometimes it has a radiating character, provoked by injuries, limb overloads and other circumstances. The cause of pain is established by means of a survey, examination, data from imaging techniques (X-ray, CT, MRI), electrophysiological methods. Until the diagnosis is clarified, the hand is provided with rest. Sometimes we can take analgesics.
A bruise occurs as a result of a fall or a direct blow to the arm, manifested by sharp pain. The intensity of the pain syndrome quickly decreases, the pain becomes dull, aching, intensifies during movements, when the forearm is felt. The hand is slightly or moderately edematous, bruising is possible. Movement is somewhat limited due to pain, limb function is usually preserved.
Hematomas on the forearm are rarely formed, as a rule, they are the result of a very strong blow or forced local compression of the limb. Manifested by constant arching pain, local dense swelling. Subsequently, the pain decreases, a cavity filled with blood forms at the site of the edema. Spontaneous resorption of large cavities is uncharacteristic.
Fractures of the bones of the forearm are characterized by unbearable explosive pain at the time of injury. Then the pain syndrome decreases somewhat, but remains very intense, increases with palpation, movements, and axial load. The limb swells quickly. Quite often crepitus, deformation, pathological mobility come to light. Symptoms vary somewhat depending on the type of lesion:
Pain in the forearm
Myositis of the muscles of the forearm often develops after unusual physical exertion - the first workouts in the gym, work in the country, etc. It manifests itself as aching pain that spreads throughout the muscle or muscle group, increases with muscle tension, combined with weakness of the limb. The general condition remains satisfactory. Inflamed muscles are compacted, slight swelling is possible.
With repeated microtraumas or chronic overload, tendonitis and tendovaginitis sometimes develop - inflammation of the tendons and tendon sheaths of the muscles of the forearm. Initially, pathologies are characterized by transient weak pulling, aching or aching localized pains in the lower third of the segment. Subsequently, the pain becomes constant, aggravated by movement, disturbed at night, supplemented by muscle weakness.
Myositis and tendovaginitis are sometimes diagnosed in patients with rheumatoid arthritis. There is a clinic of a typical lesion of the muscles and tendons of the forearm with pain and muscle weakness in combination with a symmetrical lesion of the joints of the hands. Tendovaginitis is chronic, can be complicated by carpal tunnel syndrome, in which the pain becomes shooting in nature, complemented by paresthesia.
A special form of tendovaginitis is inflammation of the tendons in de Quervain's disease. Pressing or aching pains along the radial side of the lower third of the forearm are noted with wide-amplitude movements of the 1st finger, deviation of the hand towards the 5th finger. Initially, the pain syndrome is not intense, quickly transient. Subsequently, in some patients, the pain becomes constant, aggravated by the slightest movements. Irradiation to the hand, upper third of the forearm and elbow joint is possible.
Aseptic periostitis occurs after injuries, inflammatory diseases. More often it develops in areas of the bone that are poorly covered with soft tissues (just below the olecranon, along the lateral surfaces of the forearm), manifested by moderate aching pain, which stops within 1-2 weeks. During the transition to the serous form, the pain intensifies, becomes bursting, accompanied by limb deformity due to a significant accumulation of fluid under the periosteum.
With purulent periostitis, the pain is intense, rapidly growing. Appear against the background of a purulent lesion of the forearm (furuncle, phlegmon, abscess). Palpation of the bone is sharply painful. The hand is edematous, the skin is hyperemic, the movements are limited. Symptoms of general intoxication are revealed: fever, headache, weakness, chills.
The bones of the forearm in hematogenous osteomyelitis suffer relatively rarely. Pathology is manifested by unbearable pains of a twitching, bursting or boring nature, arising against a background of a pronounced violation of the general condition, significant hyperthermia, chills, fatigue, nausea, and headache. The pain is so severe that the patient avoids even the slightest movement.
In postoperative and posttraumatic osteomyelitis, the symptoms are similar, but the disease develops against the background of an injury or after surgery, and has certain differences in dynamics. The pain syndrome usually grows more slowly than with the hematogenous variety of the disease, does not reach such intensity. In chronic osteomyelitis, the course is undulating, during periods of exacerbation, the manifestations resemble acute osteomyelitis, then the pain subsides, and a fistula forms in the affected area.
Pain in the forearm occurs with purulent diseases of the soft tissues. The pain is initially pressing or arching, quickly intensifies, becomes jerky, pulsating, prevents any movements, deprives a night's sleep. Accompanied by edema, an increase in local temperature, disorders of the general condition of varying severity - from slight hyperthermia to severe fever. Pain syndrome can be provoked by the following purulent pathologies:
Pain in the forearm against the background of purulent processes and infected wounds may be due to lymphangitis and stem lymphangitis. With lymphangitis, pain in the area of inflammation increases, the general condition worsens, a marble pattern appears on the skin around the purulent focus. With stem lymphangitis, pain, swelling and hyperemia spread along the forearm in the form of a strip, pass to the shoulder.
Phlebitis of the veins of the forearm develops with infectious diseases, after the administration of drugs (post-injection phlebitis). It is characterized by sharp pain in the area of inflammation or injection of the drug, spreading along the vein. When palpated, a dense painful cord is revealed. The general condition is usually not disturbed. In injection drug addicts, phlebitis becomes recurrent. Pain is less pronounced due to fibrous degeneration of tissues, the skin over the linear cord is dense, cyanotic.
Intense growing pains that are not relieved by non-narcotic analgesics are noted in myofascial compartment syndrome, which is a complication of trauma, inflammation, snake bites, and prolonged use of a tourniquet. The pain is aggravated by palpation of the forearm, combined with significant swelling, thickening of soft tissues, pallor and coldness of the skin.
A special case of compartment syndrome is the initial stage of Volkmann's contracture, which occurs in children with fractures of the shoulder and forearm. It develops in the first hours or days after the injury. The pain increases rapidly, increases with movements of the fingers, is complemented by a dense shiny swelling, pallor of the skin, weakening or disappearance of the pulse in the arteries of the forearm.
Benign tumors of the bones of the forearm occur quite rarely, mainly represented by chondromas. They are manifested by non-intensive intermittent pains of indistinct localization, which persist for several months or years. With the growth of neoplasia, the pain syndrome gradually increases, and a tumor-like formation of bone density is determined in the affected area.
Among malignant neoplasms of the bones of the forearm, osteogenic sarcoma is more common. The lesion of the ulna predominates. Pain at first unclear, dull. Rapidly intensify, constantly disturb, reach the degree of unbearable, progress against the background of thickening of the bone, the appearance of a venous pattern, pastosity of soft tissues, and violations of the general condition.
Pain in the forearm occurs with neuritis and neuropathy of the nerve trunks, including compression-ischemic compression of the nerves in their anatomical tunnels. For neurological pathologies, burning or shooting pains are typical, combined with paresthesias, local trophic disorders, decreased sensitivity and muscle strength in the innervated zone. Pain syndrome is caused by the following diseases:
Patients with pain in the forearm are examined by orthopedic traumatologists. With a purulent lesion, patients are referred to surgeons, with a pain syndrome of neurological etiology - to neurologists. The diagnostic program includes a survey and a physical examination, during which the condition and functions of the limb are assessed, deformity, pathological mobility, edema and other symptoms are detected. The following procedures may be prescribed:
For minor injuries, the hand is fixed with a scarf bandage, cold is applied. In case of fractures, a splint is applied from the fingers to the upper third of the shoulder, an analgesic is given. All manipulations with the injured limb are carried out carefully and carefully in order to prevent aggravation of the injury. In inflammatory diseases, topical agents with analgesic and anti-inflammatory effects are applied. With signs of purulent inflammation, sharp pains, increasing swelling, you should immediately consult a doctor.
Treatment of fractures of the radius in a typical location is usually conservative. For other types of fractures of the forearm, therapeutic measures, depending on the characteristics and severity of the damage, can be either conservative or surgical. The fracture site is anesthetized, if necessary, reposition is carried out, and a plaster cast is applied.
Conservative treatment of diseases of the forearm usually includes a change in the mode of motor activity, drug and non-drug therapy. The following methods are applied:
Taking into account the nature of the pathology for injuries and diseases of the forearm, the following operations are performed:
In the postoperative period, antibiotics are prescribed, rehabilitation measures are carried out. In malignant tumors, surgical treatment is supplemented with chemotherapy, radiation therapy.