Elbow Pain At Night (Tennis Elbow Pain), What is it?
The forearm pain is a common problem, which is many times start from the elbow. Problems such as epicondylitis and epithrocleitis are more responsible for the typical pain that radiates from the elbow towards the forearm. This post will show you What Is Elbow Pain At Night (Tennis Elbow Pain) in 2020?
Sometimes the problem manifests itself as diffuse neuralgia; other times, they are dense in particular movements. In other cases, there is an association of tingling in the fingers. In reality, forearm pain can also be caused by other types of situations, which can arise within the muscles, or much more “upstream,” in the cervical t rat. In this article, I will show you what the leading causes of forearm pain are, how they manifest themselves in terms of symptoms, and of course, a series of tips and exercises to solve the problem best.
At the end of the article, you will have a clearer idea of the characteristics of your elbow or forearm problem. However, above all, you will have an “action plan” to start improving it immediately! PS: the instructions and exercises you will find are taken from the video course “Guide to elbow and wrist problems,” which I created in collaboration with coach Alessandro Maine.
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What are the possible causes of pain in the elbow and forearm and how they manifest in terms of symptoms As I said earlier, forearm pain is often an “extension” of elbow pain. However, sometimes some problems arise directly in the forearm.
The leading causes of forearm and elbow pain are:
- epicondylitis, which is inflammation of the outer tendons of the elbow (which extend from the wrist)
- epithrocleitis, which is inflammation of the internal tendons (which flex the wrist
- tendonitis of the flexors or extensors of the fingers
- syndrome of the carpal tunnel
- Cervical hernia
It is quite rare that pain in the forearm (especially the left one) can be a “warning” for acute heart problems such as heart attack, especially if it presents itself as isolated pain without other symptoms.
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However, the appearance of sudden pain in the forearm never felt before deserves further attention, if only for greater peace of mind. The problems I refer to in this article last several weeks or several months, so there can hardly be any suspicion of an acute heart problem. Let’s see in detail what the problems I mentioned above are and what are the characteristic symptoms of each of them.
Epicondylitis (or “tennis elbow”) is an inflammation at the tendons of the wrist extensors, which originate at the level of a bone structure called the epicondyle.
This inflammation, as I explain in the article dedicated to epicondylitis, can have various underlying causes, among which certainly there are repeated micro-traumas.
Epicondylitis is characterized by often very acute pain that appears even in simple gestures, such as unscrewing a jar.
The “territory” of pain is typically the outside of the elbow. However, it is not uncommon for the pain to “go down” to the forearm and sometimes to the hand.
The ‘ medial epicondylitis (or “golfer’s elbow”) is the “neighbor” epicondylitis: in this case, to have inflamed the tendons of the wrist flexors, which originate in the inner part of the elbow.
This inflammation also has the same underlying causes as epicondylitis: while epicondylitis seems to be shared even in the non-sporting population, epicondylitis is often the prerogative of gymnasts, golfers, and sportsmen in general.
Compared to epicondylitis, pain in daily activities is more manageable.
As the “territory” of pain, epithrocleitis tends to be more localized on the inner face of the elbow.
The muscles of the forearm are mostly used to move the wrist and fingers.
For various reasons, the tendons of these muscles (i.e., the “extensions” with which they attach to the bones) can undergo a state of functional overload and become inflamed. These can be sporting gestures and postures maintained for a long time, like that type of computer employee.
When the tendons in the forearm become inflamed, the symptoms depend on which structure is most involved. Tendinitis of the flexor muscles of the fingers usually presents with pain (and sometimes burning) from the palmar side of the wrist up. Inflammations of the extensor tendons of the fingers generally involve more the opposite side, that is the dorsal face.
Carpal tunnel syndrome
The carpal tunnel syndrome is a very well-known problem and very common in orthopedic departments. This is the entrapment of the median nerve in the carpal tunnel, a narrow fibrous “bridge” that often tends to narrow further. When there is a nerve in pain, as in the case of the carpal tunnel, the symptoms are often prevalent and appear (obviously) as real neuralgia. In the case of carpal tunnel, pain often involves the entire forearm and hand. However, tingling and pain in the first three fingers are typical at the level of the hand.
A cervical hernia is a fairly common finding in cervical resonances, and not always be cause for concern, since it is often even in people without symptoms. I have explained all the details of this problem in the article on the cervical hernia. In a second article, Cervical hernia, dedicated to the symptoms to know absolutely, I have included in the three symptoms “key” just the forearm pain.
This is because forearm pain is typical when the cervical hernia is in a particularly acute and inflammatory phase. When forearm pain is caused by a cervical hernia, it is usually easy to understand—the pain changes (increases or decreases) depending on the movements of the neck.
Also, it is rare that in the case of a cervical hernia, there is only pain in the forearm: very often, there is widespread neuralgia that starts from the neck, “turn” behind the shoulder blade and culminate in the forearm.
What tests and examinations can help
Forearm problems are often easy to diagnose, and in most cases, no special follow-up tests are needed. The first fundamental step is, therefore, the “obvious” one of going to your doctor, who very often already has the skills needed for a diagnosis. It should be noted that many times, even in very painful elbows, precise tests such as magnetic resonance do not detect significant alterations.
An examination that is often performed in these cases, as it is fast and cheap, is ultrasound, which, however, has different resolution limits. The MRI is a more accurate examination but used in a minority of cases, such as when the pain persists despite treatment. I do not mind you the reason ( of continuation of pain in epicondylitis and medial epicondylitis is, unfortunately, the norm ).
If there is a suspicion of a ‘ cervical hernia, the MRI cervical is indispensable to confirm their suspicions.
Tips and remedies for the acute phase of pain
Any problem that affects the elbow or forearm, among those I mentioned above, is characterized by an acute phase. By the “acute phase,” we mean the first days/weeks from the onset of pain when the pain is often particularly strong and limiting.
In this phase, there are a series of tips and indications that can help: many of them are known to everyone, but it is always better to review them. The obvious premise is that the first instructions to follow are those of the attending physician.
# 1 Ice
15-20 minutes of ice pack 3-4 times a day can help reduce local inflammation for the first few days.
# 2 Anti-inflammatory patches and ointments
The elbow and forearm are fairly superficial areas, in which we can think that the anti-inflammatory substance contained in patches and ointments can get at least close to the “target.”
Do not place hopes of miracles in these remedies: tendon disorders are particularly severe. They do not disappear because “we have applied something on them.”
# 3 Anti-inflammatory (natural and otherwise)
In my experience (now more than 15 years) as a physiotherapist, I have rarely heard of anyone who has had significant benefits from anti-inflammatories, even less from the natural (and therefore inevitably “weakened” versions.
The reason is simple: we are talking about areas that struggle to heal due to low vascularity.
As little blood arrives, it makes sense that anti-inflammatory molecules struggle to reach the affected tissue.
# 4 Physiotherapy treatments (laser, tecar, etc.)
I don’t say much about this type of treatment because I don’t use them and have never used them.
In my opinion, there is not so much evidence of effectiveness to justify their use. However, it is also true that many colleagues use them, so on someone they can certainly be useful.
Try it if recommended by an orthopedist and trusted physiotherapist.
Specific exercises for elbow and forearm pain
After the acute phase, we enter the so-called “chronic” phase: the pain is no longer so sharp, but it still creates headaches.
Among the “headaches” there can undoubtedly be problems with training, especially in activities that require abundant use of the upper limbs, such as tennis or training in the gym.
In this phase, re-education through targeted exercises is the protagonist.
Targeted exercises allow you to:
- make structures that are more rigid (muscles and tendons) more elastic
- vascularize, thanks to movement, poorly vascularized structures
- strengthen the tendons and help them to support the load more
These three conditions can only be achieved with targeted exercise, no manipulation, medication, or therapy takes. All the scientific literature on this subject agrees that therapeutic exercise is the primary “weapon” to use when trying to solve a muscle and tendon problem (if you are interested in scientific research, the main exponent in this field is Jill Cook ).
Here is a series of exercises that you can do daily. That will help you improve the condition of the muscles and tendons of the elbow and forearm. There are four exercises: the right approach is to do the first two one day and the other two.
To whom the exercises can be useful
These exercises are not designed for a specific problem: they are intended to improve the state of the forearm muscles in a general way.
When this happens, the problems generally improve regardless of what their name is (epicondylitis, epitrocleitis, etc., the issues I mentioned earlier, basically).
PS: the exercises you will see shortly are taken from the video course “Guide to elbow and wrist problems” that I made with my friend and trainer Alessandro Maine, well known in the world of free body gymnastics.
Together we have studied a simple, complete, and following procedure for all the most common problems of the elbow and wrist.
Exercise # 1: Flexor Stretch
This simple stretching of the flexor muscles is used to release the tension of the muscles that cause the hand to close and the wrist to flex, notoriously very stressed by any sport or work activity.
Exercise # 2: Extensor Stretch
Stretching the extensors is used to stimulate an often “forgotten” muscle, the one that extends the wrist and opens the fingers.
Exercise # 3: Strengthening the flexors
After stretching the muscles, it is also time to strengthen them so that they are ready to respond to stress.
Strengthening exercises also have a high vascularization power; that is, they increase the blood supply to the muscle and tendons.
Exercise # 4: Strengthening the Extensors
After strengthening the flexors, it is crucial to increase the extensor muscles as well.
This exercise is one of the fundamental “pillars” of epicondylitis rehabilitation: to illustrate them is coach Alessandro Maine.
The elbow and forearm problems are often related to our activities, whether it be of activity sports that business work.
These are often very difficult inflammations, which take weeks to improve, but we often speak of months.
Despite this, we are sure that staying still and avoiding any form of the load is NOT the best approach for this type of problem, which benefits more from “controlled load” than from rest.
In the article, you have found a series of exercises to start. If you are interested in learning more, there is a “Guide to elbow and wrist problems.”
I just have to wish you GOOD RECOVERY!