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Forearm pain

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My forearm, down to my wrist, mostly near the outer elbow, it has been aching and aching when I lift things heavy or somewhat heavy. My doctor said its tennis elbow. I have noticed the aches, at times, go down to my wrist. Not always though, I may catch it doing that ever so often. I don't think I feel any tenderness, or rather it doesn't ache when I touch it. I kind of do a lip picking thing with my left hand, with my thumb and index or thumb and middle finger. I am trying to quit this habit so my arm can heal. Can tennis elbow be healed? Does this sound like tennis elbow to you? I know it is strained as I pick at my lip. So I know it will only get worse as I keep up the habit. I only have the aches and soreness or strain feeling. No other symptoms, except aches when lifting. Do I need to exercise my forearm to strengthen it? How can I help it heal quicker? Thanks


Category: Family Physician-GP

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Category: Sexually Transmitted Diseases(STD)Specialist
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Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Hello,

Thank you for choosing DoctorSpring.

I have discussed your concern with our team Orthopaedic Surgeon .

The pain is not very specific of a tennis elbow. We would like to know for how many days you are having this pain ? I understand that the pain is towards the outer elbow. Is it more towards the back side of the arm/elbow or towards front ?
Suppose if you hold a folder towel and twist it using both hands, do you get the pain ?

You can reply as a followup
Thank you.


Patient replied :

I've had this going on for a while now. Maybe a year or so. The aches or pain is on the top of the forearm near the elbow (outer), like where the arm bends. I can hold a towel or blanket & twist it, with palm upward, & still feel the ache or strain. I was using a tennis elbow brace or support or whatever, it seemed to help, somewhat. It seems as it is slowly getting more strained or something. But my lip picking habit doesn't help the strain. Something I need to quit.


Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

With inputs from Dr.Mukesh Tiwari.

Tennis elbow (or lateral epicondylitis) is a strong possibility, but symptoms are not 100% fitting into the diagnosis. Other possibilities are a ulnar neuritis and cubital tunnel syndrome.

Anyway the initial appraoch to the problems are similar :

1. Rest whenever possible, but there is no need to restrict activities of daily living
2. Ice packs can help
3. NSAID pain medications like Ibuprofen for short term 4-5 days.
4. Avoid activities that exacerbate the symptoms
5. A counterforce brace. (to be applied properly as per the package insert). These braces are placed on the forearm approximately ten centimeters distal to the elbow joint
6. Physical therapy. This is very important. Unfortunately it is not possible to explain it via text. You may get in touch with a physical trainer / watch some good videos.

A good plan here would be - physical therapy, rest, observation for upto 2 months. - No resolution --> further tests. Please note it make take upto an year for the symptoms to completely resolve in some cases. If the above measures are not working out second line of treatment options like Glucocorticoid injections can be considered.

Hope this helps
Feel free to ask followup questions'
Thank you


Patient replied :

My forearm seems to be getting weaker as I can't lift something such my laptop with it aching or bothering me. The arm brace or elbow brace gets to be uncomfortable and so Im not wearing it. Is there anything else that can help? And what does "distal to the elbow joint" mean? Which should be tried firsts, injection shots or physical therapy? Thanks


Expert:  Dr. Deepu Sebin Sebastian replied 2 Days.

Hello,

I need one clarification here :

When you lift a laptop , you find it difficult due to (1) the pain or (2) or the weakness ?

Weakness can easily differentiated. You will feel that you may even drop off an object (or it might have already happened) . On the contrary pain will give you a feeling of weakness which is mostly a apprehention that some action will cause you pain (and hence you will be reluctant to do it).

Thank you


Patient replied :

My arm doesn't hurt all the time just when I lift something or move it, straightening it. When I lift my lap top, I feel pain.


Expert:  Dr. Deepu Sebin Sebastian replied 1 Day.

Looks like there is tendinitis which is persisting (not nerve damage). Try to rest the arm as much as possible. Give the braces one more try . Distal to elbow joint means, from the elbow joint. A point that is 10 cm away from the joint. You can get the help of a physical therapist for applying the brace. If properly applied it should not cause much discomfort.
If the brace is not practical or if the pain persists I recommend Injection shots (Corticosteroid injections).

Hope this helps
Feel free to ask followups
Thank you


Dr. Deepu Sebin Sebastian
Category: Sexually Transmitted Diseases(STD)Specialist
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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