Forearm pain neck

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Pain in the forearm has many potential causes including arthritis, tendonitis, and bursitis.

However, when it’s coupled with neck pain, the number of possibilities is decreased.

The most likely cause of forearm pain accompanied by neck pain is referred pain from cervical radiculopathy (pinched nerve in the neck).

The cervical spine consists of 7 vertebrae, each shaped like a block, and are separated from one another by shock absorbing intervertebral discs which allow the spine to move freely. Each disc consists of a jelly-like "nucleus pulposus" in its center, surrounded by the tough fibrous membrane called the "annulus fibrosis" which is attached to the adjacent vertebral bodies.

The cervical spinal column provides support of the head and protection of the spinal cord.

Attached to the back of each vertebral body, are two bones called "pedicles", one on each side, as well as an arch of bone that encloses a hollow space that runs the length of the spine - much like a tube- and serves as the conduit for the spinal cord and spinal nerves.

At each vertebra level a pair of spinal nerves (right and left "nerve roots") exits from the spinal column through openings called foramina.

With aging, progressive degenerative changes occur in the cervical spine. The nucleus of the discs gradually dries out and becomes thinner. As a result, the annulus portion of the discs "bulges". There is increased wear and tear on the joints of the vertebral column.

Wear and tear leads to smaller neural foraminal channels for nerve roots to exit the spinal column. The result is nerve root irritation which causes severe sharp pain radiating all the way down the arm and into the forearm.

There are a number of conditions with shoulder, arm and neck pain, weakness of arm and/or hand muscles, and/or numbness of the arm or hand, that must be differentiated from cervical disc and nerve root problems.

"Brachial plexitis" (Parsonage-Turner syndrome)is a condition in which there is inflammation of the nerves in the brachial plexus in the neck, with severe neck and shoulder pain followed by paralysis of shoulder girdle and upper arm muscles. There usually is spontaneous recovery over a period of months. There is no numbness in the arm or hand. Pain occurs in the forearm on occasion.

Thoracic outlet syndrome (TOS) is a rare condition in which the nerves in the neck above the collar bone (the brachial plexus), are entrapped or squeezed by muscles, ligaments or abnormal bone, causing arm and hand discomfort.

Peripheral nerves in the arm or hand may be entrapped or inflamed, giving rise to forearm and hand pain and numbness. Examples are the median nerve at the wrist (carpal tunnel syndrome) and the ulnar nerve at the elbow (cubital tunnel syndrome). Peripheral neuropathy can also occur in the arms due to diabetes.

An interesting combination can be caused by a pinched nerve in the neck accompanied by carpal tunnel syndrome in the wrist. This is referred to as "double crush" syndrome.

Tumors or infections affecting the spinal column, although rare, must also be considered in a patient who complains of persistent neck or arm pain as well as weakness and/or numbness.

Another condition that is sometimes seen is soft tissue injury. This occurs when the tendons and ligaments surrounding the structures in the neck, shoulder, elbow, and wrist become strained. An example is epicondylitis in the elbow. Tendonitis involving the distal portion of the biceps tendon can also cause forearm pain. Entrapment of the radila nerve at the elbow can cause forearm pain.

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Click here Second Opinion Arthritis Treatment Kit

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