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Common Causes & Symptoms of Pain in Both Forearms Explained

A torso in a blue short sleeved shirt. The arms are out to the sides and red concentric circles and red lightning bolts emanate from both forearms.
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Last updated April 24, 2024

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Experiencing pain in both forearms could implicate repetitive strain from overuse, or trauma from an injury. Compressed and damaged nerves, or a wrist sprain can cause aching and sore forearms. Read below for more information on causes and treatment options.

7 most common cause(s)

Pain in both forearms symptoms

Your arms are needed for everyday tasks such as walking the dog, lifting boxes, or bringing in groceries. Pain in both forearms can limit your movement and leave you feeling unproductive. Experiencing pain in both forearms, not just one, is an uncommon symptom that should be addressed by a physician. Multiple components of the forearm can be injured and cause pain. Your forearm is the area in the upper limb between the elbow and wrist. The radius and the ulna are the long bones of the forearm. The forearm contains an anterior group of muscles that work to flex the wrist and fingers and a posterior group of muscles that work to extend the wrist and fingers. Three primary nerves run through the forearm called the radial, median, and ulnar nerve, as well as two principal arteries in the forearm, called the radial artery and ulnar artery.

Common accompanying symptoms of pain in both forearms

If you're experiencing pain in both forearms, it's also likely to experience:

  • Stiffness
  • Limited range of movement
  • Tenderness to the touch
  • Redness
  • Difficulty grasping objects or using the hands

Causes of pain in both forearms

Pain in both forearms is most likely the result of injury or inflammation to the components within the forearm space.

Forearm structure

As discussed above, the bones of the forearm include:

  • The radius: This bone starts at the elbow and connects at the wrist on the thumb side.
  • The ulna: This bone starts at the elbow and connects at the wrist on the pinkie side.
  • Muscles: The forearm also contains multiple muscles that not only work to turn the forearm/hand upwards (supination) and downwards (pronation) but also flex and extend the digits of the hand.

Musculoskeletal causes

Musculoskeletal causes of bilateral forearm pain involve issues in the way the components of the forearm work together.

  • Positional: Repetitive actions such as typing, using crutches, and even walking the dog can cause compression of the nerves and blood vessels that branch throughout the forearm. Repetitive positional injury may result in bilateral forearm swelling and pain.
  • Biomechanical: Issues in the forearm such dislocations or sprains can also result in chronic bilateral forearm pain.

Traumatic causes

Traumatic causes of bilateral forearm pain include those that result in injury to the components of the forearm.

  • Fracture: Anything that causes direct injury to the forearm — a car accident, a traumatic fall, a direct blow — can result in broken bones in the forearm as well as swelling and pain. These causes may also be associated with visible deformity and bleeding, depending on the severity of the trauma.
  • Sprain: A sprain is defined as twisting or stretching a ligament or tendon. A ligament is a band of connective tissue that connects bone-to-bone. A tendon is also a band of connective tissue, but it connects muscle-to-bone. Activities that cause bending, twisting, sudden movement or direct impact can sprain the multiple ligaments of the forearm.

Psychosocial causes

Psychosocial causes involve the intersection between social factors (stress, unemployment, etc.) and individual thoughts and behaviors.

  • Stress: Stress related to day-to-day activities may manifest in different parts of the body. The forearms are intrinsically related to many activities of daily living such as getting dressed, holding objects, typing, etc.
  • Somatization: Somatization is the expression of mental phenomena as physical symptoms. For example, you may have experienced thoughts of forearm pain that are now manifesting as physical pain.

This list does not constitute medical advice and may not accurately represent what you have.

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Wrist sprain

A wrist sprain is an injury to the ligaments in the wrist. A mild sprain involves just stretching of the ligaments while more severe sprains can tear the ligaments.

You should see your primary care doctor tomorrow. He or she may request imaging to make sure that there is no further damage to the bones of the wrist.

Thoracic outlet syndrome

The "thoracic outlet" is the space on either side of the base of the neck where nerves, arteries, and veins travel beneath the collarbone. If these become compressed or damaged, the condition is called thoracic outlet syndrome or TOS.

The most common causes are trauma, such as a car accident or fall; and repetition or overuse, such as a sports injury.

Symptoms vary depending on the structures being compressed:

  • Neurogenic TOS affects the nerves. It is the most common form and creates numbness, tingling, pain, and weakness in the arms, hand, and fingers.
  • Vascular TOS affects the arteries and veins. It creates the same symptoms as neurogenic TOS as well as cold, pale hands and arms with weak pulse.

It is important to see a medical provider about these symptoms so that the damage does not become permanent.

Diagnosis is made through patient history, physical examination, imaging such as x-ray or ultrasound, and sometimes nerve conduction and blood flow studies.

Treatment involves physical therapy, pain relievers, and sometimes surgery.

Rarity: Rare

Top Symptoms: pain in one shoulder, spontaneous shoulder pain, arm weakness, arm numbness, pain in one shoulder blade

Urgency: Primary care doctor

Non-specific wrist pain

Wrist pain is common. Repetitive motion can damage your wrist. Everyday activities like typing, racquet sports or sewing can cause pain, or even carpal tunnel syndrome. Sometimes, wrist pain doesn't identify with a single process.

Your wrist pain looks like it is variation of normal, which doesn't require any treatment, for now. You can treat the pain with over the counter pain medication if needed. If anything changes, let's re-evaluate.

Rarity: Uncommon

Top Symptoms: pain in one wrist, spontaneous wrist pain

Symptoms that always occur with non-specific wrist pain: pain in one wrist

Symptoms that never occur with non-specific wrist pain: severe wrist pain

Urgency: Self-treatment

Forearm strain from a repetitive injury

Repetitive strain injury of the forearm is caused by constantly using the wrist.

You do not need treatment, just rest from your overuse. Wearing a brace and physical therapy might be helpful.

Rarity: Uncommon

Top Symptoms: forearm numbness, forearm weakness, forearm pain from overuse

Symptoms that always occur with forearm strain from a repetitive injury: forearm pain from overuse

Symptoms that never occur with forearm strain from a repetitive injury: severe forearm pain, forearm injury

Urgency: Self-treatment

Contusion of the wrist

A bruise is the damage of the blood vessels that return blood to the heart (the capillaries and veins), which causes pooling of the blood. This explains the blue/purple color of most bruises. Bruises of the wrist are common, often due to minor injuries.

You can treat this at home with R.I.C.E - rest (exercise as tolerated), ice (10-20 minutes at a time), compression (this is optional, with bandage or tape), and elevation.

Rarity: Rare

Top Symptoms: wrist injury, pain in one wrist, wrist pain from an injury, swelling of one wrist, wrist bruise

Symptoms that always occur with contusion of the wrist: wrist injury

Urgency: Self-treatment

Carpal tunnel syndrome

Carpal tunnel syndrome causes numbness and pain in the underside of the wrist and hand. It is caused by narrowing of the carpal tunnel passageway, which puts pressure on the nerve running through it.

Narrowing and deformity of the tunnel is most often from overuse, especially highly repetitive activities such as typing or working on an assembly line. Wrist fracture or arthritis can damage the carpal tunnel, and so can diabetes and obesity.

Symptoms include numbness and shocklike pain in the wrist, palm, and fingers. There may be weakness in the hand when trying to hold an object.

Carpal tunnel syndrome virtually always gets worse over time. Permanent damage may result, so it is important to be seen by a medical provider.

Diagnosis is made through patient history and physical examination. X-rays or electromyography testing may be used.

Rest and cold packs to the wrist will reduce swelling. Wrist splints and ergonomically correct keyboards and other devices during work are often helpful.

Corticosteroid injections and surgery may also be tried.

Brachial plexopathy (shoulder nerve issue)

A shoulder nerve injury, also called brachial plexopathy, is when damage occurs to a network of nerves in the front of the shoulder known as the brachial plexus. This damage can occur from injury, inflammation, radiation therapy, or other medical conditions. Symptoms include sharp pain in the shoulder, arm, or hand. Numbness or weakness in the shoulder or arm may also occur.

You should consider visiting a medical professional to discuss your symptoms. A doctor can evaluate shoulder nerve issues with a review of your symptoms and medical history. You might also be asked to do an EMG, a test that checks the connection between muscles and nerves. Once diagnosed, some options for treatment include pain or nerve block medication, physical therapy, and braces or splints. Some cases may require surgery. Depending on the severity, recovery times can range from weeks to years.

Rarity: Uncommon

Top Symptoms: pain in one arm, shoulder pain that shoots to the arm, arm weakness, numbness in one arm, shoulder pain

Symptoms that never occur with brachial plexopathy (shoulder nerve issue): pain in the front middle part of the neck

Urgency: Primary care doctor

Acute forearm bone infection (osteomyelitis)

Osteomyelitis of the forearm is a bacterial or fungal infection of the bone, typically caused by Staph Aureus (40-50% of the time). It is difficult to diagnose as the infection can come from a break in the skin at the area or anywhere else in the body that spreads by blood.

You should seek immediate medical care at an ER, where diagnosis of osteomyelitis can be established through x-rays and culturing fluids. Treatment involves antibiotics and removing the infected tissue (by surgery).

Rarity: Rare

Top Symptoms: moderate fever, spontaneous forearm pain, constant forearm pain, warm and red forearm swelling, painful surgical site

Symptoms that always occur with acute forearm bone infection (osteomyelitis): spontaneous forearm pain, constant forearm pain

Urgency: Hospital emergency room

Severe wrist pain

Severe arm pain should be checked out with imaging and a physical exam by a doctor.

Rarity: Uncommon

Top Symptoms: severe wrist pain

Urgency: Hospital emergency room

Pain in both forearms treatments and relief

Since pain in both forearms is rare and causes are varied, it is important to make an appointment with your physician in order to get the proper diagnosis and treatment.

At-home treatments

There are some lifestyle changes and techniques you can try at home to help alleviate symptoms.

  • Practice ergonomics: If you spend much of your day typing at a keyboard or doing activities that put pressure on your forearms, make time for regular breaks. Keep your hands in a relaxed, neutral position when you type and use foam supports with your keyboard.
  • Build up your bones: Take calcium supplements to strengthen your bones and prevent fractures.
  • Use protective gear during sports activities: Using hand guards during activities such as snowboarding, rollerblading, gymnastics and tennis can help prevent injury.

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When to see a doctor

If your symptoms persist despite the strategies above, make an appointment with your healthcare provider. Depending on the cause of your symptoms, your physician may suggest:

  • Pain medication: Medications such as NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen (Advil, Motrin) can help alleviate pain in both forearms.
  • Anti-inflammatory: Inflammatory causes of pain in both forearms may be treated with various types of medications that target and decrease inflammation, including immune system suppressing drugs.

Physical therapy or rehabilitation: Your doctor may prescribe stretching exercises or a physical therapy/rehabilitation program to help you restore range of motion, strength, and stability to your forearm, hand, and fingers.

When it is an emergency

The following symptoms may be associated with a fracture or severe injury leading to decreased blood flow to that area. Seek medical care immediately if:

  • Any part of the forearm appears deformed
  • You cannot feel or move your forearm or hand
  • You notice bruising or tenderness to the touch
  • You have persistent swelling and pain
  • The forearm is numb and turns white or pink

FAQs about pain in both forearms

Is pain in both forearms life-threatening?

Usually, pain in both forearms is not life-threatening, especially if it is related to a strain or injury. The one life- and/or limb-threatening condition to be worried about is compartment syndrome — a situation in which increased pressure within a confined space can restrict blood supply to an organ. Though possible, compartment syndrome of both forearms is rare.

How do you treat compartment syndrome?

Acute compartment syndrome is a surgical emergency. Your doctor will make an incision and cut open the skin and fascia covering the affected compartment. This procedure is called a fasciotomy. Non-surgical treatment is the first option for chronic, exertional compartment syndrome. Physical therapy, braces or supports, and anti-inflammatory medicines are often suggested.

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a condition that causes pain, numbness and tingling in the hand and arm. It is a common condition that occurs when one of the major nerves to the hand — the median nerve — is squeezed or compressed as it travels through the wrist.

How do you treat carpal tunnel syndrome?

Carpal tunnel syndrome is a gradual process that usually worsens over time without some form of treatment. There are nonsurgical and surgical treatment options for carpal tunnel syndrome depending on the stage of the disease. For example, early stages can be treated with pain medication, bracing/splinting, and activity changes. However, if the condition has progressed significantly, surgical treatment may be necessary.

What are the side effects of carpal tunnel syndrome surgery?

Carpal tunnel release is a surgery used to treat and potentially heal the painful condition known as carpal tunnel syndrome. Sometimes, the surgery can have long-term complications such as scar tenderness, pillar pain (pain and tenderness localized around the bones of the hand (scaphoid, pisiform or hook of the hamate), and Tinel’s sign (pain or tingling when slightly tapping over the nerve).

Questions your doctor may ask about pain in both forearms

  • How would you explain your forearm pain?
  • Have someone feel for your pulse (at the wrist) on the side of your body that hurts. Now, turn your head to that side. Does the pulse go away? (This is known as the Adson's test.)
  • What is your body mass?
  • Have you ever been diagnosed with diabetes?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

Pain in both forearms symptom checker statistics

People who have experienced pain in both forearms have also experienced:

  • 6% Pain In Both Hands
  • 4% Weakness In Both Hands
  • 3% Swelling Of Both Forearms

People who have experienced pain in both forearms were most often matched with:

  • 40% Thoracic Outlet Syndrome
  • 30% Carpal Tunnel Syndrome
  • 30% Brachial Plexopathy (Shoulder Nerve Issue)

People who have experienced pain in both forearms had symptoms persist for:

  • 29% Over a month
  • 25% Less than a day
  • 25% Less than a week

Source: Aggregated and anonymized results from Buoy Assistant (a.k.a. the quiz).

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

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