The optical theorem is an important tool for scattering analysis in acoustics, electromagnetism, and quantum mechanics. We derive an extended version of the optical theorem for the scattering of elastic waves by a spherical inclusion embedded in a linear elastic solid using a vector spherical harmonics representation of the waves. The sphere can be a rigid, empty cavity, elastic, viscoelastic, or layered material. The theorem expresses the extinction cross-section, i.e. the time-averaged power extracted from the incoming beam per its intensity, regarding the partial-wave expansion coefficients of the incident and scattered waves. We establish the optical theorem for a longitudinal spherically focused beam scattered by a sphere. Moreover, we use the optical theorem formalism to obtain the radiation force exerted on an inclusion by an incident plane wave and focused beam. Considering an iron sphere embedded in an aluminum matrix, we compute the scattering and elastic radiation force efficiencies. In addition, the elastic radiation force is obtained on a stainless steel sphere embedded in a tissue-like medium (soft solid). Remarkably, we find a relative difference of up to 98% between our findings and previous lossless liquid models. Regarding some applications, the obtained results have a direct impact on ultrasound-based elastography techniques, ultrasonic nondestructive testing, as well as implantable devices activated by ultrasound.