Arm pain, whether it concerns pain in the upper arm or forearm, the left arm or the right arm, can indicate various causes. Pain in the upper arm can radiate to the shoulder and neck and vice versa. Arm pain may be due to a muscle strain or muscle tear, but it may also be that an underlying condition is causing the pain. It may be a nagging, stabbing or dull pain in the arm. Depending on the location and cause, a painful arm may be accompanied by numbness, tingling, redness, swelling, tenderness (to touch), limited range of motion, loss of function or stiffness (of the joints). If pain in the arm persists, it is wise to consult your doctor. The treatment for a painful arm depends on the underlying cause. Sometimes recovery is quite quick and sometimes recovery takes much longer and there may be chronic complaints. Follow the doctor’s instructions to promote recovery.
- The arm
- For which symptoms should a doctor be consulted?
- Pain in the arm due to injury or trauma
- Muscle strain or muscle tear
- Arm pain from whiplash
- Pain in the arm due to a fracture
- Dislocated elbow
- Problems with the nerves
- Carpal tunnel syndrome
- Cubital tunnel syndrome
- Thoracic outlet syndrome
- Brachial plexus injury
- Thoracic aperture syndrome
- Joints, muscles and tendons
- Tennis elbow
- Bursitis
- Tendonitis
- De Quervain’s syndrome
- Golfer’s elbow
- Rotator cuff tear
- Intervertebral discs and vertebrae
- Cervical spondylosis
- Pain in the arm due to a neck hernia
- Heart complaints
- Angina pectoris (chest pain)
- Heart attack
- Rheumatic conditions
- Fibromyalgia
- Rheumatoid arthritis
- Cancer
- Phlebitis
The arm
The arm is one of the most mobile parts of the body due to its extensive number of muscles and joints. The arm extends from the shoulder, where it is attached to the upper body, to the wrist joint, where it is attached to the hand. The arm has two parts: the upper arm, which extends from shoulder to elbow, and the forearm, from elbow to wrist. The arm has several joints: the shoulder, elbow and wrist joints and the hand joints. The arm is covered by strong muscles. The muscles, together with the mobile joints of the shoulder and elbow, ensure that the arm can perform a wide range of movements, such as lifting, bending, stretching, moving sideways, moving inwards and rotating. There are blood vessels and nerves in the arm. The main blood vessel in the arm is the brachial artery or (upper) brachial artery, which originates from the armpit artery (axillary artery) and splits at the elbow into the radial artery or large wrist artery and the ulnar artery or ulnar artery. The nerves in the arm run from the brachial plexus in the neck (a network of nerves in the neck and shoulder area), along the armpit to the arm. The bones in the arm are the humerus, the radius and the ulna. The upper arm contains one bone, namely the upper arm bone, which is connected to the shoulder blade (scapula). The forearm has two bones, the radius and the ulna, located between the elbow joint and the wrist joint.
For which symptoms should a doctor be consulted?
Emergency treatment is necessary when the pain in your arm is the result of a serious trauma or injury, or when these pain symptoms occur acutely. If you have trouble moving your arm or you see bones sticking out of your arm, you should go to a hospital emergency department immediately. Medical attention is also required in case of sudden pain associated with pressure on the chest as this may indicate a heart attack. In that case, call 112 immediately.
Pain in the arm due to injury or trauma
Muscle strain or muscle tear
A muscle strain is caused by excessive stretching of muscle fibers. You can overload muscles during physical exertion, including the muscles in the arm. With a muscle strain you suddenly feel pain. The entire muscle or part of the muscle may hurt, but you cannot properly localize the pain. If the pulled muscle is contracted, the pain worsens. Moving the muscles hurts. There is no visible bruising or swelling.
Arm pain from whiplash
A partial muscle tear or whiplash often occurs at the junction between the muscle and the tendon and can occur with an uncoordinated movement or when the muscle is tensed in an extended position. It also occurs regularly in explosive sports, such as sprinting, high jumping and long jumping, where short explosive movements are always made. Muscles that tend to shorten are most susceptible to this type of injury. In the arm this is the triceps brachii (muscle located at the back of the upper arm). With a muscle tear, you are overcome by a razor-sharp pain in a specific spot. Movement (tightening and stretching the muscle) is painful. A muscle tear can be accompanied by bruising.
Pain in the arm due to a fracture
If you fall with your arm outstretched or if you fall on your shoulder, a broken upper arm may occur. The symptoms are pain, swelling and active limitation of movement of the shoulder region. A fracture of the forearm can also occur. There is often a fracture of both the radius and the ulna. This causes instability of the forearm. In addition to the bone fracture, there is often also injury to the soft tissues, such as skin, tendons, muscles and sometimes vessels and nerves. A serious injury to the soft tissues can lead to an open fracture and failure of the nerves and/or blood vessels.
Dislocated elbow
A dislocated elbow or elbow dislocation is an injury that usually results from a fall on an outstretched arm. The elbow comes ‘dislocated’. When this happens, you acutely feel a sharp pain. Swelling occurs and you can no longer bend your elbow.
Nerve compression of the median nerve or carpal tunnel syndrome (CTS) / Source: Alexonline/Shutterstock.nl
Problems with the nerves
Carpal tunnel syndrome
Carpal tunnel syndrome (CTS) is a common problem of the hand, in which the median nerve or median nerve becomes pinched in the carpal tunnel in the hand, located on the palm side of the wrist. This carpal tunnel is a passageway for nerves and tendons that run from the forearm to the hand. CTS is characterized by tingling or numbness on the inside of the hand, radiating to the area covered by the median nerve, especially the thumb and index finger, middle finger or (part of the) ring finger, but not the little finger. Occasionally someone has numbness in all fingers, including the little finger. Sometimes CTS causes radiating pain from the inside of the hand, via the elbow region, to the upper arm and shoulder. Especially after prolonged and frequent use of the hand.
Ulnar nerve syndrome / Source: Alila Medical Media/Shutterstock
Cubital tunnel syndrome
Cubital tunnel syndrome or ulnar nerve entrapment is a nerve compression of the ulnar nerve or ulnar nerve on the inside back of the elbow. This condition causes pain around the elbow and forearm, possibly radiating to the ring finger and little finger.
Thoracic outlet syndrome
Thoracic outlet syndrome (TOS) is a collective name for conditions in which a vascular nerve bundle in the shoulder region is compressed. Tingling and numbness in the neck, shoulder, hand and arm are complaints that may indicate thoracic outlet syndrome. Due to prolonged work above shoulder height, a vascular nerve bundle (a group of blood vessels and nerves) in the shoulder region may become pinched. This condition is mainly seen in people between the ages of 20 and 40, much more often in women than in men.
Brachial plexus (nerve) / Source: Henry Vandyke Carter, Wikimedia Commons (Public domain)
Brachial plexus injury
The brachial plexus is the nerve network for the arm and arises from five nerve roots from the spinal cord. The brachial plexus branches several times and ends as the brachial nerves high in the armpit. As a result of a traffic accident, and in particular a moped or motorcycle accident, traumatic plexus injury can occur. Various functions of the arm can fail, depending on which nerves are damaged. There may also be an obstetric brachial plexus injury: an injury to the brachial plexus that occurred at birth.
Thoracic aperture syndrome
Thoracic outlet syndrome, or syndromes of the upper thoracic opening, is rare. It refers to a group of disorders that all cause pain and tingling in the hand, neck, shoulder and arm.
Joints, muscles and tendons
Tennis elbow / Source: BruceBlaus, Wikimedia Commons (CC BY-SA-4.0)
Tennis elbow
Lateral epicondylitis or tennis elbow is a common injury. Tennis elbow is an overuse syndrome in which you have overloaded the tendon of the extensor muscles of the hand. There is inflammation of the tendons that run from the elbow to the wrist. The occurrence of (nagging) pain on the outside of the elbow is a characteristic complaint. Occasionally the pain can radiate to the forearm and wrist and sporadically there is pain that radiates to the outside of the upper arm and the shoulder.
Bursitis
A bursitis in the shoulder (bursitis) can be caused by all kinds of complaints. The symptoms of bursitis in the shoulder are pain in the shoulder and (sometimes significant) limitations in movement. The pain can radiate to the elbow or neck. Bursitis is often caused by mechanical irritation of the bursa as a result of overload.
Tendonitis
Tendinitis or tendinitis often occurs in middle or older age when the tendons become more sensitive to damage. Certain tendons are sensitive to inflammation, especially those of the hand and forearm. An inflammation of the tendon that bends the thumb away from the hand is called De Quervai’s syndrome (see below). Tendonitis at the top of the biceps in the upper arm causes pain when bending the elbow or lifting and rotating the arm.
De Quervain’s syndrome
De Quervain’s syndrome, also called Quervain tendonitis, is a consequence of tendonitis of the thumb and wrist. The most common symptom is pain on the thumb side of the wrist, which can develop gradually or acutely. Occasionally the pain radiates to the forearm.
Golfer’s elbow
Medial epicondylitis or golfer’s elbow is an inflammation of the inner side of the elbow where the muscles attach (tendonitis). Often the cause is overload. A penetrating pain on the inside of the elbow, which sometimes radiates to the forearm, wrist and hand, is a characteristic complaint of golfer’s elbow. The pain rarely radiates to the upper arm and shoulder. Furthermore, loss of strength occurs.
Rotator cuff tear
The rotator cuff is a group of tendons that attach to the head of the upper arm. The tendons are very vulnerable to damage. When they rupture, moving the shoulder is painful and may cause loss of strength and an inability to lift the arm. The pain can radiate to the upper arm.
Intervertebral discs and vertebrae
Cervical spondylosis
Cervical spondylosis is most common in middle-aged and elderly people and is a condition in which the intervertebral discs and the vertebrae in the neck deteriorate. The result of this is that pressure is exerted on the spinal cord at the neck. The complaints may be related to compression of the spinal cord and/or the nerve roots. If the nerve roots are compressed, there may be loss of strength in one or both arms and the muscles may shrink.
Pain in the arm due to a neck hernia
A hernia is a bulge of the intervertebral disc. With a neck hernia or cervical hernia, there is usually no pain in the neck itself, but the pain radiates into the arm, possibly with a numb or pricking feeling. Sometimes there is loss of strength in the arm or hand.
Heart complaints
Angina pectoris (chest pain)
Angina pectoris is the Latin name for ‘chest pain’ and indicates a disease of the heart. Angina pectoris is a painful, oppressive feeling in or on the chest, which is caused by a temporary shortage of blood supply to the heart. Angina pectoris occurs during exertion and disappears immediately with rest. The pain can radiate to the neck, jaw, shoulder or arm. Angina pectoris is caused by narrowing of one or more coronary arteries, the blood vessels that supply blood to the heart muscle itself.
Heart attack
The medical name for a myocardial infarction or heart attack is ‘myocardial infarction’ and it indicates damage to the heart muscle as a result of a lack of oxygen because the blood supply in the coronary artery is completely closed off by narrowing. A heart attack can cause pain or a pressing, squeezing feeling in or on the chest, whereby the pain does not go away when you sit or lie down quietly. Pain may radiate to the left arm (painful left arm, sometimes palpable as tingling in the left arm) and sometimes the right arm or both arms at the same time, the shoulders, neck, jaw and back. Other symptoms include heavy sweating and clammy skin, nausea and/or vomiting, looking pale or gray and shortness of breath.
Fatigue / Source: Istock.com/BartekSzewczyk
Rheumatic conditions
Fibromyalgia
Fibromyalgia is a chronic pain syndrome; it is a form of soft tissue rheumatism in which pain, stiffness and fatigue are paramount. The pain is widespread and is usually experienced in the neck, buttocks (buttock pain), shoulders, arms, upper back and chest. It is not known exactly why people with fibromyalgia develop symptoms.
Rheumatoid arthritis
Rheumatoid arthritis (RA, often simply called ‘rheumatism’) causes joint inflammation. RA is an autoimmune disease and can start insidiously or develop acutely. RA is a chronic disease with an erratic course, meaning that periods of active and quiescent disease alternate. As a complication of RA, blood vessel inflammation or vasculitis can develop, in which the small blood vessels that supply the nerve become inflamed. You may then experience deafness or tingling in an arm or leg. A vertebra can also shift, causing nerve compression. This can, for example, lead to paralysis in the arms or legs.
Lung cancer / Source: Muratart/Shutterstock.com
Cancer
An osteosarcoma is a malignant bone tumor that originates from the bone. It is the most common primary form of bone cancer. This form of bone cancer mainly occurs in the arms and legs and in the knees and shoulders. Lung cancer that is localized in the top of the lung can grow into the nerves that run to the arm. This can cause pain and numbness and the arm can weaken. Breast cancer can cause metastases in the bones, usually in the spine and pelvis, followed by ribs, skull, thighs, hip and upper arms.
Phlebitis
As a result of mechanical irritation by, for example, an IV needle, vein inflammation can develop. A stiff and thick cord then develops on the arm, surrounded by a red, painful swelling. The affected area feels warm.
read more
- Elbow pain: symptoms, cause and treatment
- Tingling in arm: causes and symptoms of tingling
- Pain in shoulder, arm and neck: tendon & bursitis
- Forearm pain: causes and treatment forearm pain
- Pain in upper arm: causes of a painful upper arm
