Arm Pain

What is Arm Pain?

Arm pain is a common complaint that involves discomfort, soreness, or aching in any part of the arm, including the shoulder, elbow, wrist, and the joints and muscles in between. It can result from various causes, ranging from normal muscle fatigue after intense exercise to more serious conditions like fractures, nerve damage, or heart disease.

How Does Arm Pain Impact Your Anatomy and Health?

Depending on its cause, arm pain can impact your anatomy and health in several ways. Acute injuries can lead to inflammation, swelling, and bruising, limiting your arm's mobility and function. Arthritis, a condition resulting from long-term joint damage, can result in chronic pain and stiffness while long-term carpal tunnel syndrome can lead to irreversible nerve impairment and muscle weakness.

Regardless of its cause, persistent arm pain can significantly affect your daily activities, work, sleep, and overall quality of life.

Who is Most at Risk for Arm Pain?

Anyone can experience arm pain, but certain groups are at higher risk. These include athletes and individuals who engage in repetitive arm movements (like factory workers, painters, or musicians), older adults (due to a higher risk of conditions like arthritis or osteoporosis), and individuals with underlying health conditions like diabetes, which can lead to nerve damage.

Causes of Arm Pain

Arm pain can be attributed to various causes, from acute injuries to chronic conditions.

• Muscle Strain or Sprain: One of the most common causes of arm pain, often resulting from physical activity or an injury. A strain involves the muscles or tendons, while a sprain involves the ligaments.
• Fracture or Dislocation: A broken bone or dislocated joint in the arm, wrist, or shoulder can cause severe arm pain. These injuries usually result from a significant force or impact, such as a fall or a collision in sports.
• Overuse or Repetitive Strain Injury (RSI): Regularly engaging in repetitive arm movements, such as playing tennis or typing, can lead to overuse injuries. Tennis elbow and golfer's elbow are common examples.
• Arthritis: Osteoarthritis, rheumatoid arthritis, and other forms of arthritis can cause pain in the arm's joints, including the shoulder, elbow, wrist and hand.
• Nerve Compression or Damage: Conditions such as carpal tunnel syndrome, cubital tunnel syndrome, or a pinched nerve in the neck (cervical radiculopathy) can cause arm pain, often accompanied by tingling, numbness, or weakness.
• Cardiovascular Problems: Sometimes, arm pain can be a sign of heart disease. For example, angina or a heart attack can cause pain radiating to the arm, usually the left.
• Infections or Inflammatory Conditions: Infections in the arm or conditions like bursitis or tendonitis can cause arm pain.
• Cancer: Certain types of cancer, such as bone cancer or leukaemia, can cause arm pain, though this is less common.

Symptoms of Arm Pain

Arm pain symptoms can vary greatly, depending on its cause, location, and severity. Here are some common symptoms that can accompany arm pain:

• Pain: The pain can be sharp, dull, burning, throbbing, or aching. It may occur constantly, intermittently, or only when you move your arm a certain way.
• Swelling or Redness: Injury or inflammation can cause the affected area to swell or become red.
• Warmth: The affected area might feel warm or hot to the touch, indicating inflammation or infection.
• Numbness or Tingling: Conditions that affect the nerves, like a pinched nerve or carpal tunnel syndrome, can cause numbness, tingling, or a “pins and needles” sensation.
• Weakness: You may find using your arm or hand more difficult than usual or need help lifting objects or performing certain tasks.
• Limited Range of Motion: Conditions like arthritis or injuries like a sprain or fracture can make it difficult to move your arm, wrist, or shoulder fully.
• Stiffness: Particularly with arthritis, you might find that your joint feels stiff, especially in the morning or after periods of inactivity.
• Bruising: If your arm pain is due to trauma or injury, you may see bruising around the affected area.

Types of Arm Pain

Arm pain can be categorised into several types based on its cause, location, and characteristics. Here are some common types of arm pain:

• Muscle Pain: Usually results from strain, overuse, or injury. It is often described as aching or cramping and tends to be localised to the affected muscle area.
• Joint Pain: Often due to arthritis or other joint conditions like bursitis, this type of pain is usually felt in the shoulder, elbow, or wrist. It may be accompanied by joint stiffness and swelling.
• Bone Pain: Can be due to fractures or conditions like bone infection or cancer. Bone pain is often described as deep, penetrating, or dull.
• Nerve Pain: Results from nerve compression or damage, like in conditions such as carpal tunnel syndrome, cubital tunnel syndrome or a pinched nerve in the neck (cervical radiculopathy). Nerve pain often has a sharp, shooting, or burning quality and may be accompanied by tingling, numbness, or weakness.
• Referred Pain: Felt in the arm but originating from a problem elsewhere in the body. For example, a heart attack can cause pain in the arm, usually the left arm.
• Psychogenic Pain: Arm pain can sometimes manifest as a result of psychological stress or emotional distress, although this is less common.
• Chronic Pain: When arm pain persists for over three to six months, it is considered chronic. This can occur with conditions such as chronic tendinitis or long-term nerve damage.

Stages of Arm Pain

Arm pain doesn't typically follow specific "stages" like some conditions (for example, cancer or chronic kidney disease). Instead, the progression of arm pain often depends on its underlying cause. However, arm pain can be generally classified into stages based on its duration and progression:

• Acute Stage: The initial stage is when the pain has just begun. It's usually a result of an injury, strain, sprain, or the onset of a condition like arthritis or tendonitis. The pain can be severe and is often accompanied by inflammation.
• Subacute Stage: This stage follows the acute stage, typically within a few days to a few weeks after the onset of pain. The initial inflammation starts to reduce, but the pain might persist.
• Chronic Stage: If the pain lasts over three to six months, it's considered chronic. The pain may come and go or be constant, depending on the cause. Chronic arm pain could be due to osteoarthritis, nerve damage, or repetitive strain injuries.
• Recovery or Resolution Stage: This is when the arm pain improves through natural healing or treatment. This stage can involve physical therapy or rehabilitation to restore function and prevent recurrence.

Arm Pain Diagnosis

To diagnose the cause of arm pain, your doctor will typically perform several steps:

• Medical History: The process begins with understanding your symptoms, lifestyle, activities, and overall health. Your doctor will ask about the characteristics of your pain (such as its location, intensity, and duration), any associated symptoms, any injury or activities that may have led to the pain, and your medical history (including any history of arm or neck problems, or chronic diseases).
• Physical Examination: Your doctor will then conduct a thorough physical examination. This may include checking for tenderness, swelling, warmth, or redness, testing your arm strength and range of motion, and performing specific manoeuvres to reproduce your symptoms and help identify the cause.
• Imaging Tests: If the cause of your pain isn't clear from the history and physical exam, your doctor may order imaging tests. These could include X-rays (to evaluate the bones and joints), a CT scan or MRI (to get more detailed images of the bones and soft tissues), or an ultrasound (which can be useful to assess muscles, tendons, and ligaments).
• Lab Tests: In some cases, blood tests may be ordered to check for signs of infection, inflammation, or certain diseases that can cause arm pain, such as rheumatoid arthritis.
• Nerve Tests: If a nerve problem is suspected, like carpal tunnel syndrome or a pinched nerve in the neck, your doctor may order nerve conduction studies or an electromyogram (EMG) to assess the function of the nerves in your arm.

Arm Pain Treatments

The treatment for arm pain will largely depend on the underlying cause, the severity of the pain, and the individual's overall health. Here are some common treatment methods:

• Conservative Treatment: This usually includes rest, ice, compression, and elevation (RICE) to help reduce inflammation and pain. Over-the-counter pain relievers may also be recommended, like paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs), may also be recommended.
• Physical Therapy: Exercises and stretches guided by a physical therapist can help improve mobility, strengthen muscles, and alleviate pain. For example, physical therapy is crucial in rehabilitation during repetitive strain injury or after a fracture.
• Splints or Braces: These may be used to immobilise the arm, provide support, and allow for healing, particularly in the case of injuries, fractures, or conditions like carpal tunnel syndrome.
• Steroid Injections: For conditions like arthritis or severe tendonitis, steroid injections may be administered to help reduce inflammation and pain.
• Lifestyle Modifications: These include ergonomic adjustments at the workplace for people experiencing arm pain due to repetitive activities or weight loss and regular exercise for individuals with arthritis.
• Alternative Treatments: Some people might find relief from acupuncture, massage, or other complementary therapies, although their effectiveness varies and should be discussed with your doctor.
• Surgery: In severe cases, surgery may be necessary, such as significantly displaced fractures, nerve decompression in carpal tunnel syndrome, or joint replacement in severe arthritis.

What if Arm Pain is Untreated?

If left untreated, arm pain caused by an underlying condition can worsen and lead to complications. For example, untreated fractures can lead to chronic pain and disability, untreated nerve conditions can lead to permanent nerve damage, and untreated heart conditions can lead to life-threatening complications.