Causes of Arm Pain and Treatment Options

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Arm pain is generally experienced on the outside of the shoulder and can sometimes radiate further down towards the elbow. Causes of arm pain include overuse conditions, traumatic injuries, and other conditions that can lead to discomfort.

Causes

It is helpful to separate arm pain into categories based on the causes of discomfort. We will separate arm pain into three major categories: overuse conditions, traumatic injuries, and pain that travels to the arm from another location.

Overuse Conditions

The most common cause of pain is tendinitis or bursitis around the shoulder or rotator cuff tears. While the rotator cuff is typically considered a shoulder joint problem, the pain that is experienced with tendinitis, bursitis, or tears of the rotator cuff is often felt further down the arm.

People often complain of a deep aching sensation over the outside of the arm. Pain that occurs as a result of a rotator cuff problem is often experienced when lifting the arm up overhead, and many people complain of pain at night. In fact, the pain at night can be significant enough to awaken you from sleep, particularly when the shoulder is held in an awkward sleeping position.

Other overuse conditions that can cause arm pain include tennis elbow. This condition is the result of irritation of the tendons on the outside of the elbow joint. Much of this discomfort is experienced in the lower portion of the arm.

Traumatic Conditions

There are several traumatic conditions that can cause pain in the arm. Fractures around the shoulder joint or the humerus bone are a source of arm pain and should be considered in anyone who has had a recent fall or other significant injury. Dislocation of the shoulder or dislocation of the elbow can cause significant arm pain. Muscle contusions can also be a source of discomfort after an injury.

Other Sources of Arm Pain

Pain in the arm can also occur as a result of conditions elsewhere in the body. This can lead to so-called "radiating" symptoms. While the pain is often experienced in the arm, the source of the problem may be elsewhere in the body.

The most concerning of possible radiating symptoms is the result of angina, or a heart attack. Sometimes people with heart problems will experience pain radiating down the arm.

Another source of radiating pain is a result of a pinched nerve in the cervical spine. Problems such as a herniated disc can cause compression on the nerves leading to pain, tingling, and numbness radiating down the arm.

Lastly, a condition called thoracic outlet syndrome can cause compression of the blood vessels or nerves in the shoulder region, also leading to pain going down the arm.

When to See a Doctor

Many causes of arm pain can be managed with some simple treatments, but there are signs that you should see a doctor urgently.

Some of the signs of a more concerning source of arm pain include:

  • Pain or pressure in your chest, symptoms of a heart attack
  • A sudden injury that causes severe pain or deformity, indicating a possible fracture or dislocation
  • Severe pain is not improved with appropriate simple treatment steps
  • Worsening swelling or redness around the painful region

Diagnosis

Making the diagnosis of the source of arm pain is best accomplished by first taking a careful clinical history of the condition. This can help guide your doctor to determine if the source is coming from within the arm, or is coming from elsewhere in the body.

A physical examination of the cervical spine, shoulder, and elbow can help to determine the specific source of the problem. Imaging studies including X-rays, MRIs, ultrasound, can all be useful in helping to establish the source of the pain.

There may be situations where other tests, such as laboratory studies or an EKG, can help to guide treatment, particularly if the condition is felt to be a problem radiating to the arm from elsewhere in the body.

Treatment

As with any medical condition, the treatment should be guided by the underlying condition that is causing the problem.

If arm pain is felt to be the result of a serious condition or a recent trauma, that should be carefully evaluated and treated by a medical professional.

For more common overuse causes of arm pain, some simple treatments include:

  • Rest: Avoiding lifting, pushing, or pulling can be helpful. In some situations, wearing a sling can be supportive, but also a good reminder to rest the extremity.
  • Ice application: Applying ice to the shoulder and arm region can help to reduce inflammation and also relieve pain. Ice can be helpful at preventing swelling in the affected area.
  • Anti-inflammatory medication: Nonsteroidal anti-inflammatory medications are effective at reducing inflammation and decreasing pain. These medications can have possible side effects and should be taken under the direction of your doctor.
  • Physical therapy: Many conditions that lead to arm pain are the result of poor mechanics of the shoulder and upper extremity. Even muscular people who regularly perform physical activity can develop significant arm pain as a result of abnormal mechanics of the joints. Working with a skilled physical therapist can help to alleviate these problems.
  • Cortisone injections: A cortisone injection is a powerful anti-inflammatory medication delivered directly to the site of a problem. The benefit is delivering a significant anti-inflammatory medication directly to the problem, although there are possible side effects of a cortisone injection.
  • Surgery: Surgery is generally performed when the simpler treatments fail to provide adequate relief. However, surgery can be performed to repair rotator cuff tears, remove the inflammation from around the shoulder, repair fractures of the arm, as well as treat other conditions that are a possible source of arm pain.

A Word From Verywell

Pain in the arm can occur as a result of overuse conditions, traumatic injuries, as well as pain radiating from another part of the body. The most common reason why people have pain in their arm is from overuse conditions of the shoulder joint. Specifically, rotator cuff problems are notorious for causing symptoms of arm pain. While simple treatments are often effective at managing arm pain, it is important that the cause of the problem is correctly identified in order to ensure that the treatment can be targeted to the appropriate source. There are some serious conditions, notably heart problems, that should be considered in people who have the abrupt onset of arm pain without a known injury.

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Article Sources
  • Fields KB. (2018). Evaluation of the adult with shoulder complaints. In: UpToDate, O'Connor, FG (Ed), UpToDate, Waltham, MA, 2014.

  • O'Connor FG. (2018). Evaluation of elbow pain in adults. Fields KB, ed. UpToDate. Waltham, MA: UpToDate Inc.