Arm Pain

Where is the pain?

Arm pain can come from the arm itself or the pain can be referred from the neck. The nerves which leave the spinal cord to supply the arms are called C(for cervical)5, C6, C7, C8 and T1. These 5 nerves join together to form the brachial plexus, which runs behind the collar bone and into the arm pit, before forming names nerves called peripheral nerves. These have names including the radial nerve, ulnar nerve and median nerve as main branches, along with many smaller nerves. This can cause confusion, because pain felt in the thumb can be due to either a localised problem with the thumb itself, or a trapped median nerve in the palm of the hand called carpal tunnel syndrome, or a trapped C6 nerve in the neck. Additional symptoms such as constant aching in the joints will point toward a localised problem in the thumb such as arthitis. Night pain and tingling in the thumb and neighbouring two fingers which is helped by dangling the hand over the side of the bed tends to be associated with carpal tunnel syndrome. Whole arm pain with tingling in the thumb, which is helped by tilting the head to the opposite, painless arm, tends to be due to C6 nerve compression in the neck.

As a rule of thumb:

Shoulder Pain

Commonly causes neck pain and can coincide with neck problems, especially when a trapped nerve in the neck is treated by nursing the affected arm in a sling. This can cause a frozen shoulder, where the arm cannot rotate outwards and needs prolonged physiotherapy exercises to remedy the problem.

Impingement syndrome is very common and is related to unbalanced rotator cuff function, resulting usually in the supraspinatus tendon causing pain. The shoulder pain is typically aggravated by trying to raise the arm to the side (abduction). Again, the best way to treat supraspinatus pain is to pursue specific shoulder strengthening exercises.