Pain, in any part of the arm, is a common complaint and may be caused by various factors. The dominant arm (the arm and hand most used), usually the right arm, is more prone to pain, injury and strain, especially if the arm has to perform repetitive activities. While arm pain may not always appear to be a serious condition, it could be indicative of a major underlying pathology that requires emergency medical treatment.
The upper limb is often referred to as the arm or hand however these are only sections of the limb. Anatomically the upper limb includes the following structures :
- Arm (area between the shoulder and elbow)
- Forearm (area between the elbow and wrist)
For the purpose of this article, we will refer to the upper limb as the arm.
Types of Pain
Pain is a sensation that usually occurs as a result of injury or damage to living tissue and causes discomfort or distress, depending upon the severity. It may be constant or intermittent with varying intensity that depends on individual tolerance and extent of injury. Arm pain may be one sided or affect both arms simultaneously. Pain is a subjective experience and encompasses a number of different types of pain that may be described as a :
- dull ache
- throbbing or pulsating pain
- shooting pain
- burning pain
- pinching pain
- poking or stabbing pain
The arm (upper limb) is made up of a number of bones, muscles, tendons, and ligaments, along with their various nerve supplies, and all are susceptible to injury and damage that can lead to pain. However at times, pain in the arm may be caused by a damage at a distant point and this is known as referred pain. The upper limb is mainly composed of muscle and bone and muscle pain is a common type of arm pain that often occurs after strain or exertion. Joint pain may affect the shoulder (e.g. frozen shoulder), elbow (e.g. tennis elbow), wrist (e.g. carpal tunnel syndrome) or the small joints of the fingers (e.g. rheumatoid arthritis). There is another type of pain which seems to come from a body part that has been removed, such as an amputated hand or leg, and this is called phantom pain. Neuropathic or nerve pain may be due to degeneration of the nerve, as in a stroke, multiple sclerosis or from nerve compression (pinched nerve), nerve inflammation, or infection of the nerve (shingles), where pain can be severe. Psychogenic pain is the perception of pain with no clear cause, often a result of psychological factors like anxiety.
Acute or Chronic Arm Pain
Arm pain may be acute or chronic, depending upon its duration. Acute pain is of sudden onset and may be intense and short-lived, often due to injury. Chronic pain develops insidiously and may be of long duration, and is more likely to be due to conditions such as nerve compression. The pain may also be persistent or occur in episodes and if episodic, it is important to note factors that trigger, aggravate or precede the pain.
Arm Pain Symptoms
Hand pain may be accompanied by other signs and symptoms. Some of these concomitant symptoms include :
- muscle weakness
- swelling (refer to Arm Swelling)
- change in skin color
- increased skin temperature
While intense pain may mask other sensations, it is possible to experience pain on one part of the arm and other sensations like arm numbness or tingling elsewhere on the upper limb. At times, these concomitant signs and symptoms that accompany arm pain may not affect the upper limb only, like sweating, dizziness or blurred vision associated with the arm pain that occurs during a myocardial infarction (heart attack).
Arm Pain Diagnosis
In order to diagnose the possible causes of arm pain, your doctor will take a case history, conduct a physical examination and may request other diagnostic investigation techniques. To assist with arm pain diagnosis, it is important to report the exact site (location) of the pain, severity of the pain on a scale of 1 to 10, type of pain, duration , other signs or symptoms accompanying the arm pain and any incident that may have caused the pain or trigger factors.