Pain in the arm is not immediately a cause for concern for most of us. We all too often chalk it down to strain after a busy day using our arms. When it occurs in the morning after a night of sleep then we may attribute it to sleeping in an awkward position resulting in pressure on one arm.. However, there are times when upper arm pain may have little to do with the arm itself and rather emanate from a distant organ like the heart. Upper arm pain in these instances could be the warning sign of a potentially deadly condition.
The upper arm is that area of the upper limb that lies between the shoulder and elbow. It is often just referred to as the arm while the forearm refers to the lower arm.
The two upper arm muscles that most people are aware of is the biceps and triceps. Naturally we tend to assume that pain in the upper arm, particularly if its muscular in nature or worse with movement, must be arising from the biceps or triceps. All too often we refer to this upper arm pain as biceps pain or triceps pain but this can be misleading. There are several other muscles in the upper arm and sometimes pain here has nothing to do with the biceps, triceps or any other muscles in this area.
It is important to remember that the upper arm is composed of bones, muscles, tendons, blood vessels, nerves, connective tissue and skin. Furthermore most of these structures do not start and end in the upper arm. Some muscles and tendons may start as high up as the shoulder and end in the upper arm, while some muscles and tendons that start in the upper arm then end in the forearm. Arteries and veins in the upper arm are continuous with the vessels of the shoulder, axilla and forearm. The same applies to lymphatic vessels and nerves.
Causes of Upper Arm Pain
The different causes of upper arm pain are discussed in more detail depending on the nature and area from where the pain may emanate. It is often similar to forearm pain. Pain alone is difficult to identify without considering other symptoms. Redness, swelling, heat, arm weakness or paralysis, numbness and tingling are some of the other symptoms that may accompany upper arm pain. When there are symptoms like dizziness, shortness of breath and signs of shock then the upper pain should be considered a medical emergency.
It is important to first exclude common causes of arm pain like an injury to the upper arm or strenuous activity that may have caused muscle strain. People who suddenly start exercising particularly if they do weight-bearing exercises without being appropriately conditioned may initially experience upper arm pain that is severe and does not always seem to be muscular. However, upper arm pain that is persistent or worsening and is accompanied by the symptoms mentioned above requires immediate medical attention.
Trauma is one of the more common causes of upper pain. It may arise with mechanical or chemical trauma. The injury may be restricted to the more superficial layers like the skin and subcutaneous tissue or extend deeper to the muscles and bones. A fractured bone, muscle tears, tendon rupture, joint dislocation, contusion, lacerations and burns are some of the injuries that may occur with trauma. It may occurs as a result of falls, sporting injuries, burns, motor vehicle collisions, industrial accidents, assaults and strenuous activity. Trauma may also be responsible for the some of the conditions discussed below that can also contribute to upper arm pain.
Muscle and Tendon
A number of muscle and tendon problems may cause forearm pain. Overuse of the muscles leading to muscular strain is among the more common, and often less serious of causes. Sometimes the muscle becomes cramped which is known as spasm. The tendons may also be involved. Tendonitis refers to inflammation of the muscles tendons. Severe conditions like muscle tears and tendon rupture have been mentioned above as it may arise with injury. Rotator cuff muscles are more likely to cause shoulder pain bu this can radiate to the upper arm and may sometimes be described as upper arm pain.
Bone and Joint
There are a number of bone and joint disorders that may cause upper arm pain. Bone-related conditions may present with a deep pain in the upper arm. This includes a fracture, osteoporosis (brittle bones), osteomalacia (soft bones) and osteomyelitis (bone infection). Even minor trauma can cause a fracture in a person with osteoporosis. Joint disorders causing upper arm pain may involve the shoulder joint or elbow joint. Apart from dislocation, other joint conditions may include osteoarthritis, rheumatoid arthritis, post-traumatic arthritis and septic arthritis. A frozen shoulder may also sometimes be perceived as upper arm pain.
A number of nerves run down the arm, originating from the brachial plexus which is a network of nerves that arises from the vertebral levels of C5 to T1. Nerve problems that may cause upper arm pain may therefore arise at the vertebrae, brachial plexus or anywhere along the course of the nerve. The cause of the nerve problem may (peripheral neuropathy) be due to compression (pinched nerve), autoimmune disorders, diabetes, trauma to the nerve, infection or sometimes with the use of certain drugs. Cubital tunnel syndrome may also contribute to upper arm pain although the pain is more pronounced in the forearm. In this condition, the ulnar nerve is compressed at the level of the elbow.
Circulatory disturbances can also cause upper arm pain particularly when the blood supply is restricted. In peripheral artery disease (PAD) the artery is gradually narrowed due to the build up of fatty plaques (atherosclerosis). Eventually the artery can be fully blocked and this causes limb ischemia. Even without any pre-existing narrowing, a blood clot in the arm can block an artery or vein. The interruption in blood supply may prevent oxygen from reaching the tissues of the arm. This causes pain as a result of ischemia. Vaculitis is where a blood vessel becomes inflamed leading to thickening of the vessel wall and narrowing. It may occur with infections, cancers and autoimmune diseases.
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