It is not uncommon for neck and arm pain to occur together and it may or may not be related to the same cause. In fact there are many reasons why neck and arm pain occur together and it is often related to a problem in one part also affecting the other and vice versa. Most of the time it is related to injury or strain but there are instances where neck and arm pain can be a symptom of a life-threatening condition, like a heart attack.
Reasons for Neck and Arm Pain
Pain is a sensation that is elicited by stimulation of receptors known as nocioceptors. These receptors are spread throughout the body, both on the surface and internally within organs and tissues. Signals from these receptors are then carried by nerves to the brain where the sensation of pain is perceived. Neck and arm pain, like pain anywhere in the body, is either due to stimulation of the receptors, stimulation of the nerve itself or stimulation of the pain centers in the brain.
The nociceptors are stimulated by tissue injury in and around it. For example, injury to a muscle in the hand leads to inflammation and this stimulates the pain receptors (nociceptors). Injury to a nerve like with compression along its path can also elicit pain. The nerves that supply the arms arise from the cervical vertebrae (neck). Therefore a problem at this level can lead to pain which may felt along the entire course of the nerve – the neck, shoulder and down the arm.
Since other organs like the lining of the heart (pericardium) are also innervated by cervical nerves, injury to these organs can cause pain to be perceived in the neck and arm. It is important to note that neck and arm pain usually do not occur together without involving the shoulder as well. Therefore it is important to consider neck, shoulder and arm pain together.
Causes of Neck and Arm Pain
It is not always possible to determine whether neck and arm pain are related even if it occurs simultaneously. These factors need to be considered:
- If the neck and arm pain arise at the same time then it is most likely due to the same cause.
- If easing pain in one area (like massaging the arm/neck) eases pain in the other then it is likely related.
- If worsening pain in one area (like due to deep pressure) worsens the other area then it is likely related.
Overuse and Exertion
Overuse and exertion of the neck and/or arm is one of the main causes of neck and arm pain. It does not only refer to tasks requiring significant muscle strength like carrying heavy weights. Even activities like sitting in front of a computer screen and using a keyboard or mouse can cause it. Exertion arises with maintaining a posture which can strain the muscles that keep the head upright, the shoulder muscles that stabilize the arm and the arm muscles itself.
Injury to the neck, shoulder or arm is another obvious cause of neck and arm pain. There are a number of different ways that injury can occur, such as with a fall, assault, blunt or sharp force trauma, excessive stretching and/or twisting of the arm/neck. Severe trauma can lead to tearing of the muscles, tendons or ligaments and fractures of one or more bones in the arm, shoulder and/or neck.
Muscle spasm is where a portion or the entire muscle contracts involuntary and may remain contracted for long periods. It may also be referred to as a cramp. Although overuse, exertion and trauma are some of the more likely causes, spasm can sometimes occur for other reasons like poor posture, dehydration, mineral deficiencies, poor circulation and even with the certain medication. Spasm can result in referred or radiating pain away from the site.
Nerve compression is another common cause of neck and arm pain. The compression may occur at the spinal level, where the nerve arises from the spinal cord to pass through to the arm, or it may arise along its course.
Spinal nerve compression is also known as a pinched spinal nerve. It can arise with a number of different causes such as a bulging or herniated disc between the spinal bones (vertebrae) or when it is pressed by a portion of the bone as a result of narrowing of the holes through which the nerve passes (spinal stenosis). Cervical nerve root compression (cervical radiculopathy) arises at the level of the neck and may cause a host of symptoms.
Compression can also occur along the course that the nerve runs. This includes at the level of the shoulder, forearm or arm. Two common types include carpal tunnel syndrome at the level of the wrist and cubital tunnel syndrome at the level of the elbow. While these conditions cause arm pain, it may not cause neck pain for the same reason. Often accompanying neck pain is instead due to poor posture and muscle strain.
A stroke usually causes numbness, tingling and weakness on one side of the body. Pain is not a typical stroke symptom but has been known to occur in some people. Similarly there may be pain in the neck, shoulder and arm on the affected side after recovery and is known as post-stroke pain. Another possible cause is peripheral arterial disease where the artery to the arm is narrowed and there is insufficient blood supply to the tissue of the arm.
Neck and arm pain, particularly on the left side, is a common symptom in a heart attack. In some atypical cases, it may be one of the few symptoms present and even chest pain may be absent or minimal. A cardiac problem should always be considered as the cause of neck and arm pain if there is also excessive sweating, nausea and dizziness in a high risk person. It needs to be investigated immediately.
- Frozen shoulder (adhesive capsulitis)
- Torn rotator cuff muscles
- Cellulitis (arm)