Introduction
What chronic pain in the upper arm means for the affected person can be estimated if one considers the importance of free movement of the upper extremity in everyday life. Independent dressing, the performance of everyday household chores, hair and body care, as well as numerous forms of social interaction and even sports, are made considerably more difficult when pain in the shoulder and upper arm makes even the most trivial movement a challenge. Among the pain of the upper extremity, the upper arm is probably the most frequently affected region.
Since about 85-90% of the European population is right-handed, stress-related pain on the right side of the body is particularly common and often significantly hinders the person concerned. Even though the therapy is in many cases lengthy and those affected are often prone to relapse, pain in the upper arm is usually caused by well known and easily treatable diseases. We start with diseases of the joints. The two joints of the upper arm, the shoulder joint, a ball joint, and the elbow joint, which has the characteristics of a hinge joint and ball joint, can be the origin of various diseases that cause pain radiating into the upper arm.
Causes
The shoulder joint is the most flexible joint in the human body and offers a wide range of movement. It enables many everyday processes. Illnesses of this important part of the body can quickly lead to major problems in coping with everyday life.
Although the shoulder is relatively stable, repeated minor injuries and overstrain can lead to wear and tear of the joint structures. Especially overhead work, as performed in some trades, or sports with frequent overhead movements, such as handball or volleyball, put a strain on the shoulder joint and can later lead to signs of wear and tear and upper arm pain originating from the shoulder joint.
- In the calcified shoulder, load-related local remodelling processes on the shoulder tendon lead over time to calcification, which causes inflammation-related pain and sometimes severely restricts the mobility of the upper arm in the shoulder joint.
- If overhead movements are hardly possible or only possible with severe pain, a so-called impingement syndrome may be present.
The characteristic shoulder pain that occurs when the arm is spread between 70° and 130° is caused by degeneration or entrapment of components of the joint capsule or tendon apparatus. An impingement syndrome can also painfully restrict mobility in the area of the elbow.
- Arthrosis is another very widespread joint disease that is caused by stress on the joint structures. Years of stress lead to wear and tear of the joint sliding surfaces and to a painful restriction of movement of the affected joint.
Characteristic is the so-called “starting pain”, which is stronger in the morning and at the beginning of movement and improves with warming up of the joint. Although osteoarthritis occurs less frequently in the shoulder and elbow joint than, for example, in the knee joint, it can be responsible for more pain in the upper arm as the patient grows older.
- The inflammation of the joints, which is to be distinguished from arthrosis in the context of rheumatoid arthritis, can affect any joint in the body, regardless of the ongoing stress. In the shoulder and elbow joints, it causes painful swelling associated with redness and overheating and reduces the range of motion of the affected joint.
Chronic pain of the upper arm, which emanates from the joints, is therefore also a disease from the rheumatic form.
- Golfers’ and tennis elbows are stress related disorders that can occasionally cause pain that radiates from the elbow into the upper or lower arm. For right-handed people, they occur on the right arm, the stronger arm that is preferably used for work or sports. It is assumed that overloading the muscles of the forearm, as occurs for example during the incorrect practice of stroke sports (tennis, golf) as well as when using computers or carving tools, is responsible for the development of these diseases.
- The muscles of the upper arm can also cause pain of various kinds.
Most often, these are due to sore muscles.This pain, which is caused by short-term, heavy strain on the muscles concerned, should be sufficiently known and easy to diagnose.
- The so-called biceps tendon rupture is much more unpleasant for those affected. This is the rupture of one of the tendons of both biceps heads below its base near the shoulder joint or the rupture of the common tendon of both biceps heads near the elbow joint. A biceps tendon can tear if, as in some (strength) sports, it is subjected to unusually heavy loads or if years of wear have weakened its structure.
The main symptoms are a sudden onset of pain in the upper arm, a cracking sound like a whip and a palpable dent in the course of the torn tendon. The now displaced muscle belly of the biceps is also clearly visible externally.
- In the area of the vascular system, blood clots can cause pain. Due to metabolic diseases, years of nicotine abuse, immobilization or medication, blood clots can form in the blood vessels, seal them as so-called thromboses or be torn off the vessel wall and float as a so-called embolus into more distant vessels.
The occlusion of an upper arm artery is manifested by sudden, severe pain, paleness of the affected extremity, numbness and restricted mobility. If a deep humeral vein is affected, the pain tends to increase slowly over the course of time, the extremity is reddened and overheated. In both cases a doctor must be consulted immediately.
- The bone of the upper arm is called humerus in medical terminology.
It is extremely stable, but can break under great force. If a minor injury leads to severe pain in the upper arm, bone loss, so-called osteoporosis, is a possibility, especially in older people. In younger people, the bone structure should be intact. However, tumor diseases of the upper arm bone can also lead to chronic pain and even spontaneous fractures.
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