Symptoms
Depending on the causative disease, pain in the upper arm can be accompanied by other symptoms. It is precisely these accompanying symptoms that often make it possible to narrow down the possible underlying diseases. In addition, the pain in the upper arm can vary greatly depending on the causative disease.
In this context, the quality (stabbing, burning, dull), the intensity and the exact localization of the upper arm pain play a decisive role. Also the presence of pain radiating into neighboring body regions can often help to exclude possible causes. In most cases, pain in the upper arm is perceived as a pulling pain along individual muscles, fasciae or nerve tracts.
In addition, the upper arm pain felt by the affected patients can often be provoked by certain movements. Often, the pain is perceived as particularly pronounced when working overhead (for example putting on a sweater). In addition, many of those affected report that one-sided strain, for example carrying a shopping bag, leads to an increase in upper arm pain.
Although pain on the upper arm is typically perceived especially during stress, there are also cases in which the pain is already present at rest. Some patients even report that their night’s rest is so impaired by the severe pain in their upper arm that they suffer from lack of sleep and chronic fatigue. In addition to the frequently observed stabbing pain in the upper arm, the complaints can also take on a pulling, flat or punctual character.
While flat pain typically occurs on the front of the upper arm, punctual pain often occurs on the back of the upper arm. In addition to the muscular impairments, nerve damage is one of the most common causes of pain in the upper arm. In these cases, not only individual muscles, but rather entire muscle groups in the supply area of the affected nerve are affected.
Pain in the upper arm caused by nerve damage is usually accompanied by tingling. In addition, affected patients report having repeatedly felt that their hands had fallen asleep. Pain in the upper arm can also be accompanied by complaints in the shoulder, neck and throat area.Pain in the upper arm is often caused by injuries to the shoulder.
The pain that occurs in the shoulder and shoulder joint area often radiates further along the upper arm. In addition to harmless causes such as aching muscles or temporary muscle tension, serious injuries and diseases of the shoulder can also be the reason for pain in the upper arm. First of all, it makes sense to divide the pain into acute pain and pain that has existed for a longer period of time: In many cases, the pain in the upper arm and shoulder occurs when the arm is raised.
Depending on whether the arm can no longer be lifted at all and from which moment the pain starts, different clinical pictures can be possible causes. Especially in the case of the impingement syndrome, pain when lifting the arm is in the foreground. Even if the rotator cuff is problematic, it may be that lifting the arm is only possible with pain or even no longer possible at all.
- Acute events leading to pain in the shoulder and upper arm can be caused by accidents and injuries. It is not always necessary for an injury to be visible from the outside. A tear of a muscle or tendon of the so-called rotator cuff can be responsible for the discomfort after an accident.
The complete or partial loss of a muscle often causes typical symptoms. In particular, the tendon of the supraspinatus muscle, which forms the upper part of the rotator cuff, is frequently affected. An orthopedist can usually make a suspected diagnosis by means of a physical examination.
Injury to the joint itself or a bone involved in the shoulder can also cause acute symptoms.
- Chronic complaints that do not correlate with a specific event are just as diverse. Both degenerative diseases such as shoulder joint arthrosis and systemic diseases such as rheumatism can be involved in the development of pain. Inflammatory diseases of the shoulder are also particularly common.
Bursitis is particularly common here. Likewise, an impingement syndrome can occur when certain structures in the shoulder become trapped. Calcification of the tendons are also possible causes of the complaints.
Pain in the muscles (myalgia) is usually described as “pulling” or “cramping” and often manifests itself in everyday life in the form of sore muscles.
Classic muscle soreness, however, disappears after a few days, which is why persistent muscle pain has other causes. When the pain first occurs after exercise, it is often a minor muscle strain, i.e. overstretching of the muscles. If the stretching is very strong, it can also lead to muscle injuries through tears.
Depending on the size of the tear, these are called muscle fiber tear, muscle belly tear or muscle tear and, in addition to the typical muscle pain, often manifest themselves as bruises, swellings or dents. If the pain was caused by an accident or other external influence, a muscle contusion or bleeding may have occurred. In this case, the blood presses against the muscles, which, however, can hardly be displaced as they are embedded in so-called fasciae.
Since muscles are very sensitively innervated and therefore very sensitive to pain, even small amounts of blood are sufficient to cause classic muscle pain. Other, rarer causes of muscle pain are inflammation (myositis), or muscle diseases such as fibromyalgia, dystrophies or metabolic disorders. Pain in the upper arm, which occurs after a fall, can be caused by a variety of different factors.
A fall directly onto the upper arm is relatively rare. However, falls on the elbow or shoulder can also cause pain in the upper arm. If muscle injuries or tendon ruptures occur as a result of the incident, the pain is usually severe.
In the shoulder area, falls often cause ruptures of the rotator cuff, which can explain the pain. Injury to bone or joint cartilage can also cause severe pain in the area of the affected bone and upper arm. After a fall and subsequent pain symptoms, the painful arm and, depending on the location of the pain, the elbow joint and shoulder joint should be X-rayed.
Fractures of the upper arm (humerus), collarbone (clavicle) or acromion as well as the forearm bones and the olecranon can be diagnosed with the help of an X-ray. Injuries to soft tissues such as muscles, tendons, ligaments, blood vessels and nerves can be visualized with an MRI examination.Pain on the inside of the upper arm is usually of muscular origin. Thus, pain at this point may be due to a sore muscle.
If the pain occurs during a sporting activity or a sudden movement, it may also be due to a pulled muscle. The muscles on the inside of the upper arm are mainly responsible for bringing the arm closer to the body. During a powerful movement of this kind, a muscle can be overstrained.
A pulled muscle is an overstretching of the muscle. This also damages individual muscle fibers. Especially when the pain is acute, the painful area should be spared, cooled, and stored high.
Also the application of a pressure bandage can make sense. In rare cases other causes can also lead to the pain. A heart attack can trigger sudden, very strong, so-called destruction pain in the upper arm.
The skin in this area should also be examined to exclude dermatological diseases as a cause. In the rear area of the upper arm there are mainly muscles. If there are complaints in this area, the muscular cause is therefore in the foreground.
In the rear part of the upper arm a so-called extensor of the arm is located: The so-called musculus triceps brachii. Overloading this muscle through excessive training or careless movement can lead to sore or strained muscles (muscle stretching) and thus to pain. Torn muscle fibers with the development of bruising, fractures of the humerus or the development of systemic diseases such as osteoporosis are also known to be causes of pain in the back of the upper arm.
Last but not least, the muscles of the shoulder should also be examined, since pain that develops there often radiates into the rear upper arm. Possible diseases include impingement syndrome or a torn rotator cuff. Pain that is localized on the outer upper arm can have a variety of causes.
Often pain occurs not only in the upper arm but also in the shoulder. This is mainly due to the fact that many structures of the shoulder “leak” into the upper arm and often radiate pain and can therefore affect several areas simultaneously. In this case, it should be clarified whether the cause is on the upper arm or on the shoulder, as the respective therapy can vary greatly.
In contrast to the upper arm, the shoulder is an extremely complicated joint, which is a challenge even for doctors. The shoulder is surrounded by many different muscles, ligaments and tendons, which enable the joint to move in many different ways. The probability of pain occurring in the shoulder joint and radiating into the upper arm is therefore much higher than the other way around.
However, there is always the possibility that both the upper arm and the shoulder are injured, especially in the case of traumatic injuries. While upper arm pain usually involves muscle, muscle-tendon or bone pain, the shoulder is also often affected by joint space, cartilage or a bursa. Tendons are the connection between the muscles and the bones to which the muscles are attached.
The muscle is directly connected to the tendon, which in turn is very firmly attached to the bone and periosteum. Therefore, muscle and tendon pain often occur in combination. When the muscle is stretched, the tendon is automatically stretched as well.
As with muscles, excessive stretching of tendons can lead to strains or tears. However, these are much more unpleasant with tendons, since tendons heal less well and therefore remain in pain for longer. In adults, however, tendons are more stable than muscles and are therefore less frequently affected.
More often, however, tendon pain is caused by inflammation of the tendon or tendon sheath. The tendon sheath encloses the tendon, protects it and reduces its friction. Inflammation of these structures is usually caused by overstimulation or chronic illness and manifests itself in long-lasting pain that can severely restrict movement.
Inflammation of tendons or tendon sheaths can be diagnosed in X-rays by calcification and should be therapeutically immobilized. This is usually made possible by an appropriate splint. If pain occurs only or mainly at rest, such as when sitting for long periods or sleeping, this is also known as “resting pain”.There are many different causes of resting pain, ranging from circulatory disorders to rare organic diseases.
Because of the wide range of diagnoses, a doctor should always be consulted if the pain is prolonged or frequent. The easiest explanation for pain occurring during the night is poor positioning of the body, or “lying on the wrong side”. This can lead to entrapment of vessels, which causes numbness and tingling, or tension in the muscles. In addition to these common causes, chronic diseases such as polyneuropathies, Raynaud’s disease or fibromyalgia can also be possible.
