11 Causes of Shoulder & Arm Pain

  • Written by Dr. Lucas Szczepanik B.Sc., D.C.

    Shoulder and arm pain are a problem for many people. Symptoms can range from loss of sensation, numbness and tingling, sharp or burning pain, and physical weakness. Although symptoms can seem similar to each other, there are a number of different reasons for shoulder and arm pain. Most people understand that when pain or loss of feeling occurs in the left arm they should seek immediate medical attention as a serious heart complication (i.e. Heart attack) may be occurring. Here is a list of other possible causes for shoulder & arm pain.

    1. 1) Tunnel Syndromes: There are a number of “tunnels” that run through the arm, elbow and wrist. There are certain spots where arteries, veins, nerves, and muscle tendons meet in a common opening that we call “tunnels”. The tunnel that gets the most publicity is the carpal tunnel in the wrist (i.e. Carpal tunnel syndrome). Compression of the structures inside these tunnels can cause a range of symptoms from pain, weakness, numbness and tingling. It is common to see carpal tunnel syndrome in cashiers, receptionists, and transcriptionists. Other tunnel syndromes include Cubital Tunnel Syndrome (this is where the “funny bone” is), and Radial Tunnel Syndrome (also in the elbow on the opposite side of the funny bone)

    2. 2) Impingement Syndrome: This is a common shoulder problem for people who play sports or that have a history of playing sports. This will cause shoulder pain that is worse with overhead activities. There are a number of tendons that can be “pinched” in the shoulder from the rotator cuff muscles to the biceps muscle. Chiropractors and physiotherapists can manage this condition, usually involving rehabilitation of the shoulder and avoidance of aggravating activities.

    3. 3) Cervical Disc: The disc is located between the bones of your spine (neck and back). It’s job is to handle compressive forces on the spine. It can be broken (herniated disc) or can simply be bulging. Both of these situations can irritate the nerve roots in your neck. The nerves travel from the neck down both arms and can cause arm pain described as a constant ache or a burning ache, as well as weakness in the hand. A lot of the times raising the affected arm overhead will decrease the pain. This is a good indication of a disc problem. Discs usually do not herniate after the age of 40 because the disc begins to loose it’s elasticity. Degenerative disc disease can also lead to neck and arm pain as well (that’s basically arthritis of the disc).

    4. 4) Referred pain: Irritation of the joints in the neck from minor to moderate trauma (a mild car accident for example) can result in arm pain. This is different than pain felt from a disc problem. Referred pain is often less intense and there is no weakness in the affected arm/hand. The nerves in the neck become irritated from this minor trauma and produce arm symptoms.

    5. 5) Fracture: This one is usually a “no-brainer”. Most people know when they’ve broken their shoulder, or arm. There is an accident or some kind of physical trauma that causes the fracture. Fractures can occur in the wrist and hand bones as well, but sometimes tiny fractures may not exhibit symptoms as obvious as if you broke your arm or shoulder.

    6. 6) AC Separation: Your collar bone meets up with a portion of your shoulder blade known as your acromion. These two structures are held together by ligaments that form what we call the “acromioclavicular” or AC joint. This is a common injury for hockey players. Aggressive body checks into the boards can separate this joint. The ligaments holding this joint together can be partially or fully torn. A full AC separation is not hard to miss. Total weakness in the arm, a lot of pain, swelling over the joint, and a raised bump over the shoulder are indications. Consult a health care practitioner should this injury occur. Once the ligaments start to heal rehabilitation is vitally important to restore proper function and strength in the arm and shoulder.

    7. 7) Thoracic Outlet Syndrome (TOS): Common symptoms of TOS include arm pain, often accompanied by a sensation of numbness and tingling down the arm. It is common to feel these symptoms on the inside of the arm all the way down to the little finger and ring finger. This is often made worse by overhead activity. Many times there is a postural problem in the upper back and lower neck. The arteries and nerves that travel through your neck, shoulder, and down the arms can be entrapped by local structures in the area causing these symptoms. The postural problems referred to are usually seen in individuals sitting at a desk working in front of a computer, or those doing repetitive overhead activities.

    8. 8) Rotator Cuff Tear: The rotator cuff is a group of 4 muscles around your shoulder blade and humerus (the upper arm bone). This is often the result of trauma to the shoulder such as lifting a heavy weight or falling on an outstretched arm. Pain is very evident with overhead activities or weakness in lifting the arm. The signs and symptoms of a rotator cuff tear are very similar to those of a person with shoulder impingement. Imaging such as diagnostic ultrasound is needed to confirm the tear. If the tear is partial then rehabilitative techniques are very helpful in the healing process. If the muscle has been fully torn then surgery is needed to repair the muscle.

    9. 9) Instability in the Shoulder: This is very common with those that have a prior history of a dislocated shoulder. Pain or weakness often result when the arm is placed in an overhead position. It is not uncommon to have shoulder impingement as a result (see above for shoulder impingement). Rehabilitative exercises are vitally important to return the shoulder to proper function.

    10. 10) Adhesive Capsulitis (FROZEN SHOULDER): This is usually seen in an individual over 40 years of age. There are number of stages frozen shoulder will go through. It starts with shoulder pain, often needing pain medication to cope, that may last 1-3 months. As the pain decreases over the next couple of months the individual will notice a stiffening of the shoulder and eventually a loss of range of motion (hence the name FROZEN SHOULDER). Physical therapy and rehab are not very effective in the initial stage, as the pain can be too severe. Chiropractic becomes very helpful in the later stages, once the initial pain is reduced and the shoulder range of motion is affected.

    11. Calcific Bursitis: As you age it is common to see calcium deposits in the tendons of the shoulder and elbow. It is usually a result of excessive wear and tear. A burse is a fluid filled sac that sits under the tendons and reduces the friction on the tendon. It is when the body tries to reabsorb the calcium that the bursa becomes inflamed, therefore causing bursitis.



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