By Catherine Etty-Leal
Physiotherapist at Life Ready Physio + Pilates Camberwell.
Arm pain can result for many different reasons. The most common sources of upper arm pain are the shoulder, neck or rib cage. When the cause is of a musculoskeletal origin, or a mechanical reason, the pain will usually come on with a particular movement. Often, the neck, shoulder and rib cage can be a source of pain with sustained postures as well. These include sitting for long periods of time, awkward lifting postures, or lying down. It is often lying down at night time for a prolonged period of time that results in upper arm pain at night.
Most commonly, pain is resultant from an incident or injury. It might be something obvious like falling off your bike, or it might be something less obvious such as sleeping awkwardly. Sometimes, pain can appear gradually. This tends to happen with repeated loading from the same or similar tasks. The most common ones include heavy lifting, overhead activities like tennis and throwing sports, and pushing and pulling heavy or awkwardly shaped items. Other mechanisms are usually related to a sudden or unexpected change in load. This can be related to starting a new sport or activity, or a lifestyle change like becoming a new parent and having to lift, carry and hold your baby.
All three of the neck, shoulder and rib cage can refer pain to the upper arm. This is because these structures share a nerve supply with the skin overlying the upper arm. In some cases, a person can experience upper arm pain as their only symptom. It is important that you seek advice from a physiotherapist, as they will be able to assess all of these areas thoroughly and therefore determine the source of your pain. This will make it easier to implement strategies to manage and treat your pain.
The most common treatment your physiotherapist will provide you is a combination of manual therapy (hands on therapy) and exercise. Ultimately it is the exercise-based therapy that will lead to long term recovery, but the manual therapy can be very useful in reducing pain in the short term. At times, you may need to pursue imaging to further assess the exact structure that is the source of your pain. This can be anything from an ultrasound to an MRI. Your physiotherapist may organise this scan, or they may direct you to source the image from your doctor. In some cases, a medical approach may be indicated. This can be something as simple as oral medication, which your doctor will prescribe to you, or in rarer cases may involve injections or surgical procedures. It is important that you discuss all of your available options with both your physiotherapist and doctor to find the right plan for you.
In rare instances there may be a medical reason for upper arm pain. If you are experiencing upper arm pain associated with shortness of breath, chest pain, loss of colour in your skin, slurred speech, difficulty swallowing, blurry vision, or unexplained weakness, seek emergency medical care to rule out anything sinister.
