Pain in the forearms (left, right, both)

Causes of pain in the shoulder joint

When determining the reasons why the arm does not rise up, it is important to differentiate diseases of the internal organs.
The most dangerous of them is myocardial infarction. Pain when raising your arm up in this condition is accompanied by other symptoms: weakness, arrhythmia, nausea, shortness of breath, fear. The patient requires immediate hospitalization. It can also be difficult to raise your hand in case of other therapeutic diseases - cholecystitis, cholelithiasis, pleurisy, etc. They are also characterized by other symptoms not related to the musculoskeletal system - nausea, vomiting, cough. Among the causes of muscle pain when raising the hand Diseases and injuries that directly concern the shoulder joint can be distinguished. Injuries include fractures, bruises, dislocations, damage to ligaments and joints. They usually do not cause difficulties in diagnosis.

The most common reason that the arm cannot be raised up is diseases of the joint tissues:

1. Arthritis is an inflammatory process that occurs for various reasons. The main ones are infections (viral, gonorrheal, borreliosis arthritis) and autoimmune reactions (rheumatoid arthritis). Arthritis is characterized by night pain, redness, swelling, and increased temperature in the joint area.
2. Arthrosis is the gradual destruction of joint cartilage due to injury or age-related changes. Pain due to arthrosis intensifies after physical activity and subsides after rest.
3. Bursitis, in which excess synovial fluid accumulates in the joint capsule due to the inflammatory process. In addition to acute pain with bursitis, there is severe swelling and increased temperature of the shoulder or the whole body.
4. Capsulitis (“frozen shoulder”), in which, as a result of chronic inflammation, the joint capsule loses its elasticity and limits movement. It is characterized by an undulating course with night pain and progressive limitation of mobility of the shoulder joint.
5. Humeral periatritis, which has a degenerative-inflammatory nature. The inflammatory process involves ligaments, muscles, and tendons of the shoulder joint. Patients experience severe pain, the arm does not rise well, and it is impossible to move it behind the back.
6. Tendinitis, characterized by inflammation of the tendons. Pain can occur both with movement and at rest. It is difficult for the patient to raise his arms forward, to the sides or back, depending on the location of the pathological process.
7. Osteochondrosis. When the cervical spine is damaged, the nerve endings are pinched; this process can spread to the upper limbs. In addition to the fact that the arm hurts and does not rise up, numbness and “lumbago” may be observed.
8. Calcification or calcification of the ligaments, in which calcium salts accumulate in the tendons. The disease develops gradually with increasing pain and stiffness. In the initial stages, mild pain may be felt, the patient has difficulty raising his arms, and as the process progresses, sharp pain and stiffness appear, which can even cause sleep disturbances.
9. Damage to the brachial nerve (neuritis) and nerve plexus (brachial plexitis). These neurological diseases are caused by metabolic disorders and inflammatory processes in nerve fibers. In addition to pain when raising the arm up in the forearm, patients experience weakness in the muscles, numbness of the arm, and decreased sensitivity of the skin.
10. Tumors in the shoulder joint are a rare pathology that leads to tissue compression, discomfort and pain due to pressure on nerve fibers.

As you can see, there are many reasons why your arms hurt when you lift them up. Effective treatment can be prescribed and pathology can be eliminated only after an accurate diagnosis has been made. Some conditions that cause pain when raising the arm up in the shoulder and forearm are deadly, so this symptom should not be ignored or self-medicated.

Reasons for development.

Most often caused by repetitive movements that involve the wrist muscles. Activities that create excessive mechanical stress create microtears and initiate degenerative development of the extensor tendon. Patients with chronic pain show signs of tissue necrosis and the presence of regeneration. In the progressive stages of tendinopathy, there is cell death and disorganization in the cellular matrix. The first type of collagen is replaced by a third, which leads to weakening of the tendon and reduces its resistance to stretching.

Normal type 1 collagen structure in healthy tendon

Degenerative tendinopathy - changes in the collagen matrix, tissue necrosis and replacement of type 1 collagen with less elastic type 3

The condition worsens with intense and prolonged work of the muscles - they spasm, local inflammation of the “squeezed” nerve appears, followed by disruption of its function and deterioration of nutrition of muscle and other structures, weakening of the blood supply. As a result, degenerative-dystrophic processes occur and the likelihood of injury increases. When injured, the damaged area is replaced by scar tissue, which further weakens the tendon and disrupts its trophism. New injuries occur and degenerative processes worsen.

The following are factors that contribute to the occurrence of the disease:

• 1. Types of tennis, badminton. Often the pathology is provoked by incorrect striking technique, so it is extremely important to monitor its execution (especially when the first symptoms appear).
• 2. Other sports when there is tension in the muscles of the shoulder and forearm (boxing, weights, wrestling).
• 3. Work of a painter, mason, programmer, seamstress, milkmaid, etc.
• 4. Changes caused by old age.
• 5. Concomitant vascular and endocrine diseases.

Diagnostics

To determine the reasons why the arm does not rise up, various diagnostic methods are used. Diagnosis begins with examination of the patient, palpation of the painful area and collection of anamnesis. Based on the data obtained about the nature of the pain, clinical picture, lifestyle and concomitant diseases of the patient, the doctor makes a preliminary diagnosis. During further examinations, this diagnosis is clarified or refuted. The full range of diagnostic measures includes:

1. Laboratory diagnostics - blood tests (biochemical, general, C-reactive protein). With their help, it is possible to identify the presence of inflammation, autoimmune reactions, and metabolic disorders.
2. X-ray, which gives an idea of ​​the condition of bones and cartilage. The degree of cartilage wear is assessed by the size of the gaps between the heads of the mating bones.
3. Ultrasound is an ultrasound examination that allows you to identify excess synovial fluid in the joint cavity, foci of inflammatory processes, neoplasms and abscesses.
4. Computed tomography (CT), which allows you to assess the condition of cartilage and bone tissue in osteoarthritis, osteochondrosis, injuries of bones and joints.
5. MRI is magnetic resonance imaging, which makes it possible to visualize the condition of osseous, cartilage and soft tissues by layer-by-layer scanning.
6. Puncture of the shoulder joint to take synovial fluid for analysis.
7. Arthroscopy, which involves introducing a miniature video camera into the joint cavity through a tiny incision.

The use of these methods provides comprehensive information about the reasons why the shoulder hurts when raising the arm. Depending on the identified diseases, the patient is treated by specialized specialists: traumatologists, orthopedists, rheumatologists, neurologists.

Symptoms.

The first manifestations are usually minor. The patient experiences periodic discomfort and unpleasant sensations after loading the shoulder joint. Pain gradually arises and increases, disturbing even at rest. Symptoms go away on their own in 90% of cases within 1-2 years.

• The pain symptoms are of a certain nature, similar to a burning sensation, and quite intense. First it is localized in the elbow area, then spreads to the forearm and shoulder. There is a possibility of swelling. With lateral epicondylitis, pain occurs when the hand is extended, and with medial epicondylitis, pain occurs when the hand is flexed.
• An important symptom is muscle weakness, the inability to perform certain movements associated with grasping and holding objects.
• The functions of the entire limb are affected. The flexion and extension of the forearm, the functions of the hand and fingers are difficult. The pain becomes unbearable and prolonged.

Treatment

In a condition where the arm hurts when raising the arm, treatment is prescribed in accordance with the diagnosis. If it is discovered that this symptom indicates diseases of the internal organs, then treatment of the underlying disease is carried out. Rheumatoid arthritis is treated by a rheumatologist. In case of injuries, the joint is immobilized using special devices to ensure tissue regeneration, or surgery is performed. In the acute phase of diseases of the musculoskeletal system, drug therapy is carried out:

1. To relieve inflammation and pain, non-steroidal anti-inflammatory drugs are used in various forms: injection solutions, capsules, tablets, ointments.
2. Glucocorticosteroids are used to relieve autoimmune inflammation and prevent joint destruction. They can be inserted directly into the joint cavity.
3. To eliminate muscle spasms, muscle relaxants are prescribed.
4. To activate blood circulation in the affected shoulder joint, warming ointments are used.

If the inflammatory disease is caused by an infection, the patient is prescribed antibiotics. For osteoarthritis, the doctor prescribes chondroprotectors; for neurological diseases, B vitamins are used.

After the inflammatory process has been relieved, massage and various physiotherapeutic procedures are added to the treatment: electrophoresis, magnetic therapy, electrical myostimulation, etc. During the period of remission, so that the shoulder no longer hurts when raising the arm, it is recommended to regularly perform a set of physical exercises.

If it is impossible to solve problems with the shoulder joint with therapeutic methods, surgical treatment is indicated. It can be prescribed to restore the integrity of ligaments and bones after injuries, remove pathological fluids by puncture, replace the affected joint with an endoprosthesis, etc. The most modern and effective joint treatment can be performed in our clinic.

Mechanism of occurrence

Mechanism of occurrence

If pain is detected in the shoulder joints of the arms, treatment must be prescribed taking into account the development mechanism.

Stages of the disease

Clinical manifestations of arm lymphostasis depend on the stage and type of pathology:

• temporary reversible lymphostasis often occurs after surgery in the chest or upper extremities, and easily resolves when wearing a compression sleeve;
• subacute lymphostasis is characterized by pain and severe tissue swelling, subject to correction using a compression sleeve;
• Chronic lymphostasis has a long course and is difficult to treat.

Based on the characteristic signs of lymphostasis, you can easily determine the stage of development of the pathology:

• Stage I is called spontaneously reversible. The swelling is noticeable, increases in the evening and goes away in the morning; when pressing on the skin, a dimple forms.
• Stage II – spontaneously irreversible. The skin at the site of swelling becomes denser, and when pressure is applied to the skin, the hole does not remain. The skin is tense and sensitive, and pain is noted.
• Stage III is irreversible. Due to the stretching and proliferation of connective tissue, the skin becomes covered with scars, cystic formations and papillomas. The limb becomes deformed and becomes almost immobile. The stage of elephantiasis begins, named after the characteristic shape of swollen limbs that lose their original shape.

Possible complications

In the absence of timely medical care, the patient may develop:

• severe pain caused by compression of nerve endings;
• deep skin damage with multiple trophic ulcers and inflammatory processes;
• deep vein thrombosis;
• depression;
• compaction of lymphatic vessels.

Treatment methods for lateral epicondylitis.

“Whatever the stage, methods such as load modification, gradual therapeutic progression and adaptation should form the basis of treatment.”

Goals include reducing pain, maintaining motor function, increasing grip strength and endurance, and returning to function. During the acute phase, treatment focuses on reducing pain symptoms and inflammation. The use of corticosteroid injections is avoided until the full potential of conservative techniques has been exploited. The basis is training, therapeutic progression of the load and its modification. Individually selected exercises take into account the load, painful angles of movement, strength, endurance, preferences and characteristics of the patient. Eccentric exercises (EC) have the highest evidence of effectiveness. EC stimulate the restoration of the matrix of collagen structures and collagen synthesis, have an analgesic effect and improve the tendon’s tolerance to physical activity.

Correction of biomechanics, muscle imbalances and motor control training should be the basis of selected exercises to eliminate wrist extensor overactivity and compensation in upper extremity functionality. Self-massage and stretching of the tendon are usually limited, as they can increase compression and friction, which have a negative effect on it. The use of shock wave therapy and other procedures has moderate evidence and is used in the first 4-6 weeks as additional physical support. Whatever the stage of development of tendinopathy, modification of load and achievement of tissue tolerance should be the main principle of treatment of lateral epicondylitis.

• It is important to limit the functionality of the affected arm. Athletes should stop training. This way you can quickly relieve muscle spasms and inflammation, and avoid repeated microtraumas.
• The doctor prescribes anti-inflammatory drugs, which reduces pain and swelling. Sometimes it is necessary to use glucocorticosteroids in addition to NSAIDs. Additionally, muscle relaxants are prescribed if necessary.
• Anti-inflammatory drugs and platelet-rich plasma are injected into the epicondyle area.
• At the initial stage, it is recommended to periodically apply cold to reduce pain.
• Taping and orthoses are good helpers on the path to recovery - they limit the rotation of the arm, promote reduction and contribute to less trauma.
• Physiotherapeutic procedures (magnetic therapy, shock wave therapy, electrophoresis, electromyostimulation, acupuncture) are used in courses in combination with anti-inflammatory therapy.
• Physiotherapy exercises are prescribed after pain has been eliminated to restore the function of the upper limb.

After treatment, it is important to follow a therapeutic and protective regimen to avoid relapses of inflammation and repeated injuries.

Arthroscopy of the elbow joint

In advanced cases, when conservative treatment does not give the expected result, surgical intervention may be recommended. The most gentle method is arthroscopic surgery. It allows you to preserve the surrounding tissue as much as possible and remove the affected areas, and then restore muscle fixation. They perform sanitation in the area of ​​damage, eliminate fibrous formations, adhesions, and release nerves from compression. Rehabilitation after arthroscopy is faster than after an open approach. With this operation, there is less risk of damage to nerves and blood vessels due to good visualization of all structures. Immediately after the operation, the arm is subject to immobilization, that is, wearing an orthosis. Rehabilitation measures begin after 1-2 weeks. They include physical therapy, wearing braces, taping, and kinesiotherapy. The results of complex treatment for this pathology are optimistic: patients regain functionality and painless movements.

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Causes of shoulder myalgia

Myalgia can be either an independent disease, for example, with physical muscle fatigue, or a manifestation of a disease, for example, with pathology of the shoulder joint. It is often difficult to determine what is causing the pain: pain of articular origin or pain associated with pathology of the ligaments and tendons or the muscle itself.

In a doctor’s practice, quite often there are combined conditions when one or another pathology of the shoulder joint is observed, for example, arthrosis, against the background of which a reflex contraction of the muscles surrounding this joint occurs. In this case, the pathology of the joint can be of a traumatic nature or be a consequence of a systemic inflammatory disease (rheumatological diseases). But in both the first and second cases, changes in the joint will be accompanied by local inflammatory reactions, in which pro-inflammatory biologically active substances are released (serotonin, bradykinin, prostaglandin E2, etc.), which in itself contributes to the formation of spasm and muscle pain surrounding the inflamed joint. An indirect sign that suggests that the pain comes from the muscle and not from the joint is the increase or appearance of pain when the muscle is loaded, but this test has extremely low specificity to clearly state that the cause is in the muscle.

Also, pain in the shoulder area can occur due to inflammation at the site of attachment of the ligament or tendon of the muscle to the bone, this condition is called enthesopathy. It is often observed with prolonged shortening of a muscle, prolonged force load on this muscle, and the ligament or tendon of the muscle at the site of attachment begins to peel off the periosteum from the bone, causing an inflammatory reaction. In addition, blunt trauma to the muscle, underlying bone and periosteum can cause a reflex local spasm.

All of the above situations, in most cases, will occur with the formation of myofascial syndrome, which is characterized by the appearance of dense cords in the thickness of the muscle, pain, and in some cases sensory disturbances are possible: numbness, a crawling sensation. The pain can be local, or it can be referred.