Cervicobrachialgia (neck pain radiating to the arm)

Causes of pain: from tumors to injuries

As in most other cases of painful sensations in various organs of the musculoskeletal system, only a specialist can answer the question of why the arm hurts from the shoulder to the elbow. Causes include various diseases and injuries. Discomfort may occur due to the following reasons:

1. Organ damage due to trauma.
2. Diseases of the shoulder joint of various origins.
3. Abnormalities of the spinal column.
4. Accumulation of anaerobic metabolism products in muscle tissue.
5. Osteoporosis and its consequences.
6. Neuralgia of the brachial and other nerves.
7. Connective tissue diseases.
8. Tumor diseases.
9. Consequences of infections.

Injuries are often a consequence of athletes' passion for sports or professional activities. Also, many traumatic situations arise due to extreme entertainment.

The inability to raise your arm is a fairly common problem. Shoulder pain can be one of the most debilitating and painful conditions. Many of you just wake up one day with this pain. The pain can be localized in the upper part or along the lateral surface of the shoulder joint. In some patients, the pain is most pronounced in the evening and at night, while in others it occurs only when raising the arm up. Most of you will not remember any shoulder injury. Most did not change their training regimens or make them more aggressive. In most cases you are 40-60 years old and it can be your dominant or non-dominant hand. Let's look at the most common causes:

• Upper shoulder pain
• Pain in the shoulder joint when raising the arm
• Limitation of movements in the shoulder joint.

There are many problems that limit movement in the shoulder joint or cause pain when lifting or moving the arm. Most often these are problems with the rotator cuff.

The rotator cuff is the most common cause of pain along the outer shoulder joint in adults. This is also the main reason why you cannot lift your arm up or experience pain when moving.

Shoulder pain can be caused by injury. Believe it or not, shoulder injury is a less common cause of pain.

Rotator cuff injuries often occur due to repetitive stress, such as lifting weights or throwing sports equipment. Rotator cuff injuries can also occur from falls and from prolonged work with raised arms (such as trimming trees or painting a house).

The rotator cuff is formed by four muscles located under the deltoid muscle. Together, these muscles control movement in the shoulder joint, ensuring normal function.

If the rotator cuff becomes damaged, inflamed, or torn, you lose the ability to lift your arm up. The most common rotator cuff problems are:

• Rotator cuff tendonitis
• Rotator cuff tendinosis
• Rotator cuff tears
• Partial rotator cuff tears
• Calcific tendinitis
• Adhesive capsulitis or frozen shoulder

The causes of shoulder pain vary depending on age. Some problems are more common in certain age groups. Tendonitis is more common in athletes at a younger age. In middle age - tendinosis, calcific tendonitis, arthrosis of the acromioclavicular joint (ACJ) and frozen shoulder. Let's take a brief look at each of the most common causes of pain and limitation of movement in the shoulder joint.

Arm pain: similarities and differences

Patients presenting with pain in the arm may describe completely different symptoms due to differences in the causes of the disease. But at the same time, there are often similarities in complaints. So, the muscles of the arm from the shoulder to the elbow hurt, combined with numbness due to nerve compression, and this, in turn, can be a consequence of both inflammation of the joints and dislocation. Referral of pain to the arm is observed with angina pectoris, colic, cholecystitis, and stomach ulcers.

So, based on the nature of the pain, they distinguish:

• acute, starting abruptly, which cannot be tolerated without medication - characteristic of injuries, damage to joints, nerves;
• having a baking character - together with shortness of breath and bluish discoloration of the skin, they are often a companion to myocardial infarction, in which case an ECG is required;
• dull, without strong expression, when the arm aches from shoulder to elbow - characteristic of a bruise, closed fracture, arthrosis, tear of muscles, ligaments and tendons.

Sensory disturbances can cause numbness in the hand, causing painful discomfort. Patients in this case also describe a symptom such as “crawling goosebumps.” Both signs are evidence of the onset of osteochondrosis, which must be treated promptly.

Symptoms

The pain is most often sharp, but can also be dull or with a burning, tingling or electrical sensation. The pain can lead to neck or shoulder stiffness and decreased range of motion. In addition, there may also be a headache. The peculiarity of the symptoms is important for the doctor, as it allows you to find out the cause of the pain syndrome.

Weakness may be associated with severe pain in the muscles or bones when moving. In addition, damage can also affect nerves and therefore it is necessary to differentiate true weakness (muscular or nerve) from reduced weakness associated with pain or inflammation.

Numbness. If there is compression (bruise, injury) of the nerves, sensitivity may be impaired. In addition to numbness, there may be a tingling or sinking sensation.

Cold weather. Cold arms or hands may indicate possible damage to veins or arteries. This symptom usually indicates insufficient blood circulation in the limb.

Color change. Blue or pale discoloration of the arm or shoulder may also be a sign of damage to the veins or arteries. Redness may be a sign of infection or inflammation.

Swelling. Swelling can be either generalized throughout the arm or local in the area of ​​problematic structures (for example, a fracture zone or an inflamed bursa). Muscle spasms or tightness can simulate swelling. Dislocation or deformation can also cause swelling.

Deformation can occur due to a fracture or dislocation. Tendon ruptures can cause abnormal alignment of bone structures.

If you have symptoms such as increasing pain, weakness, coldness of the limb, deformity, fever, or symptoms such as dizziness, difficulty breathing or severe numbness or weakness, you should immediately seek medical help.

Diagnostic methods for pain in the ulnohumeral region of the arm

A patient who complains of discomfort and pain in the arm from shoulder to elbow is examined. The doctor details the complaints, examines the damage, visually assesses the color scheme and tone of the skin in the area where the pain is localized. By comparing the condition of the joints and studying motor activity, we can make the first assumptions about the presence or absence of damage. In cases where the arm is pulled from the shoulder to the elbow, a flexion resistance test helps.

But, as a rule, an examination cannot give an objective picture of the disease. Therefore, to make an accurate diagnosis, the following research methods are used:

• general (clinical) blood test (CBC);
• blood test for biochemistry;
• X-ray examination;
• CT;
• MRI;
• densitometric study.

The CBC diagnoses inflammation in the body, and a biochemical study clarifies the presence of specific pathological abnormalities. Thus, osteoporosis is characterized by changes in calcium levels.

An x-ray is needed to determine the condition of the bones. Computed tomography and magnetic resonance imaging help to assess the condition of tissues and skeletal components. Densitometry reveals deviations from bone density standards, which is especially important for osteoporosis.

Problems with the cardiovascular system

In addition to common causes, such as damage to joints and bone tissue, we should not forget that pain in the shoulder blades may indicate problems with the cardiovascular system. Sudden pain in this area, if caused by heart pathology, requires immediate medical attention.

If the causes of pain in the back of the shoulder blades are caused by changes in the heart muscle or coronary vessels, then the following symptoms are observed:

• Shortness of breath with little physical exertion
• Increased shortness of breath when moving to a lying position
• Occasionally (at the initial stage of the disease) or constantly (at an advanced state of the pathological process), dense “cardiac” swelling on the legs and face can be detected
• Pale or bluish skin in the area of ​​the nasolabial triangle
• Periodic chest pain
• Feeling short of air

How to treat arm pain from shoulder to elbow

First of all, you need to remember the dangers of self-medication and not to make the disease worse. Only accurate diagnostics carried out in laboratory and outpatient conditions by specialists can identify methods of subsequent therapy. At the initial stage, medications will be prescribed to help relieve pain symptoms. Further, drug and physiotherapeutic treatment of pain in the shoulder and arm is carried out in a complex. Sometimes it is supplemented with herbal medicine.

The following types of medications are usually prescribed:

1. Non-steroidal anti-inflammatory drugs - to relieve inflammation, bleeding and pain.
2. Hormonal and anti-inflammatory - to support immune resistance.
3. Painkillers.
4. Chondroprotective - for the treatment and restoration of joint functions.
5. Calcium-containing - to accelerate bone healing and relieve osteoporosis symptoms.

Vitamin D is also used to activate healing procedures. A number of drugs have a whole range of side effects. Therefore, when prescribing, specialists are guided by the dynamics of the body’s condition and expediency.

Treatment

Help before diagnosis

Without establishing the cause of pain in the right shoulder blade, the doctor cannot give specific recommendations. If the patient’s condition is satisfactory, the examination is carried out on an outpatient basis, and standard analgesics from the group of non-steroidal anti-inflammatory drugs or antispasmodics are prescribed to relieve pain. If, in addition to pain, the state of health sharply deteriorates, the person is immediately hospitalized.

Conservative therapy

After determining the origin of the pain under the right shoulder blade, complex drug treatment is carried out. Most diseases are subject to outpatient therapy, but during a period of severe exacerbation of a chronic process, it is advisable to undergo a course in a hospital. Drugs are selected based on the location of the disorders:

• When the hepatobiliary system is damaged,
  choleretic agents are used - choleretics, cholekinetics or their combinations, hepatoprotectors, antibacterial drugs. To correct hypermotor dyskinesia of the gallbladder, antispasmodics are prescribed.
• In case of vertebral pathology,
  therapeutic blockades or electrophoresis with analgesics are performed to relieve severe pain. In order to eliminate the neurological complications of osteochondrosis, B vitamins and neurometabolic agents are used.
• For bronchopulmonary diseases
  , massive antibiotic therapy is most often recommended, and expectorant, anti-inflammatory, and antihistamine medications are indicated to eliminate associated symptoms. When infected with Koch's bacillus, long-term anti-tuberculosis treatment is required.

Pharmaceutical treatment of the causes of pain under the scapula on the right is complemented by non-drug methods. This is especially important for diseases of the spinal column, the correction of which requires wearing supportive corsets, traction therapy, kinesiological taping and exercise therapy. According to strict indications, massage and manual therapy are performed. For functional changes in the gallbladder, acupuncture methods, ozokerite applications, and inductothermy are effective.

Surgery

Surgical methods are appropriate for serious injuries of the scapula and bones of the shoulder girdle, when open reposition of bone fragments and osteosynthesis are indicated. In orthopedic practice, surgical interventions are resorted to when there is compression of the spinal cord, accompanied by unbearable pain. Among minimally invasive methods, puncture vaporization of the disc and microdiscectomy are popular.

In case of hepatic colic, biliary peritonitis, perforation or bleeding from a duodenal ulcer, emergency assistance from abdominal surgeons is required. In case of pulmonary infarction, pulmonary hemorrhage and tension pneumothorax, the participation of specialists in the field of thoracic surgery is necessary. Treatment of skin tumors is carried out by oncodermatologists who combine surgical, chemotherapy and radiation treatment.

How to avoid pain in the humeroulnar area?

Prevention is the best alternative to treatment. This simple truth also applies to cases where the arm hurts above the elbow. Strong, but regular exercise will help strengthen joints and muscles. Atherosclerosis loves people with excess body weight, so you should eat right and move more. Of course, you need to avoid traumatic situations, not get involved in fights and not look for extreme sports where it is unnecessary. Regular medical examinations and timely diagnosis will help to avoid a situation where the arm hurts between the shoulder and elbow.

How does glenohumeral periarthrosis manifest?

Among the main symptoms are the following:

• Persistent pain, especially when rotating the shoulder, muscle contracture in the shoulder joint.
• The pain intensifies at night, as well as when moving the arm to the side or when trying to put it behind the back.
• A person does not experience discomfort when freely moving the arm back and forth like a pendulum, unlike arthrosis.
• It becomes impossible to sleep on the side of the affected joint.
• Sometimes the “shoulder-hand” symptom appears: the fingers swell, the folds disappear, and the color of the skin changes.

Periarthrosis mainly affects the right shoulder: it is not without reason that it is called the “disease of right-handers”

How is glenohumeral periarthrosis diagnosed?

Orthopedists and traumatologists who deal with various manifestations of joint diseases are well aware that glenohumeral periarthrosis is diagnosed mainly in women. The disease is localized mainly in the right shoulder and has a unilateral manifestation, however, during consultation, doctors, after examination and palpation, pay attention to other signs and also prescribe additional studies.

• A general clinical blood test shows an increase in ESR and a shift in the leukocyte formula.
• The X-ray image shows salt deposits, but there are no obvious changes: otherwise, instead of a diagnosis of periarthrosis, we would already be talking about arthrosis - a more serious degree of damage.
• MRI of the thoracic and cervical spine will help clarify the extent of joint damage.

If the patient cannot move his arm to the side by 60-120°, he most likely has periarthrosis