Arm Pain Treatment
What Causes Arm Pain?
Arm pain can result from injuries, inflammation or illnesses that develop in the muscles, tendons, ligaments, bones, or nerves of the arm. Pain felt in the arm can also originate from a problem in another area of the body, such as the upper spine, the neck or the heart. Tendinitis, carpal tunnel syndrome, and bursitis are all common arm pain causes and conditions, along with reflex sympathetic dystrophy and chronic regional pain syndrome.
Inflammation Conditions that Cause Arm Pain
The bursae are fluid-filled sacs surrounding the joints that help your tendons, ligaments, and bones move together smoothly. The shoulder and elbow are two of the more common sites for bursitis, which develops when the bursae become inflamed. Bursitis causes pain, swelling, and sometimes redness or stiffness at the inflammation site. Arthritis, another condition associated with inflammation, can cause symptoms like those of bursitis in any of the joints of the arm.
Tendonitis causes arm pain due to inflammation in the tendons in the joints of the shoulder, elbow, or wrist. Tennis elbow is a specific type of tendinitis that results from repetitive arm and wrist motions that lead to a strain in the muscles and tendons of the arm. Athletes aren’t the only people who can develop tennis elbow; it can happen to anyone who commonly moves their wrist and arm in a particular manner. Tennis elbow pain originates at the outside of the elbow but can radiate downward into the forearm or the wrist.
Arm Pain Causes Originating in the Wrist or Shoulder
Carpal tunnel and De Quervain’s tendinitis (or De Quervain’s tenosynovitis) both primarily affect the wrist, but the pain from these conditions can extend into the forearm. Carpal tunnel syndrome can be the culprit if you experience swelling in the tendons or connective tissues of the wrist, while De Quervain’s tendinitis can be the diagnosis if you have swollen wrist tendons at the base of the thumb. The pain from both conditions can radiate upward into the forearm.
The muscles and tendons surrounding the shoulder joint are referred to as the rotator cuff. Usually the result of an overhead repetitive motion, a rotator cuff injury causes an ache in the affected shoulder that worsens when compressed during sleep. The pain of a rotator cuff injury is localized in the shoulder but can also cause arm weakness and discomfort.
Frozen shoulder, which is also known as adhesive capsulitis, causes stiffness, tenderness, and pain in the shoulder joint that can radiate down the arm and limit its range of motion. People with diabetes are prone to frozen shoulder, as are those who have had to immobilize the shoulder due to an arm injury or surgery.
Reflex Sympathetic Dystrophy and Chronic Regional Pain Syndrome
Reflex sympathetic dystrophy (RSD) causes burning pain, tenderness, and swelling in the arm. It is also characterized by fluctuations in body temperature along with sweaty, flushed, shiny, blotchy, or discolored skin. Also referred to as chronic (or complex) regional pain syndrome, or simply, “the shoulder-hand syndrome,” RSD is thought to result from a dysfunction in the central or peripheral nervous system. This dysfunction sends abnormal signals along nerves that affect skin and blood vessels. More common in women than men and in people ages 20 to 35 years old, RSD is sometimes triggered after an injury or surgery and can be heightened by emotional stress.
When is Arm Pain Cause for Concern?
Pain, stiffness, bruising, or swelling in any portion of the arm after a fall or accident could signal a sprain or broken bone. Visible abnormalities in the arm, such as a bend in the arm or a bone protruding through the skin, signal a bone fracture and cause intense pain.
A dislocated shoulder or elbow can also cause intense pain and difficulty moving the arm when the bones of the shoulder or elbow joint are forced out of alignment. Typically resulting from a fall, shoulder dislocations are the most commonly dislocated joint among adults, followed by the elbow.
Arm pain that comes on suddenly, feels especially severe and is accompanied by a feeling of fullness or squeezing in the chest could signal a heart attack. If arm pain is accompanied by chest discomfort, comes on with exertion and gets better with rest, it could be due to angina, a condition caused by reduced blood flow to the heart.
Any of these more serious arm pain causes should be treated as soon as possible by a doctor.
How is Arm Pain Treated?
Possible treatments for arm pain depend on the underlying cause or condition and may include exercises, physical therapy, and oral or topical therapies. Other arm pain treatments include superficial muscle injections, epidural steroid injections or joint injections; transcutaneous electrical nerve stimulation; and nerve blocks. The caring providers at Balcones Pain Consultants consider both alternative and holistic treatments as well as medical methods for treating different types of arm pain.
Acupuncture to Treat Arm Pain
An ancient healing technique of traditional Chinese medicine, acupuncture is a noninvasive technique that can be effective at treating pain. It involves stimulating specific points on the body with extremely fine, sterile needles, to promote the natural healing process. Acupuncture can be a beneficial component of treatment for shoulder, arm, and wrist pain conditions such as bursitis, arthritis, tennis elbow and carpal tunnel syndrome.
Treatments for Inflammatory Conditions
A treatment plan for bursitis, arthritis and tendinitis can also include transcutaneous electrical nerve stimulation or acupuncture. Medications like NSAIDs (non-steroidal anti-inflammatory drugs) or DMARDs (disease-modifying anti-rheumatic drugs) can also reduce pain and inflammation. Pain from inflammatory conditions can also be successfully treated with epidural steroid injections or physical therapy.
Shoulder, Elbow, and Wrist Pain Treatments
Treatment for arm and wrist pain due to carpal tunnel syndrome or De Quervain’s tendinitis is typically a combination of wrist splinting, medications, and lifestyle changes. NSAIDs and corticosteroids can help relieve pain, along with cold packs applied periodically to the pain site.
Pain from shoulder conditions such as rotator cuff injuries and frozen shoulder can be treated with physical therapy along with NSAIDs and alternating heat and cold packs. In the case of a dislocated shoulder or elbow, the bones must first be moved back into proper alignment and then the joint must be immobilized. The pain of a dislocated shoulder or elbow can intensify during manipulation of the bones; for this reason, muscle relaxants, pain medication or sedatives may be used while correcting the alignment.
The pain of a dislocated joint should greatly reduce once the alignment has been completed. After a period of immobilization and once the joint has had time to begin the healing process, physical therapy is an important part of restoring full range of motion. Further use of pain medications or muscle relaxation methods may also be necessary throughout the healing process.
Other Arm Pain Treatments
Pain from reflex sympathetic dystrophy (also referred to as chronic regional pain syndrome) can be treated with rehabilitative exercise programs along with drugs like NSAIDs, opioids, or corticosteroids. Topical anesthetic creams and patches can also be part of an effective treatment regimen for this condition, as well as measures to address the emotional components of the condition, such as stress, anxiety, or depression.
Pain and stiffness resulting from an arm sprain or broken bone can be treated with a variety of methods. The combination of pain medications, especially NSAIDs, along with ice applications and a cast, bandage, or splint can greatly reduce pain after an injury of this type. Some people continue experiencing chronic pain following an arm injury, however, even after the tissues or bone fracture has healed. In this case, longer-term arm pain treatment might include physical therapy, medications, and exercises.
Chronic arm pain following an injury might also be treated with injections, in which a mixture of anesthetic and steroid medications is injected to relieve pain and reduce inflammation. Joint Injection may target the shoulder joint, while subacromial injection targets the area under the part of the shoulder blade called the “acromion.” Balcones Pain Consultants physicians perform these procedures, which may utilize fluoroscopy for precise needle placement, on an outpatient basis.
Treatment of chronic arm pain may also include transcutaneous electrical nerve stimulation or nerve blocks, or more advanced treatments including: