From the neck
A common source of arm pain is the neck. Not only do nerves to the arm come from the neck, but irritation of neck joints can also cause referred pain into the upper arm. If the neck is the issue, there will usually be complaints about discomfort there as well, and the pain may be felt in a line from the neck into the upper shoulder and down the arm, possibly all the way into the fingers.
But this is a simplification, as nerves can be irritated anywhere along their length, not just at the neck. Our job is to discover where the irritation is coming from.
This is quite important as the appropriate treatment will depend on the correct result, and jumping to conclusions about where the problem is can mean ineffective treatment and wasted time and money spent by you as a patient.
From the shoulder joint
Pain radiating from the shoulder joint can often be reproduced by arm movements and the person will usually complain about certain movements being difficult, such as putting on a coat, fastening a bra, reaching up or brushing the hair.
From the elbow
The elbow is a third source, and everyone has heard about tennis elbow, though not all pain on the outside of the elbow is necessarily tennis elbow, in the same way that not all leg pain is sciatica. There are two long bones in your forearm with a joint between them at the elbow. A dysfunction or restriction of this joint can also cause pain in the area and into the forearm.
From the wrist
You'll find content for this under the website section on Wrist pain and Carpal tunnel.
Case study - One problem, lots of competing explanations!
A man in his early thirties came in complaining of sore hands and a sore back. He was a floor layer, a job involving a lot of gripping of heavy tools, and the problem had been going on for 4 years & it was affecting his sleep. He’d had 15 treatments with a chiropractor before consulting us.
On examination, I could reproduce the numbness and burning symptoms in his hands by applying pressure at different points well away from the hand and with tests for something called Thoracic Outlet Syndrome, basically a name for a situation where specific nerves that run down the arm are pinched or irritated by muscles & other structures near the neck.
But that wasn’t all. The forearm was very tight from the internal pressure of the hard working muscles there, and the same symptoms could be re produced with lots of other tests. Normally, this would be confusing, as it could be interpreted as the patient suffering from several problems at the same time!
But if a limb or area is ‘facilitated’, it means it becomes abnormally sensitive to stimuli such as the pressure of the therapist’s fingers on a certain muscle, or a particular test. This probably explains why different tests for different causes all managed to come out positive.
After 4 treatments he is not totally pain free; after all he goes back to the same job each day doing imposing the same heavy demands on his hand, wrist and arm. But he is now sleeping much better and many of those tests are now negative when repeated, indicating a reduction in the facilitation.
Osteopathy keeps a broad perspective
In the case study above, it would have been all too easy for a therapist to stop & jump to a quick diagnosis with the first positive tests for the man’s pains. But in doing so, he or she would never discover that there were other possible causes and other possible treatments.