Upper Arm Muscle Pain Treatment
Upper arm muscle pain is a common presentation that affects people of all ages and activity levels.
Whether it’s a dull ache or a sharp pain, intermittent or persistent, pain down the arm can be quite painful and debilitating.
In this blog post, we’ll explore some of the most common causes of upper arm muscle pain and recommend treatment options for each case.
Common Causes of Upper Arm Muscle Pain
The main causes for musculoskeletal arm pain are:
- Myofascial Trigger Points. The most common cause for arm pain that we see in clinic. This still hasn’t made its way into most GP surgeries. As a result a great number of people experiencing Myofascial trigger points as a cause for arm pain get misdiagnosed with something else. We’ll look into it further down.
- Muscle Strain.
- Tendinitis: Inflammation of the tendons, particularly in the biceps or triceps.
- Bursitis: Inflammation of the bursa sacs in the shoulder joint.
- Frozen Shoulder: A condition involving the inflammation of the joint capsule and characterised by restricted motion and pain in the shoulder joint.
We’ve written about Frozen shoulder on a previous post so we’ll skip that one on this post. Tendinitis, bursitis and muscle strain can be topic for future posts.
In this post I wanna focus on two of the most common causes for arm pain that we see in clinic, both causes are in reality one, myofascial trigger points, located in 2 main different areas.
Understanding the anatomy and mechanics of these two areas is crucial to understanding pain down the arm.
- The shoulder joint, its components and its relationship with the arm
- The neck, its components and its relationship with the arm
1 THE SHOULDER JOINT
The arm attaches to the scapula at the shoulder through the glenohumeral joint.
The glenohumeral joint, also known as the shoulder joint, is a ball-and-socket joint that connects the humerus (long upper arm bone) to the glenoid, a part of the shoulder blade.
Here are the key elements of the shoulder joint:
- Humeral head: The ball-shaped head of the humerus fits into the glenoid cavity.
- Glenoid labrum: A cartilaginous tissue within the glenoid cavity of the shoulder joint that provides stability and shock absorption within the joint.
- Rotator cuff muscles: Key elements in arm pain! Four muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) that attach to the humerus and stabilise the joint.
- Joint capsule: A fibrous sac that hugs the joint reinforced by ligaments.
- Glenohumeral ligaments: Three ligaments that provide stability to the joint.
These elements must work together to allow for the amazingly wide range of motion of the shoulder (that can move in all planes) while keeping it stable. Believe me, NOT AN EASY TASK!
Understanding these structures is crucial when dealing with upper arm muscle pain, as issues in any of these components can lead to discomfort and reduced function.
ARM PAIN CAUSED BY MYOFASCIAL TRIGGER POINTS IN THE ROTATOR CUFF MUSCLES
The rotator cuff muscles, 4 muscles that attach to the very top of the arm and stabilise the joint, they connect shoulder blade and arm.
Supraspinatus, Infraspinatus, Teres minor, and Subscapularis!
Our lifestyle means that these muscles are rarely in harmony and almost always, weak! It also means that they are overloaded with weight they can’t deal with.
Most of us are front chain dominant due to our lifestyle. This means that our back chain is usually weak and not firing properly, resulting in the common postural patterns we see around everywhere, slouching, medially rotated shoulders, collapsed diaphragm, anterior pelvic shift and so on. When the back chain isn’t firing properly, the rotator cuff is overloading.
When a muscle overloads it develops Myofascial Trigger Points (commonly known as knots). These Trigger Points case pain either locally or referred, in this case down the arm.
Trigger Points in the rotator cuff muscles can refer radiating pain down the arm, even all the way down to the hand and can mimic nerve pain with an intensity that is sometimes surprising.
ROTATOR CUFF MUSCLES REFERRED PAIN
TERES MINOR
SUBSCAPULARIS
SUPRASPINATUS
INFRASPINATUS
OTHER MUSCLES AROUND THE SHOULDER THAT CAN ALSO REFER PAIN DOWN THE ARM
There are also some other main muscles around the shoulder joint that can also refer pain down the arm.
LATISSIMUS DORSAE
The Latissimus dorsae muscle originates in the inferior angle of the scapulae, 4 last ribs, the spine, toracolumbar fascia and the iliac crest. It then inserts into the humerus.
This flat huge muscle takes a big part of the back and it’s weak in most people.
Even though pain as a result of trigger points on this muscle is usually felt at the inferior angle of the scapulae, it is often felt at the back of the shoulder and down the medial side of the arm all the way down to the hand.
2 THE NECK
The neck, also known as the cervical spine, is a complex structure that plays a crucial role in upper arm pain. It consists of seven vertebrae (C1-C7) and various muscles, nerves, and other soft tissues.
In relation to arm pain there are two main elements within the neck that are often involved.
- Scalen muscles
- Brachial plexus nerve group
SCALEN MUSCLES
The scalene muscles are a group of three muscles located in the lateral-frontal area of the neck. They play a crucial role in neck movement and breathing. The 3 muscles are:
- Anterior scalene: Runs from the 3rd to 6th cervical vertebrae to the first rib.
- Middle scalene: Extends from the 2nd to 7th cervical vertebrae to the first rib.
- Posterior scalene: Attaches from the 4th to 6th cervical vertebrae to the second rib.
Myofascial Trigger points in the scalene muscles and their associated Thoracic outlet entrapment syndrome are often overlooked source of pain in the shoulder girdle and the upper arm.
Scalene trigger points are among the more demanding of skill for identification and treatment and are among the most important myofascial trigger points.
Myofascial trigger points in these muscles often get misdiagnosed with carpal tunnel syndrome due to the similar symptomatology.
Typical symptoms of scalene involvement are:
- Pain in the neck, shoulder, arm, and hand
- Numbness, tingling or burning sensations in the arm and hand
- Weakness in the arm or hand
- Headaches
- Neck stiffness, difficulty or pain when moving the head
- Neck pain, burning sensations
THORACIC OUTLET ENTRAPMENT SYNDROME
Thoracic outlet entrapment syndrome (TOS) of the brachial plexus nerve group is a condition that occurs when the nerves that pass through the thoracic outlet (the space between your collarbone and first rib) become compressed. This can be cased in two main ways:
When the scalene muscles develop trigger points the increased pressure in the tissue can cause neurological symptoms.
Entrapment caused by trigger points in scalens anterior and medius is quite common, symptoms pain down the arm, tingling and numbness.
Equally, these symptoms can occur with the elevation of the first rib as neurovascular structures exit the thoracic outlet.
OTHER MUSCLES AROUND THE NECK THAT CAN ALSO REFER PAIN DOWN THE ARM
There are other muscles around the neck that can also cause pain into the shoulder or upper arm. An important one is pectoralis minor.
PECTORALIS MINOR
This small but strong muscle lives deep to the pectoralis major.
It originates from the outer surface of the 3rd, 4th, and 5th ribs near the costal cartilages. It inserts into the coracoid process of the scapula.
This muscle plays a crucial role in stabilizing the scapula and assisting with breathing. However, due to its location and function, it can become tight and develop trigger points, potentially leading to pain in the chest, shoulder, and arm area.
This is also an area for entrapment of the brachial plexus nerve group as it passes deep to the pec minor so trigger points in this muscle can often cause entrapment of the neurovascular structures.
Trigger points in the pec minor can cause pain radiating down the arm that often gets misdiagnosed with carpal tunnel syndrome.
RECAP
We’ve covered the most important muscle groups that can be a source of muscle pain in the upper arm either directly due to Myofascial trigger points that develop in these structures or due to neurovascular entrapment with muscle involvement.
UPPER ARM MUSCLE PAIN TREATMENT
A good effective treatment for upper arm muscle pain involves a good assessment to localise the possible source, followed by a treatment of combined techniques from different disciplines.
At INSIDE we use a combination of myofascial release and trigger point work, as well as massage strokes and some others. This combined approach has shown great results and effectiveness in relieving pain restrictions of presentations involving the soft tissue.
Due to the frequency of misdiagnosis we see in clinic, the great amount of possible pain sources and therefore possible presentations as well as due to the complexity of the soft tissue, if you are experiencing pain down the arm, seeking the opinion and treatment of a good soft tissue specialist before proceeding with more invasive treatment is the most reasonable thing to do.
About the author
Rocio Santiago
MA in Nursing, Dip. Soft Tissue Therapy
Ro initially began her career as a nurse. Following this and after a difficult time in her life that resulted in a career change, Ro went on to train at one of the leading soft tissue therapy schools in Europe, completing a 3 year degree level course and specialising in effective soft tissue manipulation for the treatment of musculoskeletal pain.
The treatment method Ro uses consists of a combined approach using different specialised techniques, myofascial release and trigger point work among others, with the intention and focus on providing effective results in the least possible amount of time.
Combining her training, science background and life experience, her treatment method is based in science and built using a whole body approach, where mind and body are addressed as one.
Ro has been seeing clients as a soft tissue therapist for 8 years, successfully treating a wide range of conditions.