Upper arm pain refers to pain that is felt anywhere from just below the shoulder joint to just above the elbow.
It may be a problem in the muscles, tendons or bones, or even referred pain from elsewhere such as the neck or heart.
Upper arm pain may be a sign of wear and tear, postural problems, an injury or even an underlying medical condition.
The most common causes of upper arm pain are:
We are going to look at how they present, how to tell the difference between them, how to know if it is something serious and the best treatment options for each of these causes of upper arm pain.
What Is It: A rotator cuff tear is a very common cause of pain in the upper arm caused by damage to one of the tendons of the rotator cuff - a group of muscles that surround the shoulder joint and control the movement and stability of the shoulder
Onset: May be gradual due to wear and tear over time from repetitive friction, or sudden with an injury such as falling on to an outstretched arm or picking up something heavy
Symptoms: Upper arm pain across the shoulder and down the upper arm, usually a dull ache, weakness and cracking/popping noises when you move your arm
Aggravating Factors: Lying on the affected arm, lifting or twisting the arm
Recovery: Rotator cuff tears are often slow to heal and it can take a few months to fully recover. If symptoms persist for more than 6 months, surgery may be recommended
Find Out More: Rotator Cuff Tears - Causes & Treatment
What Is It: A shoulder fracture is where there is a break or crack in the upper arm bone known as a fractured shaft of humerus. It may be anything from a small hairline fracture to a complex fracture where the bone has completely broken into two or more pieces. Fractures are one of the most serious causes of upper arm pain.
Onset: Sudden onset from a direct blow to the upper arm, e.g. a fall or RTA, sudden severe twisting of the arm or occasionally from an extreme contraction of one of the arm muscles e.g. when throwing. In most cases there is an obvious event that caused the fracture. If this is not the case, there may be an underlying pathology that has weakened the bone making it more likely to break e.g. osteoporosis or cancer
Symptoms: Severe upper arm pain - often described as a sharp pain, deformity (if the fracture has displaced there may be a bulge where the bone is out of place), shortening of the arm, bruising, swelling, minimal arm movement
Aggravating Factors: Any arm movement, pressure over the fracture site
Treatment: Minor fractures may be treated by immobilizing the arm in a cast for 4-6 weeks. Major fractures will require surgery to realign the bones and fix them back together using either a metal rod or a metal plate and screws
Recovery: It usually takes around 3-6 weeks for the bone to knit back together and then the same length of time again for it to strengthen. However, in elderly patients healing is often slower. You will need physical therapy to regain strength and movement in the arm as stiffness and weakness is a common problem. It can take up to a year to fully recover from an arm fracture.
Find Out More: Shoulder Fractures - Types, Causes & Treatment
What Is It: Shoulder impingement syndrome is a collective term for anything that reduces the amount of space in part of the shoulder, known as the subacromial space, which places pressure and friction on the rotator cuff. Shoulder impingement is a common cause of shoulder and upper arm pain affecting approximately 20% of people at some point usually caused by repetitive overhead activities such as throwing or swimming, aging, posture or genetics.
Onset: Gradual onset that gets progressively worse over time. Most frequently develops in middle age (45-65)
Symptoms: Shoulder and upper arm pain, usually on the outside of the arm which may extend down to the elbow, often described as feeling like toothache. Painful arc with shoulder movement (as shown in picture) and weakness. Shoulder movement is not usually restricted initially, but over time, stiffness may develop due to lack of use
Aggravating Factors: Reaching and lifting above your head, lying on your side, reaching behind your back, getting dressed
Treatment: Rest from aggravating activities, ice, rotator cuff exercises to strengthen and stretch the muscles, upper back stretches and steroid injections. If the impingement is caused by small bone spurs in the subacromial space, surgery will be required to remove them, known as a subacromial decompression
Recovery: It can take 3-6 months for upper arm pain to settle with shoulder impingement syndrome, with or without surgery
Find Out More: Shoulder Impingement Syndrome - Causes & Treatment
What is it: A frozen shoulder aka adhesive capsulitis is where there is thickening and tightening of the joint capsule, a fluid filled sac that surrounds the glenohumeral (shoulder) joint
Onset: Gradual onset over weeks/months, most common between the ages of 40-70 and in females. Often no obvious cause but it can develop after a shoulder injury or surgery
Symptoms: There are three phases to a frozen shoulder, each with different symptoms - shoulder and upper arm pain that gets gradually worse (phase 1) then increasing restriction of shoulder movement (phase 2) in what is known as a capsular pattern – lateral rotation most limited, then flexion and medial rotation least affected. The pain gradually subsides but stiffness remains for a number of months (phase 3). Upper arm pain from a frozen shoulder is often worse at night
Aggravating Factors: Arm movement, particularly above head height or twisting movements
Treatment: Initially focuses on pain management e.g. medication and steroid injections. Once the pain has settled, an exercise programme is followed to strengthen and stretch the shoulder to regain full movement. If symptoms fail to improve after six months, surgery may be recommended
Recovery: It can take up to 2 years to fully recover from a frozen shoulder, for the upper arm pain and stiffness to fully resolve. Each phase can last for a number of months
Find Out More: Frozen Shoulders - Causes, Stages & Treatment
What is it: Biceps tendonitis is where there is inflammation and thickening in one of the biceps tendons. It is often associated with other shoulder problems such as impingement and arthritis. People who do lots of heavy lifting overhead are at increased risk of biceps injuries
Onset: May develop gradually over time from overuse, or suddenly with an injury such as a fall or lifting heavy weights
Symptoms: Tendonitis – achy upper arm muscle pain, mostly at the front, especially when the arm is overhead. Complete tear – sudden, sharp upper arm pain, sometimes accompanied by an audible pop, and bruising from the mid upper arm to the elbow. There may be a bulge in the upper arm, known as a “Popeye Muscle”. The upper arm pain may in both cases extend down to the elbow
Aggravating Factors: Heavy lifting, raising your arm above your head
Treatment: Rest, ice, injections and exercises. In persistent cases of tendonitis, or severe tendon tears, surgery may be required, after which you will need to wear a sling initially and then work on a rehab programme of strengthening and stretching exercises
Recovery: It usually take 3-6 months to fully recover from biceps tendonitis
Find Out More: Biceps Tendonitis: Causes & Treatment
In some instances, upper arm pain may actually be a symptom of a problem elsewhere which could be potentially life-threatening:
Angina: A condition where the blood supply to the heart is restricted which can cause upper arm pain. The pain usually gets worse with activity and eases with rest
Heart Attack: Where a blood clot blocks the blood supply to the heart. This is a medical emergency. If your upper arm pain, usually in the left arm, is accompanied by chest pain (may feel like a squeezing sensation or pressure), shortness of breath, nausea, light-headedness or sweating call for an ambulance immediately
Pressure on the nerves that run from the neck across the shoulder and down the arm can cause pain in the upper arm. The nerve may get pinched where it exits the spine or anywhere along its path which leads to pain.
Most cases of upper arm pain benefit from strengthening and stretching exercises - visit the shoulder exercises section for a whole range of exercises that might help.
You can find out more about the causes of upper arm pain and how to treat them by using the links above. If you have other symptoms alongside upper arm pain and you want some help working out what is causing your pain, visit the shoulder pain diagnosis section.
You may also be interested in the following articles:
Page Last Updated: 01/03/2022
Next Review Due: 01/03/2024