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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes intense pain in upper arms?

Answered by
Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 3583 Questions

Posted on Mon, 6 Jun 2016 in Pain Management
Question: Pain - strong in my upper arms. My father suffered the same and called it the 'screws'. My sister who is three years younger is also starting with pain. I am 75 and although overweight(which I am currently trying to lose) my doctor has tested for Poliomyalgia rheumatic which came back clear. However I am just finishing taking steroids 2.5 mgs which have not touched it this time. Had tried before and it had relieved the symptons. The pain also wakes me at night as I think a nerve touches my elbow and I keep moving my arm to get it away from the elbow pain - my left arm is more of the culprit. I suffered Carpal Tunnel syndrome when much younger to my right wrist so I do know what nerve pain feels like. My general health is satisfactory as I am a controlled Type 2 Diabetic so have a twice yearly check-up and everything comes back okay. I take an anti- innflammatory 800 Brufen tablet every morning, and one stomach soother (can't think of its name but it is very common). I have no problems with my stomach or digestive system nor bowels or bladder problems. I take one fish oil tablet and one 375g of Magnesium and my Dr. approved of this. I hate bothering my own Doctor who is brilliant but in great demand but the intense pain in my upper arms does get me down and makes putting on anything with sleeves very hard and my bra too. This I cannot get my arms round so have to yank it round - not an easy procedure! Can I do anything to help this myself like physiotherapy, acunpuncture etc., all of which I can pay for privately. Thank you for your time.
Answered by Dr. Matt Wachsman 1 hour later
Brief Answer:
Several possibilities.

Detailed Answer:
Several features of pain can be helpful in clarifying what is going on and the next steps for diagnosis and treatment.

Type of pain. Burning mostly means a nerve is having problems. This can be either a sick nerve or a nerve that has had an injury. Electrical, shooting would be others implying nerve source for pain.

Location of pain. There is a lot to this. First, if something goes in the pathway of a nerve, then that is the nerve involved. Nerves are long and the pain is in a belt-like long pathway. Smaller areas are smaller nerves. This also tends to say what might be going on. Obviously if there was an injury to the area and then there was pain outward from it "hit a nerve" would be a possibility. Sick nerves are MULTIPLE areas and tends to be the TIPS of the nerve not the whole nerve.

diabetes is associated with sick nerves. The fact that it is localized and goes out of the arms can be a problem with structures other than nerves. Two of the most common are disk and skeletal problems in the bones in the neck. Mostly in diabetics, this is due to increased bone formation hitting nerves in the neck. There would be pain traveling out from the neck, down the shoulders and out to the hands. Frankly, your doctor might have already thought of this, and other possibilities and decided that 1) surgery is not all that successful 2) the treatment of all the structural problems are to help increase mobility and started reasonable treatment and not done tests that probably will not change things.

I am not in that situation and so have to give ALL the information I have and it may not apply.
Visualization studies of the neck and upper limbs with CT or MRI are often done.
But the single most helpful test would be a nerve conduction test. In this test, the nerves have needles stuck in them and electricity applied to see if the nerves are sick or broken (yes, it DOES actually feel like a nerve having needles stuck into them and electricity shot through it, another reason why your doctor might not have chosen to go this route).

Treatment depends on the condition. sometimes there is a structure hitting a nerve that can be easily removed. Not so common, but it occurs. with diabetic pain, pills that damp down nerve action can be helpful and they are at best 50/50 on working. Increasing mobility with physical therapy is probably the most helpful modality but a diagnosis would be really a good idea prior to ordering it.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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