Pain in your arm or shoulder can slow you down. And the longer it goes untreated, the worse it can get, making it hard to work, sleep, and perform everyday activities like buttoning a shirt or reaching for something in the cupboard. Before you spend weeks trying to work around the pain, consider consulting with a chiropractor.
While arm, shoulder, elbow or wrist pain isn’t a back condition, chiropractors can often provide helpful treatments for these conditions, especially when treated early.
Common Conditions That Cause Arm Pain
Causes of Shoulder Pain
Rotator Cuff Injury
The rotator cuff is collection of muscles and tendons that connects the shoulder blade to the arm bone and support the motion of the arm. Over time, the rotator cuff can become painful. This type of shoulder pain could be caused by several conditions such as tendonitis, impingement, arthritis, and rotator cuff tendon tears.
Injury and degeneration are the two main causes of rotator cuff tears.
- Acute (sudden) rotator cuff tears can occur from excessive force, such as a direct fall on the shoulder or trying to catch or lift a heavy object.
- Degenerative rotator cuff tears are the result of the wear-and-tear that happens as we age. Low blood supply and repetitive stress are two main factors that contribute to rotator cuff degeneration.
Common symptoms of a rotator cuff tear can include:
- Pain and weakness in the affected shoulder. Typically, the larger the tear, the more weakness you will experience.
- Crackling sensation (called crepitus) when moving the shoulder in certain positions. The sounds associated with crepitus can be muffled or loud enough for other people to hear.
The labrum is a rim of soft tissue that makes the shoulder socket more like a cup. The labrum turns the flat surface of the glenoid, which is part of the scapula (shoulder blade) into a deeper socket that molds to fit the head of the humerus (upper arm bone).
Labral tears are often caused by a direct injury to the shoulder, such as falling on an outstretched hand. Overuse can also lead to labral tears.
Common symptoms of a labral tear in the shoulder can include:
- A sharp pop or catching sensation in the shoulder during certain shoulder movements, followed by a vague ache that lasts for several hours
- A loose feeling in the shoulder as though it “slips” with certain movements
Bursitis is a general term used to describe inflammation of the bursa. A bursa is a lubricated sac of tissue that cuts down on the friction between two moving parts. It is located between the acromion (the roof of the shoulder) and the rotator cuff tendons. Impingement syndrome, a condition where the rotator cuff tendons rub against the acromion, is a leading cause of bursa inflammation.
Typically, impingement-related bursitis is caused by overuse. This includes working with the arms raised overhead, repeated throwing activities, or other repetitive actions of the shoulder.
Common symptoms of bursitis caused by impingement syndrome can include:
- Generalized shoulder aches in the early stages
- Pain when raising the arm out to the side or in front of the body
- Sharp pain when reaching behind you
- Greater discomfort as it progresses, which can include stiffness and a catching sensation when you lower your arm
- Weakness and instability to raise the arm, which indicates that the rotator cuff tendons may be torn
Tendonitis and tendonosis are conditions that affect tendons in the arm. While they do share similar symptoms, they differ in their causes and how they manifest themselves.
- Tendonitis (also spelled tendinitis) is an acute (sudden onset) condition where the tendons that connect muscle to bone become inflamed. Although tendonitis can be caused by a sudden injury, it is more likely to develop from the repetition of a particular movement over time. It can also be caused by impingement and the accumulation of calcium deposits.
- Tendonosis is a chronic (long lasting) tendon injury. It occurs when tendons degenerate (break down) due to the normal wear and tear that comes with age.
Both conditions share common symptoms that can include:
- Swelling and tenderness in the front of the shoulder
- Minor shoulder pain that is felt both during activity and while at rest
- Sudden pain when lifting or reaching
- Pain that radiates from the front of the shoulder to the side of the arm
- Loss of strength and motion in the arm
- Difficulty performing daily activities like buttoning or zippering
- Stiffness in the joint
- Restricted joint movement
- Localized burning pain and swelling around the tendon
- Pain that gets worse during and after activity
- Pain that persists for several months
AC Joint Injury/Hypertrophy (Arthritis)
The acromioclavicular (AC) joint is the connection between the scapula (shoulder blade) and the clavicle (collarbone). The AC joint in the shoulder is a common spot for injury, such as AC separation, as well as the development of osteoarthritis in middle age. Overgrowth in the AC joint, which is often due to the inflammation associated with osteoarthritis, is called hypertrophy.
The most common cause of an AC joint separation is falling on the shoulder. As the shoulder strikes the ground, the force from the fall pushes the scapula down. The collarbone, because it is attached to the rib cage, cannot move enough to follow the motion of the scapula. Something has to give. The result is that the ligaments around the AC joint begin to tear, separating (dislocating) the joint.
Symptoms of AC joint separation range from mild tenderness felt over the joint after a ligament sprain to the intense pain of a complete separation. More serious separations can cause a noticeable bump on the shoulder and a considerable amount of swelling. Some people may also feel a popping sensation due to the shifting of the loose joint.
Osteoarthritis of the shoulder
The resulting strain of arm overuse makes AC joint osteoarthritis a common disorder. AC joint osteoarthritis may also develop following an injury to the joint, such as an AC joint separation. While the shoulder does heal, years of degeneration cause the AC joint to become painful.
In its early stages, AC joint osteoarthritis usually causes pain and tenderness in the front of the shoulder around the joint. Pain may spread to include the shoulder, the front of the chest, and the neck.
Causes of Elbow Pain
Tennis Elbow/ Golfer’s Elbow
Tennis elbow and golfer’s elbow are two common elbow conditions that fall under the diagnosis of elbow tendonitis.
Tennis elbow refers to inflammation of the tendons that attach to the outside (lateral) part of the elbow, while golfer’s elbow refers to inflammation of the tendons that attach to the inner (medial) part of the elbow.
Both are caused by repetitive strain that are not necessarily related to high-level sports competition. Hammering nails, picking up heavy buckets, shoveling, or pruning shrubs are examples of other repetitive activities that can cause the pain of tennis and golfer’s elbow.
Symptoms of tennis elbow can include:
- Tenderness and pain that starts at the outside of the elbow. The pain may spread down the forearm. It may go as far as the back of the middle and ring fingers.
- Tightness and soreness in the forearm muscles.
- Pain that worsens when you bend your wrist backward, turn your palm upward, or hold something with a stiff wrist or straightened elbow.
Symptoms of golfer’s elbow can include:
- Tenderness and pain that starts at the inside of the elbow. The pain may spread down the forearm.
- Pain that worsens when bending your wrist, twisting your forearm down, or grasping objects.
- Weakness when grasping items or squeezing your hand into a fist.
Cubital Tunnel Syndrome
Cubital tunnel syndrome, also called ulnar nerve entrapment, is a condition that affects the ulnar nerve where it crosses the inside edge of the elbow. When this area becomes irritated from injury or pressure, it can lead to cubital tunnel syndrome.
The exact cause of cubital tunnel syndrome is not known. Part of the problem may lie in the way the elbow works. The ulnar nerve actually stretches several millimeters when the elbow is bent. When your bend your elbow, the ulnar nerve must stretch around a bony bump at the inside of your elbow called the medial epicondyle. Over time, this can cause irritation.
Cubital tunnel syndrome can also be caused by other things including:
- Frequent bending of the elbow, such as pulling levers, reaching, or lifting.
- Constant direct pressure on the elbow, such as leaning on the elbow while you sit at a desk or from using the elbow rest during a long drive or while running machinery
- A direct blow to the cubital tunnel
Common symptoms of cubital tunnel syndrome include:
- Numbness on the inside of the hand and in the ring and little fingers. The numbness may develop into the pain.
- Clumsiness of the hand and thumb
- Electric shock sensation, called Tinel’s sign, if the nerve is bumped or tapped
Radial Tunnel Syndrome
Radial tunnel syndrome, also called radial nerve entrapment, happens when the radial nerve is squeezed where it passes through a tunnel near the elbow. When this area becomes irritated from injury or pressure, it can lead to cubital tunnel syndrome.
Pain is caused by pressure on the radial nerve. There are several spots along the radial tunnel that can pinch the nerve. If the tunnel is too small, it can squeeze the nerve and cause pain. Repetitive, forceful pushing and pulling, bending of the wrist, gripping, and pinching can also stretch and irritate the nerve.
Other causes of radial tunnel syndrome can include:
- A direct blow to the outside of the elbow
- Constant twisting movements of the arm
People with radial tunnel syndrome may experience symptoms such as:
- Tenderness and pain on the outside of the elbow. The pain gets worse when you bend your wrist backward, turn your palm upward, or hold something with a stiff wrist or straightened elbow.
- An achy type of pain or fatigue in the muscles of the forearm.
- Weakness in the muscles on the back of the forearm and wrist, making it difficult to steady the wrist when grasping and lifting.
- Wrist drop, meaning the back of the hand can’t be cocked up.
The symptoms of radial tunnel syndrome are very similar to the symptoms of tennis elbow. One difference between radial tunnel syndrome and tennis elbow, however, is the exact location of the pain. In tennis elbow, the pain starts where the tendon attaches to the lateral epicondyle. In radial tunnel syndrome, the pain is centered about two inches further down the arm, over the spot where the radial nerve goes under the supinator muscle.
Because there are very few helpful tests for radial tunnel syndrome, it can be hard to diagnose.
Causes of Wrist Pain
Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) occurs when one of the major nerves to the hand called the median nerve is squeezed or compressed as it travels through the wrist. Early diagnosis and treatment are important. The condition worsens over time but can be slowed down quite a bit by chiropractic treatments.
Carpal tunnel is caused by a combination of factors, which include:
- Gender. Women are three times more likely than men to develop the condition.
- Age. It is more commonly seen in older people.
- Heredity. The carpal tunnel may be smaller in some people or there may be anatomic differences that alter the amount of space for the nerve. Both of these traits can run in families.
- Repetitive hand use. Repeating the same hand and wrist motions or activities over a prolonged period of time can aggravate the tendons and cause them to swell, which puts pressure on the nerve.
- Hand and wrist position. Activities that involve extreme flexing or extending the hand and wrist for a prolonged period of time can put excess pressure on the nerve.
- Health conditions. Conditions associated with carpal tunnel syndrome include diabetes, rheumatoid arthritis, and thyroid gland imbalance.
- Pregnancy. Hormonal changes during pregnancy can cause swelling.
There are several symptoms of carpal tunnel syndrome, which can include:
- Pain or tingling that might travel up the forearm toward the shoulder
- Pain, tingling, numbness, and burning primarily in the thumb and index, middle, and ring fingers
- Occasional shock-like sensations that radiate to the thumb and index, middle, and ring fingers
- Weakness and clumsiness in the hand that may cause you to frequently drop things and make it difficult to perform fine movements such as buttoning your clothes
De Quarvain’s Tenosynovitis
De Quervain’s tenosynovitis is a painful condition that affects the tendons on the thumb side of your wrist. It occurs when the tendons become swollen. The swelling causes the sheaths (casings) covering the tendons to become inflamed, which results in pain and numbness due to the pressure it puts on nearby nerves.
De Quarvain’s tenosynovitis can be caused by various factors including:
- Repeatedly performing hand and thumb motions such as grasping, pinching, squeezing, or wringing.
- Arthritic diseases that affect the whole body, such as rheumatoid arthritis.
- A previous wrist injury. Scar tissue from an injury can make it difficult for the tendons to slide easily through the tunnel.
The first sign of trouble may be soreness on the thumb side of the forearm, near the wrist. If left untreated, the pain may spread up the forearm or further down into the wrist and thumb. Other symptoms people can experience include:
- A squeaking sound as the tendons move within the swollen sheaths (called crepitus)
- Increasing pain when grasping objects with the thumb and hand
Chiropractic Treatments for Arm Pain
Chiropractic care can be a very effective option for treating arm pain, often times, providing relief without surgery. A growing list of research studies and reviews demonstrate that the services provided by chiropractors are clinically effective, safe, and affordable.
Chiropractic treatments available at Village Chiropractic include: