What causes neck arm pain?
Neck arm pain is an umbrella term which covers a range of conditions affecting the neck or upper back as well as the arm.
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Neck arm pain is a serious condition that can minimise your ability to carry out normal, everyday activities.
The neck comprises seven bones called vertebrae, which are piled on top of one another. Sandwiched between each bone is a spongy material or cushion called the intervertebral disc.
Each bone has two joints towards the back that link with the joints of the bones below it. The bones of your neck shield your spinal cord and also allow for normal movement to occur.
The neck is very flexible, permitting forward, backward and side bending, as well as rotational movements of the head. This allows you to look and move in many directions. The neck muscles also offer movement and additional support.
The neck is very mobile, which implies that it is less stable than other parts of the body and hence more vulnerable to injury. Trauma, poor posture and conditions such as arthritis are the most common causes of neck pain.
Causes
When the bones of the neck get too close together they can press onto a nerve, minimise the gap through which the nerve passes or cause the cushions in-between the bones to press onto the nerve which passes into the arm.
This can generate pain in various parts of the arm depending on which nerve is affected. The pain can range from a dull ache to severe burning pain with or without the sensations of pins and needles and/or numbness.
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It is imperative to try and decrease the pressure on the nerve, and as a result reduce the arm pain.
The majority of the pain is due to improper posture. The bones of the neck press together when you sit in the same position for prolonged periods of time and this causes the muscles and the cords that join two bones together controlling the movement of the head, neck and shoulders to become stiff and painful.
The neck has more capacity to rotate than any other part of the spine and is therefore susceptible to strain.
Typical positions that you may unconsciously adopt during your daily activities, for example turning your head slightly to one side when working on the computer or watching television at home or looking down for long periods when typing or reading eventually has a negative effect on your neck. Another cause is using too many pillows in bed.
All these lead to changes in the way your bones are arranged and over time produces pain/ache or discomfort in the neck, shoulders, between the shoulder blades, arm and sometimes even further down the spine.
Also a poor sitting posture places the neck in an awkward position and eventually causes pain. Other causes may be trauma (such as a motor vehicle accident or a sports injury) or wear and tear from the neck bones or cushions in between the neck bones.
Symptoms
Neck arm pain is frequently linked with upper back, shoulder and arm pain. Stiffness may also be present and often precedes neck pain.
The part or area of the pain on the arm show a relationship with the muscles and affected nerves in the neck. For this reason, you may experience numbness only over the 4th and 5th fingers, or 2nd and 3rd fingers, or burning pain over the outside of your elbow but not the inside. It indicates the specific neck nerves affected.
The individual may wake up with a stiff neck that becomes a little flexible as the day progresses but gets stiff and sore again by the end of the day.
The neck more often than not gets painful if kept in the same position for prolonged periods of time, for example sitting at the computer, watching television or driving.
Pain may also be experienced directly in your neck or on one side of the neck. Pain from your neck can also often be felt in the upper aspect of your back.
If a nerve in your neck is affected, you may feel pain travelling down your arm and into your hand. Weakness, numbness or tingling sensations may sometimes be felt in your arm and hand as well.
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Diagnosis
The symptoms that you experience provide an indication of the condition and hence the individual undergoes various examinations such as moving the arm and neck into specific positions to ascertain whether specific response would be obtained.
The range of movement of your neck and affected arm are also assessed and compared to unaffected side to see whether there is a limitation in either arm.
An X-ray is also conducted to reveal the current condition of the neck bones for a diagnosis to be confirmed.
To be continued...
• The writer is a Senior Physiotherapist at the 37 Military Hospital.
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