Chronic Right Upper Arm Pain: Causes and Management Strategies

Persistent pain in the right upper arm?

I would like to ask the doctor, I am currently 18 years old, but I have experienced persistent pain in my right upper arm since childhood.
It's not particularly severe, but certain specific positions can trigger intense soreness, requiring me to change my posture to alleviate it somewhat.
This issue often occurs during sleep; for example, I cannot sleep on my left side, as it causes significant soreness in my right upper arm, making it difficult to fall asleep.
Sometimes, I can relieve the pain by raising my arm, but as soon as I return to the original position, the soreness returns.
I have researched many articles online, but since this has been an issue since childhood, I am unsure if it is caused by poor posture or related to writing and sitting habits.
The primary symptom is soreness in the right upper arm.
I would like to know if there is an underlying cause for these symptoms or if there are any management strategies available.

ROU, 10~19 year old female. Ask Date: 2021/04/05

Dr. Jiang Junyi reply Neurology

Hello, based on your described symptoms, they are very similar to cervical myofascial pain syndrome.
Clinically, it often presents as pain at the affected site, discomfort, muscle stiffness, or a heavy sensation, and sometimes palpable fibrous nodules in the subcutaneous tissue.
Symptoms may worsen in the morning or with changes in weather, but can be alleviated with stretching activities, and often recur.
During acute episodes, there may be local muscle tension and spasms, leading to restricted movement.
Intervertebral disc compression at the fourth and fifth cervical levels can cause shoulder and neck pain, while compression at the fifth and sixth levels can affect the nerves supplying the upper arm and fingertips, resulting in symptoms of numbness, tingling, and weakness in both hands.
The Lhermitte sign, where neck flexion induces an electric shock sensation in the shoulder or arm, may indicate increased sensitivity of demyelinated nerves.
I recommend consulting with a rehabilitation specialist or a neurologist/neurosurgeon for further evaluation and treatment.
Wishing you good health and peace.
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital.

Reply Date: 2021/04/05

More Info

Chronic right upper arm pain can be a frustrating and persistent issue, especially when it affects your daily activities and sleep. Given your age of 18 and the long-standing nature of your symptoms, it is essential to consider various potential causes and management strategies.

Possible Causes
1. Muscle Strain or Overuse: Chronic pain in the upper arm may arise from muscle strain due to repetitive activities or poor posture. If you frequently engage in activities that require lifting or repetitive arm movements, this could lead to muscle fatigue and discomfort.

2. Poor Posture: As you mentioned, your symptoms may be exacerbated by poor posture, especially during activities like writing or sitting for extended periods. Slouching or leaning can put undue stress on the muscles and nerves in your upper body, leading to pain.

3. Nerve Compression: Conditions such as thoracic outlet syndrome or cervical radiculopathy can cause nerve compression, leading to pain radiating down the arm. This is often associated with specific positions that aggravate the symptoms.

4. Rotator Cuff Issues: Although you are young, rotator cuff injuries or tendinitis can occur, especially if there is a history of repetitive overhead activities. This can lead to pain in the shoulder that may radiate down the arm.

5. Referred Pain: Sometimes, pain in the arm can be referred from other areas, such as the neck or upper back. Conditions like cervical spondylosis or muscle tension in the upper back can manifest as arm pain.

Management Strategies
1. Posture Correction: Focus on maintaining good posture while sitting and writing. Ergonomic adjustments to your workspace, such as using a chair that supports your back and keeping your writing surface at an appropriate height, can help alleviate strain.

2. Stretching and Strengthening Exercises: Incorporating regular stretching and strengthening exercises for the shoulder and upper back can improve flexibility and muscle strength. This can help reduce the risk of muscle strain and improve overall function.

3. Physical Therapy: Consulting with a physical therapist can provide you with a tailored exercise program that addresses your specific issues. They can also teach you techniques to improve your posture and body mechanics.

4. Heat and Cold Therapy: Applying heat or cold packs to the affected area can help reduce pain and inflammation. Heat can relax tight muscles, while cold can numb sharp pain and reduce swelling.

5. Activity Modification: If certain activities exacerbate your pain, consider modifying them or taking breaks to prevent overuse. For example, if writing for long periods causes discomfort, take regular breaks to stretch and move around.

6. Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain and inflammation. However, consult with a healthcare provider before starting any medication.

7. Regular Check-ups: Since your symptoms have persisted for a long time, it may be beneficial to consult with a healthcare professional for a thorough evaluation. They may recommend imaging studies, such as an X-ray or MRI, to rule out any underlying conditions.

Conclusion
Chronic right upper arm pain can stem from various causes, including muscle strain, poor posture, nerve compression, or referred pain. Implementing posture correction, engaging in targeted exercises, and seeking professional guidance can significantly improve your symptoms. If the pain persists or worsens, it is crucial to consult a healthcare provider for a comprehensive evaluation and tailored treatment plan. Remember, early intervention can lead to better outcomes and improved quality of life.

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