Pain occurring in the upper arm between the elbow and the shoulder is a common complaint. This discomfort is often confusing because it is localized in the mid-arm, away from major joint structures. The source of this pain is rarely the humerus bone itself, but rather the soft tissues or nerve pathways running through the area. Understanding the diverse origins of this symptom, which can range from simple irritation to complex neurological issues, is key to effective management.
Causes Related to Muscles and Tendons
The most frequent source of discomfort in the upper arm is the muscle and tendon, usually due to overuse or direct trauma. Acute muscle strains involve tears in the biceps or triceps fibers, causing immediate, sharp pain and tenderness. These injuries typically occur during strenuous activity, such as lifting heavy objects or sudden, forceful contractions. The affected area may show localized bruising and swelling, and pain intensifies when the muscle is engaged or stretched.
Biceps Tendinopathy is a chronic cause involving irritation or inflammation of the long head of the biceps tendon near the shoulder. Although the problem originates at the shoulder, the resulting pain often radiates down the front of the humerus toward the elbow. This is an overuse injury, often involving micro-tears from repetitive actions like throwing or lifting overhead. The pain is usually a deep ache that worsens with specific arm movements, such as lifting a heavy load.
Delayed Onset Muscle Soreness (DOMS) is a temporary form of upper arm pain following intense exercise. This dull, aching pain results from stress on the muscle fibers, peaking roughly 24 to 72 hours after the activity. Unlike a strain, DOMS affects the entire muscle group rather than a localized spot, and it resolves naturally with rest.
Structural Issues in the Nearby Joints
Mid-arm pain is often referred pain originating from pathology within the shoulder or, less commonly, the elbow joint. Shoulder Impingement Syndrome is a common example, where rotator cuff tendons are compressed beneath the acromion bone, causing inflammation. This irritation creates shoulder pain and sends an aching sensation down the side of the humerus.
Rotator cuff tears, involving damage to the tendons stabilizing the shoulder, are another frequent cause of radiating pain. Smaller, degenerative tears can present as a deep, persistent ache that travels along the upper arm, often worsening at night or when elevating the arm.
Subacromial bursitis, the inflammation of the fluid-filled sac cushioning the rotator cuff tendons, also produces pain radiating down the arm. The inflamed bursa causes friction and swelling, resulting in tenderness that extends into the upper arm. Similarly, Osteoarthritis in the shoulder or elbow joint can cause chronic, deep pain perceived in the middle of the arm. This joint discomfort is typically accompanied by stiffness and a reduced range of motion.
Pain Originating from Nerves and Other Sources
When upper arm pain includes sensory changes, the source is likely neurological, involving nerves traveling from the neck down the arm. Cervical radiculopathy occurs when a nerve root in the neck is compressed or irritated by a herniated disc or degenerative changes. Pain from the C5 or C6 nerve roots is classically described as a sharp, shooting, or burning sensation radiating down the humerus.
The defining characteristic of nerve-related pain is the presence of neurological symptoms, such as tingling, numbness, or muscle weakness. These symptoms distinguish radiculopathy from muscular or joint issues, which typically present only as pain and tenderness. Activities like tilting or straining the neck often intensify the radiating nerve pain.
Thoracic Outlet Syndrome (TOS) is a less common condition causing upper arm pain due to the compression of nerves or blood vessels between the collarbone and the first rib. This pain may be accompanied by a feeling of heaviness or fatigue, along with tingling in the fingers. In rare but serious cases, pain felt in the left upper arm can be referred pain from cardiac issues, such as a heart attack. This pain often presents with other symptoms like chest pressure or shortness of breath.
Knowing When to Seek Medical Attention
While many cases resolve with home care, certain symptoms warrant professional medical evaluation. Immediate attention is required if the pain is sudden and severe, or if it is accompanied by obvious deformity, an inability to move the arm, or a loud popping sound at the time of injury. These signs suggest a structural compromise. Any upper arm pain accompanied by chest pressure, shortness of breath, dizziness, or pain radiating to the jaw should be treated as a medical emergency due to the possibility of referred cardiac pain. For non-emergency situations, a consultation is appropriate if the pain persists for more than seven to ten days despite rest, ice, and over-the-counter medications. A prompt assessment is also needed if symptoms worsen, such as increased redness, swelling, or the onset of persistent numbness or tingling.