The sensation of pain when lifting your arm, especially overhead or away from the body, is a common experience signaling an issue within the shoulder complex. This specific symptom, often described as a sharp catch or deep ache, indicates a disruption in the smooth mechanics of the glenohumeral joint and its surrounding soft tissues. The shoulder is the most mobile joint in the body, and this extensive range of motion makes it vulnerable to wear, inflammation, and mechanical friction. The discomfort can stem from issues localized directly within the shoulder joint itself or from problems originating in the neck or spine.
Understanding Shoulder Impingement and Bursitis
One of the most frequent causes of pain during the act of raising the arm is subacromial impingement syndrome. This mechanical issue occurs when the soft tissues traveling through a narrow space at the top of the shoulder become compressed. Specifically, the rotator cuff tendons and a fluid-filled sac called the subacromial bursa get pinched between the head of the humerus and the acromion as the arm is lifted.
This repetitive friction leads directly to inflammation of the bursa, a condition termed bursitis. The bursa normally functions as a cushion to reduce friction between the moving structures, but when it becomes swollen, it takes up more space and is easily irritated, causing sharp pain. This mechanical compression and resulting inflammation are often experienced as the “painful arc.”
The painful arc describes discomfort that is intense between approximately 60 degrees and 120 degrees of arm abduction (lifting the arm out to the side). Below 60 degrees and above 120 degrees, the pain often lessens or disappears because the structures are no longer being actively compressed. Structural factors like the shape of the acromion bone or age-related bone spurs can narrow the space, making the soft tissues more susceptible to pinching.
Injuries to the Rotator Cuff and Tendons
Pain when lifting the arm can indicate structural damage or inflammation within the four muscles and their tendons that form the rotator cuff. These tendons—supraspinatus, infraspinatus, teres minor, and subscapularis—are responsible for stabilizing the shoulder joint and initiating arm movements. Inflammation of these tendons, known as tendinitis, results from chronic overuse, repetitive motions, or microtrauma that causes the fibers to swell and become irritated.
Tendinitis generally causes a dull, persistent ache that sharpens significantly when the arm is actively moved or placed under load. Chronic irritation and continued use can lead to a more substantial injury, such as a partial or full-thickness tear of one or more tendons. A tear represents a structural failure in the tendon tissue, resulting in pain accompanied by noticeable weakness.
While tendinitis may improve with rest, a tear often results in an inability to lift the arm against gravity or maintain the arm in an elevated position, signifying a loss of functional strength. The tendon of the biceps muscle, which runs through the shoulder joint, can also become inflamed, a condition known as bicep tendinitis. This separate tendon issue often causes pain in the front of the shoulder that worsens when lifting the arm forward or carrying heavy objects.
Nerve Compression and Referred Pain
Sometimes, the pain felt when lifting the arm does not originate in the shoulder joint but is instead a form of referred pain stemming from the neck. This occurs in cervical radiculopathy, where a nerve root is compressed or irritated as it exits the cervical spine. The nerves that supply sensation and motor control to the arm and shoulder originate in the neck, meaning that compression in that area can transmit pain along the entire nerve pathway.
The pain from cervical radiculopathy is often described as a sharp, burning, or electrical sensation that can travel down the arm, sometimes extending all the way into the hand and fingers. Unlike shoulder joint pain, which is typically localized and worsens only with specific shoulder movements, nerve pain is accompanied by distinctive neurological symptoms. These symptoms commonly include numbness, tingling, or a “pins and needles” feeling in the arm, hand, or specific fingers.
The weakness experienced with radiculopathy is due to impaired nerve signaling to the muscles, rather than a structural failure of the muscle or tendon tissue itself. Movements of the neck, such as tilting or turning the head, may also provoke or intensify the arm pain, which serves as a differentiating factor. Identifying these neurological signs is important because the treatment must focus on the source of the compression in the spine, not the shoulder.
When to Seek Medical Attention
While many instances of arm pain from lifting resolve with rest and temporary activity modification, certain signs indicate the need for professional medical evaluation. You should consult a healthcare provider if the pain persists or worsens for more than a few weeks despite attempting conservative measures. Pain accompanied by noticeable swelling, warmth, or a visible change in the shape of the shoulder joint requires prompt attention.
Immediate medical care is necessary if the pain began following a sudden, traumatic injury or fall, especially if you heard an audible “pop” or “snap.” Significant, immediate weakness that prevents you from lifting the arm against gravity, or a complete inability to move the arm, should also be evaluated quickly. Professional guidance is important if the arm pain is associated with new numbness, tingling, or weakness in the hand or fingers.