Neck Arm Pain

Article by John Miller

What is Neck-Arm Syndrome?

Neck arm syndrome or neck arm pain, are umbrella terms which encompass a variety of conditions affecting your neck or upper back that also include some arm symptoms. The most common type of neck arm pain is Neck-Shoulder Pain, which is obviously a relationship between neck and shoulder pain.

Neck-arm pain is specific to dysfunctions which refer symptoms down the arm and have the potential to cause abnormal neural tension or compression.  

Common Causes of Neck-Arm Pain

• Abnormal Neurodynamics
• Cervical radiculopathy - pinched nerve
• Thoracic Outlet Syndrome
• Carpal Tunnel Syndrome
• Repetitive Strain Injury
• Tennis Elbow

What Causes Abnormal Neural Tension? 

Neural tension refers to the amount of strain on a nerve at rest and with movement. An abnormal increase in neural tension occurs when the nerve becomes caught or restricted anywhere along its path. 

Common causes for this include a restriction in neck joint mobility, inflammation at soft tissue interfaces or muscle spasm around a nerve.  

Neural tension can be increased or decreased by changing the position of your arm. Different arm positions will target different nerve branches. Your physiotherapist is an expert at the assessment of your neurodynamics (nerve mobility). 

What are the Symptoms of Neck-Arm Syndrome? 

• Neck pain, stiffness or soreness
• Pins and needles 
• Numbness  
• Weakness  
• Burning, sharp or dull pain radiating down the arm.

The location of your symptoms correlates with the muscles and skin innervated by the affected nerve. This is why you may experience numbness over only the 4th and 5th fingers, or 2nd and 3rd fingers, or burning pain over the outside of your elbow but not the inside. Your symptoms are nerve specific. It is important to keep your physiotherapist updated on any changes in the location and degree of your symptoms.  

How is Neck-Arm Pain Diagnosed? 

The nature of your symptoms is very useful in differentiating between Neck-Arm Syndrome and other causes of your arm pain. In addition, your physiotherapist is able to identify abnormal neural tension by moving your arm into specific positions to test the movement of each nerve as it travels down the arm. 

The range of movement on your affected side is compared to your unaffected side to see what is normal for you. Once the presence of abnormal neural tension has been confirmed, your physiotherapist will conduct a series of tests to determine the area and structures which are restricting the movement of the nerve.  

Neck-Arm Pain Treatment

Abnormal neural tension normally resolves with treatment of the primary dysfunction. Commonly this is within your neck or upper back joints, where the nerve is exiting the spinal canal.  

Your physiotherapist will use an array of treatment tools to reduce your pain and inflammation, restore full joint movement and normalise muscle activity at the site of the dysfunction. These may include: thermal therapy, acupuncture, electrotherapy, taping techniques, soft tissue massage, joint mobilisation and alignment techniques, muscle stretches and neurodynamic exercises.  

Your physiotherapist is an expert in the techniques that will work best for you and will tailor your rehabilitation to help you achieve (and maintain!) your own functional goals. 

What Results Can You Expect? 

Pure Neck-Arm Pain is generally resolved completely when the primary dysfunction is fixed. The length of recovery is often affected by how long you have had the symptoms. 

In most cases, you can expect a noticeable decrease in your arm symptoms within the first few treatment sessions.  

In some cases, a local dysfunction in the arm may also be present. This is most common in conditions such as Carpal Tunnel Syndrome and Tennis Elbow, where both areas will need to receive treatment in order to enable a full recovery!  

More Advice 

If you have any concerns or have some specific questions regarding your condition, please ask your physiotherapist.

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