Neck Arm Pain

Neck Arm Pain

Article by J. Miller, A.Clarke

What is Neck-Arm Syndrome?

Neck arm syndrome or neck arm pain are umbrella terms that encompass various 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 that refer to symptoms down the arm and can cause abnormal neural tension or compression.

Common Causes of Neck-Arm Pain

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 pressure occurs when the nerve becomes caught or restricted anywhere along its path.

Common causes 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 other nerve branches. Your physiotherapist is highly experienced and  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, 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 instrumental in differentiating between Neck-Arm Syndrome and other causes of your arm pain. In addition, your physiotherapist can 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 exits 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 high;y skilled 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.

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

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

More Advice

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

Article by John Miller

When Should You Be Concerned About Neck Pain?

What's Urgent?

There is one situation where there’s no need to wait several weeks before deciding if your neck pain is serious.

If you’ve had an accident with forces that may have been sufficient to fracture your spine or tear nerves, seek a medical assessment as soon as possible. In this instance, either call an ambulance or head to a hospital emergency department.

Red Flags for Neck Pain

Otherwise, the rule of thumb is to start a more thorough medical investigation only when you meet all three of these conditions.

The three general red flags for neck pain are:

  1. it’s been bothering you for more than about six weeks
  2. it’s severe and/or not improving, or getting worse
  3. there is at least one other “red flag” (see below)

Red flags are reasons to seek a professional opinion rather than to worry. Seek the advice of your physiotherapist or doctor if any of these red flags apply to you.

  • Light tapping on the spine is painful.
  • A torn artery may cause severe, throbbing or constrictive (novel pain), with a high risk of a stroke. Pain is the only symptom of some tears. Most cases are sudden, on one side, and cause neck and head pain (in the temple or back the skull), but the pain is usually strange. Any hint of other symptoms? Promptly attend a hospital emergency.
  • There are many possible signs of spinal cord trouble in the neck, with or without neck pain, mainly affecting the limbs: e.g. poor hand coordination; weakness, “heavy” feelings, and atrophy; diffuse numbness; shooting pains in the limbs (especially when bending the head forward); gait awkwardness. Sometimes patients present with both neck pain and more remote symptoms and don't realise they are related.
  • Unexplained episodes of dizziness or nausea, and vomiting may indicate a problem with the stability of the upper cervical spine.
  • Weight loss without dieting (it's a potential sign of cancer).
  • Mystery fevers or chills, especially in people with diabetes).
  • A severe headache that comes on suddenly is a “thunderclap headache”! Most are harmless, but it is always wise to investigate thoroughly.
  • Symptoms of meningitis (inflammation of the membranes covering the brain and spinal cord, caused by infection or drug side effects). The presence of a fierce headache or an inability to bend the head forward, fever, or an altered mental state.
  • The main signs that neck pain might be caused by autoimmune disease specifically include:
    • a family history of autoimmune disease,
    • gradual but progressive increase in symptoms before the age of 40,
    • marked morning stiffness,
    • pain in other joints as well as the low back,
    • rashes,
    • difficult digestion,
    • irritated eyes, and
    • discharge from the urethra (bladder).
  • Steroid use, other drug abuse, and HIV are all risk factors for a serious cause of neck pain.
  • If you feel pretty unwell in any other way, that could indicate that neck pain isn’t the only thing going on.

More info: Neck Pain