Neck and Arm Pain
It is common that we see patients who have neck pain that starts from their neck and goes all the way down their arm. Patients often describe this pain as sharp, shooting or lancinating. In some cases, numbness, tingling and pins & needles will be present.
This is often termed “cervical radiculopathy.” Radiculopathy implies “true” neurological findings. This may include a loss of strength, reflexes and/or sensation. If present, this finding (such as loss of strength, sensation and/or reflexes) will be closely monitored to assure they are not worsening.
Radicular pain is the less severe cousin of radiculopathy, as it implies arm pain without true neurological findings. Radicular pain is far more common than radiculopathy, though it can be more painful than radiculopathy. This reason for this is the sensation of the nerve is fully intact.
Often patients with limited neck rotation feel relief when we provide a manual traction to the neck. Further, there are various positions we can place your arms to tell if the arm pain is more likely to be from nerves. The goal of treatment is “centralize” the symptoms; getting the arm pain to go closer to the neck. Recovery is in this order: 1) get rid of hand symptoms (if present), 2) get rid of forearm pain, 3) get rid of upper arm pain, and 4) get rid of neck pain. This is simply how the body recovers. Treatment options include neck traction, manual therapy and exercises to increase mobility of the neck.
- “Neck Pain Guidelines: Revision 2017: Using The Evidence To Guide Physical Therapist Practice,.”. Vol 47, no. 7, 2017, pp. 511-512. Journal Of Orthopaedic & Sports Physical Therapy (JOSPT)https://doi.org/10.2519/jospt.2017.0507.
There are conditions that may result in neck pain and/or headaches that are medical emergencies and not candidates for PT. These are cervical artery dissections (stroke), upper cervical instability and cervical myelopathy.
Neck pain often times occurs with headaches which maybe on one side or both sides of the head and are precipitated/aggravated by neck movements and/or sustained positions/postures.
While neck pain is the most common sign, patients frequently have dizziness, nausea, headaches, concentration difficulties in addition to neck pain. This often occurs following motor vehicle accidents (whiplash) and sports injuries, even when several years ago.