Stabbing pain in the upper arm is a commonly reported symptom, in particular the older population. The prevalence of self-reported neck-shoulder-arm pain was found to be 25% for females and 15.4% for males. (1)
There are multiple reasons that can lead to pain in the upper arm/shoulder. The most common causes of shoulder pain are described below:
Causes Of Stabbing Pain In Upper Arm
Stabbing pain in the upper arm can be the outcome of muscular, nervous, or even heart disturbances. Below we’ll discuss some of the possible causes of upper arm pain.
Rotator Cuff Injury
The rotator cuff is an important structure of the shoulder formed by muscles and tendons of the region. Millions of people across the globe visit healthcare facilities due to rotator cuff injuries.
The prevalence of this injury for inhabitants of a mountainous village was found to be 20.6%. (2). Rotator cuff tear can present itself as a sharp pain in the arm.
Individuals involved in performing overhead vigorous activities are more prone to developing this sort of arm pain. Painters and basketball and tennis players are at a greater risk.
Symptoms include pain in the upper arm and a reduced range of motion. (3)
You might experience muscle upper arm pain due to muscle sprain and pulls. A muscle sprain can occur while carrying out any weight lifting activity and is muscular in nature.
Muscle sprain is a common cause of upper arm pain.
Soft Tissue Inflammation
The shoulder and upper arm are formed by the connection of various soft tissues structures including bursa, tendons, and ligaments.
Overuse can lead to tendinitis (inflammation of tendons), and bursitis. Arm pain arising from tendonitis is usually mild that is accompanied by tenderness and swelling in the region.
A fracture of the humerus can lead to inflammation, pain, and reduced movement in the upper arm. Common risk factors for humerus fracture include low dietary calcium intake, hormonal imbalances (menopause), etc. (5)
Also, soft tissue and hard tissue injuries can occur on either of the sides i.e. left or the right arm. A fracture in the shoulder blade can cause also pain in the upper arm
Nerve Impingement as a cause of stabbing pain in upper arm
Pinching of the nerves can be the root cause of stabbing upper arm pain. Typical stabbing pain is associated with numbness, and tingling is indicative of spinal cord abruptions.
A disc slip can lead to a pinched nerve that manifests itself as pain and paraesthesia. If the vertebral disc(s) of the upper back and neck (cervical) region are involved, it’s likely to cause upper arm pain which is sometimes known as cervical radiculopathy.
Studies have shown that patients suffering from cervical radiculopathy experience neck pain, or arm pain. Some people report having both types of pain at the same time. (5)
The brachial plexus is a network of nerves that innervates the neck, arms, and hands. Persistent pinching of the nerve paves way for inflammation of the nerve (neuritis). Brachial neuritis can be caused by injury, trauma, accidents, or infection (Coxsackie B virus, HIV, mumps, etc.).
The prevalence of neuropathic pain in brachial plexus injury patients is as high as 76% which indicates that pain management is a must in such patients. (6)
This pain is attributed to nerve damage rather than nerve impingement in the shoulder joint.
Plus, brachial neuritis patients also face loss of function. This is known as neuralgic amyotrophy, and brachial neuritis is characterized by pain in the ipsilateral arm and muscle weakness from atrophy. (7)
Arthritis as a cause of stabbing pain in upper arm
Another major cause of arm pain is arthritis. Though the chronic bone abnormalities do not directly cause pain their impact on the joints can leave you unable to move.
Osteoarthritis is a bone degenerative disorder that leads to the formation of bone spurs that can cause aches in joints during movement (due to neuritis).
Rheumatoid arthritis is another chronic malady that triggers inflammation of the joints due to a hyperactive immune system. The result of this overactivity is an accumulation of auto-antibodies inside the joints that is accompanied by tenderness, swelling, fatigue, and pain.
Other auto-immune diseases that can have similar manifestations include systemic lupus erythematosus (SLE) and Sjorgen’s syndrome, etc.
The severity of the pain is high, which is why opioid analgesics are at times considered a suitable option.
Aside from nerve and muscle disorders, there are some more serious conditions that might present themselves in the form of arm pain.
But which side the pain is occurring and the nature of the pain are crucial in determining the cause. For example, right arm pain is mostly attributed to soft and hard tissues abruptions, whereas left arm pain is linked to cardiovascular pathologies.
Angina or cardiac angina is a chronic disease characterized by chest pain during activity. It can feel like chest congestion/pain and sometimes pain radiating into the left shoulder and arm. Some patients also report pressure in the back and neck region. This condition arises when the heart is unable to receive the required amount of oxygen.
This is usually the result of the narrowing of cardiac blood vessels leading to the inadequacy of oxygen supply to the heart, and is diagnosed by checking the medical history of coinciding symptoms including:
- shortness of breath
- chest pain that radiates to the jaw, neck, and arm
It’s more common for symptoms to appear when carrying out any high-impact activity.
Cervical angina is another condition that resembles cardiac angina but is the outcome of a cervical spine disorder. (8)
Heart Attack (Myocardial Infarction)
An episode of radiating pain in the left arm accompanied by cold sweats, and shortness of breath must ring some bells as it is indicative of a heart attack.
Patients will usually experience a dull ache in the chest initially that gradually increases in severity and converts into chest congestion and sharp pain travelling from the chest into the neck and left arm.
Immediately call 911 if experiencing the above-mentioned symptoms.
Liver Cirrhosis/Failure as a cause of stabbing pain in upper arm
Rare cases of right arm pain include liver disturbances. In severe cases of liver cirrhosis, patients might experience pain in the upper part of the abdomen and right arm.
Diagnosis of stabbing pain in upper arm
To provide pain relief it is crucial for the doctor to know the underlying cause of arm pain. In most cases, the physician starts by carrying out a thorough physical examination paired with a medical history of the patient.
The initial examination might involve the doctor asking you to perform a range of activities to check for any underlying fracture or injury.
An X-ray or MRI scan is generally recommended if an underlying fracture or any musculoskeletal issue is suspected. Ultrasounds may be used along with the more advanced CT and MRI scans to detect soft tissue abnormalities (tendon and ligament tears).
If the arm pain is suspected to be an outcome of cardiac issues, the doctor might recommend you undergo blood tests and heart performance tests (ETT, etc.).
Heart enzyme levels in the blood are immediately checked to rule out myocardial infarction.
Treatment of stabbing pain in upper arm
Treatment options depend upon the nature and the severity of the pain. Symptomatic treatment involves prescribing over-the-counter painkillers (ibuprofen, diclofenac potassium, etc.).
In cases of overuse or injury/trauma, rest is recommended to allow quicker healing of the tissues.
If OTC analgesics do not work, stronger anti-inflammatory drugs such as corticosteroids are given (orally, or via IM/IV injections). Neuritis cases are managed with analgesic drugs such as gabapentin, or pregabalin.
Physical therapy is an effective treatment modality for musculoskeletal and spinal cord associated pain. A physiotherapy session can help take off the burden from your arm muscles, improve the blood circulation in the region and enhance your range of motion.
However, in severe cases (ligament/tendon tear or fracture), surgery is the only option. An orthopaedic surgeon opts for open reduction and fixation of the broken bones.
For in-home remedies, you can follow the RICE principle i.e. rest (R), ice/cold application (I), compression (C), and elevation (E) of the affected arm.
Stabbing upper arm pain is a common phenomenon and affects millions of people across the globe. There is a wide variety of disorders and diseases that fall under the umbrella of arm pain. Muscle pull, rotator cuff injury, bursitis or tendonitis are major soft tissue disorders that can lead to upper arm pain. Nerve compression/impingement/destruction can also cause severe pain in the neck and upper arm region. Brachial neuritis and cervical radiculopathy are to be blamed.
Serious complications such as angina pectoris, cervical angina and heart attack also present in the form of upper arm pain. Thus, attention should be paid to the type of arm pain and any associated symptoms (chest congestion, cold sweats, and shortness of breath).
Symptomatic treatment involves OTC analgesics, muscle relaxants and corticosteroids. Medical advice may not include physical therapy but this particular treatment modality can mean a great deal in pain reduction. Surgery is limited to severe cases that are non-responsive to non-interventional approaches.
Frequently Asked Questions:
What causes an electric shock feeling in the arm?
Brachial plexus injury can cause an electric shock feeling in the arm. Minor injuries during sports, like wrestling or football, may compress or stretch brachial plexus nerves, called burners or stingers. So, whether the nerve is strained or inflamed, you may feel burning or electrical shock sensations that shoot down in your arms.
What does nerve damage in the arm feel like?
You may feel weakness, numbness, stabbing pain, burning, or tingling (needles and pain) in your arm if you’ve got your arm’s nerve damage. Most people with nerve damage or neuropathic pain are more sensitive to cold or touch and feel pain to even harmless stimuli.
Can a pinched nerve feel like an electric shock?
A pinched nerve may sometimes feel as intense and sharp as an electric shock, but often it feels like a burning or stabbing sensation. A pinched nerve occurs when the discs, ligaments, or bone restricts the blood flow to the specific nerve.
How long does a pinched nerve last?
A pinched nerve can heal itself without any medical treatment, but you suffer a lot in the meantime. In some people, a pinched nerve usually heals in as little as a few days, but in some, it may take as long as four to six weeks or more. So, if your pinched nerve is taking too long to heal, you should probably consult your doctor.
In the meantime, some pain-relieving medications like acetaminophen or ibuprofen or some hot and cold therapies can help you improve the symptoms.
What causes a stabbing pain in the bicep?
Stabbing pain in the bicep may be caused by a trauma (fracture), injury to the bicep muscle fibers, bicep tendon tear, or nerve compression. Additionally, severe stabbing pain in the bicep may also be due to chronic conditions like osteoarthritis or a frozen shoulder. If you’re feeling an unusual stabbing pain in your bicep that worsens day by day, you should probably seek medical help.
What to do if you have a sharp pain in your arm?
If you have a sharp pain in your arm, these might help you relieve pain:
- Bed rest
- Apply an ice bag to your affected arm for 15 to 20 minutes 3 to 4 times a day.
- Try to keep your arm elevated to reduce swelling