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Upper Back Pain That Shoots Down The Arm Symptoms & Causes

A person's back with a pain spot near the shoulders that radiates down the arm.
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Last updated April 15, 2024

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Upper back pain that shoots down the arm is often caused by an herniated disc in the upper back or myofascial pain syndrome. A pinched nerve in the upper back can also cause pain that radiates down the arm. Read below for more information on causes and relief options.

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3 causes of upper back pain that shoots down the arm

This list does not constitute medical advice and may not accurately represent what you have.

Thoracic outlet syndrome

The "thoracic outlet" is the space on either side of the base of the neck where nerves, arteries, and veins travel beneath the collarbone. If these become compressed or damaged, the condition is called thoracic outlet syndrome or TOS.

The most common causes are trauma, such as a car accident or fall; and repetition or overuse, such as a sports injury.

Symptoms vary depending on the structures being compressed:

  • Neurogenic TOS affects the nerves. It is the most common form and creates numbness, tingling, pain, and weakness in the arms, hands, and fingers.
  • Vascular TOS affects the arteries and veins. It creates the same symptoms as neurogenic TOS as well as cold, pale hands and arms with weak pulse.

It is important to see a medical provider about these symptoms so that the damage does not become permanent.

Diagnosis is made through patient history, physical examination, imaging such as x-ray or ultrasound, and sometimes nerve conduction and blood flow studies.

Treatment involves physical therapy, pain relievers, and sometimes surgery.

Pinched nerve in the neck

A pinched nerve in the neck is also called cervical radiculopathy. It means that a nerve in the neck, at a point where it branches off from the spinal cord, is being compressed by the surrounding bones, muscles, or other tissues.

It can be caused by a traumatic injury, such as from sports or an automobile accident, especially if the injury results in a herniated disk. It may also arise from the normal wear and tear of aging.

Symptoms include sharp, burning pain with numbness and tingling from the neck to the shoulder, as well as weakness and numbness in the arm and hand.

Diagnosis is made through patient history, physical examination, and simple neurological tests to check the reflexes. Imaging such as x-ray, CT scan, or MRI may be done, as well as electromyography to measure nerve impulses in the muscles.

A pinched nerve in the neck often improves with simply a few days or weeks of rest. Physical therapy, nonsteroidal anti-inflammatory drugs, and steroid injections into the spine can all be very helpful.

Rarity: Common

Top Symptoms: pain in one shoulder, spontaneous shoulder pain, pain that radiates down the arm, pain in the back of the neck, severe shoulder pain

Urgency: Primary care doctor

Myofascial pain syndrome

Myofascial pain syndrome is also called chronic myofascial pain (CMP.) Pressure on certain points of the muscles causes referred pain, meaning the pain is felt elsewhere in the body.

The cause is believed to be muscle injury through overuse, either from sports or from a job requiring repetitive motion. Tension, stress, and poor posture can also cause habitual tightening of the muscles, a form of overuse.

This overuse causes scar tissue, or adhesions, to form in the muscles. These points are known as trigger points since they trigger pain at any stimulus.

Symptoms include deep, aching muscular pain that does not go away with rest or massage, but may actually worsen. There is often difficulty sleeping due to pain.

Myofascial pain syndrome should be seen by a medical provider since it can develop into a similar but more severe condition called fibromyalgia.

Diagnosis is made through physical examination and applying mild pressure to locate the trigger points.

Treatment involves physical therapy, pain medications, and trigger point injections. In some cases, acupuncture and antidepressants are helpful.

Rarity: Common

Top Symptoms: dizziness, spontaneous shoulder pain, pain in the back of the neck, tender muscle knot, general numbness

Symptoms that always occur with myofascial pain syndrome: tender muscle knot

Urgency: Primary care doctor

Herniated (slipped) disk in the upper back

A herniated, ruptured, or "slipped" disc means that a vertebral disc – one of the soft pads of tissue that sit between each of the vertebral bones – has become squeezed out of shape. Its cushioning material has been forced against, and possibly through, the ring of fibrous tissue that normally contains it. This causes pain, numbness, and weakness in the legs.

The normal aging process causes the discs to lose moisture and become thinner, making them more vulnerable to "slipping."

Most susceptible are men from ages 30 to 50. Smoking, obesity, lack of exercise, and improper lifting are also risk factors.

Symptoms include pain, weakness, numbness, and tingling in the back, leg, and foot.

Diagnosis is made through patient history, neurological examination, and MRI scan.

Treatment begins with rest, nonsteroidal anti-inflammatory drugs, physical therapy, and sometimes epidural steroid injections into the back to ease pain and inflammation.

Surgery to remove the herniated part of the disc – the part that was squeezed out of place – can also be helpful.

Rarity: Common

Top Symptoms: upper back pain, neck pain, arm weakness, back pain that gets worse when sitting, upper spine pain

Symptoms that always occur with herniated (slipped) disk in the upper back: upper back pain

Urgency: Primary care doctor


Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.

The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.

Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.

Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.

There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.

Fibromyalgia does not go away on its own but does not get worse, either.

Treatment involves easing symptoms and improving the patient's quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.

Brachial plexopathy (shoulder nerve issue)

A shoulder nerve injury, also called brachial plexopathy, is when damage occurs to a network of nerves in the front of the shoulder known as the brachial plexus. This damage can occur from injury, inflammation, radiation therapy, or other medical conditions. Symptoms include sharp pain in the shoulder, arm, or hand. Numbness or weakness in the shoulder or arm may also occur.

You should consider visiting a medical professional to discuss your symptoms. A doctor can evaluate shoulder nerve issues with a review of your symptoms and medical history. You might also be asked to do an EMG, a test that checks the connection between muscles and nerves. Once diagnosed, some options for treatment include pain or nerve block medication, physical therapy, and braces or splints. Some cases may require surgery. Depending on the severity, recovery times can range from weeks to years.

Questions your doctor may ask about upper back pain that shoots down the arm

  • Turn your head toward the side of your body that is hurting. Lift your head up as someone else pushes down on your head. Does this cause greater pain in your upper body? (This is known as Spurling's test.)
  • What is your body mass?
  • Do you feel a painful, tight knot or band in your muscle anywhere on the body?
  • What makes your back pain worse?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

Upper back pain that shoots down the arm symptom checker statistics

People who have experienced upper back pain that shoots down the arm have also experienced:

  • 15% Pain In One Shoulder
  • 13% Shoulder Pain That Shoots To The Arm
  • 5% Pain In One Shoulder Blade

People who have experienced upper back pain that shoots down the arm were most often matched with:

  • 33% Herniated (Slipped) Disk In The Upper Back
  • 33% Myofascial Pain Syndrome
  • 33% Pinched Nerve In The Neck

People who have experienced upper back pain that shoots down the arm had symptoms persist for:

  • 34% Less than a day
  • 27% Less than a week
  • 21% Over a month

Source: Aggregated and anonymized results from Buoy Assistant.

Hear what 3 others are saying
Once your story receives approval from our editors, it will exist on Buoy as a helpful resource for others who may experience something similar.
The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
2 yrs of pain--from spine, to shoulder blade, to arm, to numbness in last two fingersPosted November 28, 2021 by L.
It started out as numbness in my left hand...specifically, my ring finger and pinky. Then, about a week later, my arm began to hurt, especially right above my elbow. Analgesic creams and ibuprofen were no help at all. Then, a few days later, my shoulder blade and the left side of my spine and neck began to hurt. Massage made it worse. The only thing that would relieve it any was lying down in bed with my arm propped up on a pillow till I could fall asleep. By the time I woke up in the morning, the pain was gone (but the numbness in my fingers never went away). Every day the same thing. Over a year, it got worse, then it began to get just a tad better, and my friend convinced me to go see my doctor. She ran me through a test that activates the nerves up and down the arm. Don't know what nerve she hit at one point, but I felt it when she hit that one, it immediately aggravated the symptoms and it's been a downhill spiral since then, every day worse and worse...then Covid hit and I waited another yr. (Oh, BTW, she said the tests came back as "carpal tunnel". Side note: I have carpal tunnel in my right hand, and I can assure you this is not the same at all. Much different pain...this is severe pain that radiates down from spine to hand with only two fingers numb, whereas the numbness in right hand is in all fingers, isolated, and never goes up past my wrist.) But recently, when I went back in to ask her for a referral to a chiropractor, she poo-pooed that idea, saying she would rather send me "to a surgeon for the carpal tunnel" or a pain specialist, with really no hope for any other possibility, other than "just living with the pain". Needless to say, I am at a loss as to what to do, because I would like to see a chiropractor, preferably one that also knows acupuncture, but I need a referral for the insurance to cover it. I found this website, took the quiz, and (no big surprise) the symptoms I am having are EXACTLY what I thought...diagnosis online was much more accurate than she was, even with her test results...your quiz mentioned the possibility of one of three things, none of which are carpal tunnel, and they fit my symptoms precisely.
Burning pain from upper back to shoulder with deep, aching pain radiating into handPosted March 7, 2021 by E.
I have had nearly my entire spine fused, except for C1, C2, & T3 (where I am going to be fused because of kyphosis). For nearly 1 1/2 years, since my neck was fused from C3 to T2, I have had radiating burning pain from near center upper back into my shoulder that then becomes a moderate to severe deep, aching pain that radiates all the way into my ring finger and little finger. My neurosurgeon is sending me to an associate of his to be treated for ulnar nerve entrapment. I simply don’t understand how that diagnosis can include the upper back through shoulder burning pain along the area enervated by what eventually does become the ulnar nerve without there being some spinal disk involvement.
Severe pain in upper back/left armPosted March 13, 2020 by J.
For 5 days I have had severe pain in my mid back radiating into my arm. Painkillers didn't help. Sent to A&E. They did xray and blood tests and sent me home despite seeing I was in severe pain. (Said it wasn't secondaries from breast cancer). Further contact with GP by phone resulted in a prescription for MST with Oramorph for breakthrough pain. Told to go back to see him next week!! Don't know where to turn as the pain is the worst I have ever had. I thought they should have found out cause of problem in hosp not left me suffering?

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