Upper Back Pain That Shoots Down The Arm Symptoms & Causes

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

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.