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Arm Pain of Spinal Origin

Arm Pain of Spinal Origin

What are the Causes of Arm Pain of Spinal Origin?

Most often arm pain from spinal nerve compression occurs due to degenerative changes of the spine from aging or an injury that causes a bulging or herniated disc.

Degenerative Changes: As spinal vertebral discs age, they become stiffer, dry out, lose water content, lose height, and ultimately bulge out. This causes a collapse of the disc space and loss of disc space height. The body reacts to the collapsed disc by forming more bone called bone spurs around the disc to strengthen it.  These bone spurs lead to stiffening of the spine as well as narrowing of the foramen (small openings on each side of the spinal column where the nerve roots exit) leading to compressed or pinched nerves.

Herniated disc: A herniated disc most often occurs with sudden trauma felt with bending, twisting, pulling, or lifting movements. A disc herniates when the nucleus (jelly-like centre) pushes against its annulus (outer ring). When the herniated disc bulges out toward the spinal canal, it exerts pressure on the sensitive nerve root, causing pain and weakness in the area the nerve supplies.

What are the Symptoms of Arm Pain of Spinal Origin?

The pain in most cases originates from a compressed nerve in the neck and travels down the arm area. The pain can be described as sharp or burning in nature. Neck movements such as straining or extending the neck or turning the head may result in pain. Other symptoms may include:

  • Weakness in the muscles of the neck, shoulder, arm or hand
  • A sensation of “pins and needles” or tingling in the hand or fingers
  • Loss of sensation

Diagnosis of Arm Pain of Spinal Origin

To diagnose arm pain of spinal origin, your doctor will discuss your symptoms and perform a physical examination. During the physical exam, your doctor will prompt you to perform certain arm and neck movements to assess for muscle weakness, reflexes, or certain tender points on the neck, shoulder, arm or hand to find out the origin of the pain. Furthermore, imaging tests such as X-rays or MRI scans may be ordered for further details and confirmation of the diagnosis.

Treatment of Arm Pain of Spinal Origin

Treatment for arm pain of spinal origin depends on the severity and cause of the nerve compression. Treatment normally includes both non-surgical and surgical options with non-surgical option being the first line of treatment.

Nonsurgical treatment options include medications such as NSAIDs and oral corticosteroids, physiotherapy, steroid injections, and narcotics in the case of severe pain.

Surgical treatment options will be considered if conservative management fails to alleviate pain symptoms. There are many surgical procedures to treat arm pain of spinal origin. Based on your symptoms and the location of the nerve root involved, your doctor will recommend a suitable spinal decompression surgery, such as:

  • Laminotomy or laminectomy: Both procedures include removing a small section of the bony arches of the spinal canal, known as the lamina, which creates more room in the spinal canal, relieving pressure.
  • Foraminotomy or foraminectomy: These procedures are conducted to enlarge openings for the nerve roots to exit the spinal cord by removing portions of tissue and bone causing compression.
  • discectomy: This procedure includes removing a portion of a disc to mitigate pressure on the nearby nerve roots.
  • Corpectomy: This procedure involves removing the body of a vertebra, as well as the discs to decompress the spinal cord and nerves.
  • Osteophyte removal: This procedure includes removing bony growths called osteophytes or bone spurs causing irritation of the nerves.

Prevention of Arm Pain of Spinal Origin

Some of the preventive measures that should be followed include:

  • Maintaining proper posture
  • Quitting smoking
  • Maintaining a healthy body weight
  • Regular exercise
  • Avoiding heavy lifting activities
Neck Pain

Neck Pain

Cervical Anatomy

The first 7 vertebral bones of the spinal column form the cervical spine in the neck region. The neck bears the weight of the head, allows a significant amount of movement, and is less protected than other parts of the spine. All these factors make the neck more susceptible to injury or other painful disorders. 

What is Neck Pain?

Common neck pain may occur from muscle strain or tension from everyday activities including poor posture, prolonged use of a computer and sleeping in an uncomfortable position.

Causes of Neck Pain

The most common cause of neck pain is injury to the soft tissues (muscles, ligaments or nerves) or prolonged wear and tear. Traumatic accidents or falls and contact sports can cause severe neck injuries and pain. Neck pain can also occur from infections, tumors or congenital abnormalities of the vertebrae. The common conditions producing neck pain include:

  • Rheumatoid arthritis: It is an autoimmune disease in which the body's immune system attacks healthy joints, tissues, and organs. The condition occurs most often in the upper neck area, causing inflammation of the lining (or synovium) of joints, and resulting in neck pain, stiffness, swelling, and loss of function.
  • Cervical disc herniation: disc herniation is the bulging or rupture of the soft fibrous disc that cushions the vertebrae. The soft central portion called nucleus pulposus bulges out through the tear in the capsule. Cervical disc herniation refers to the herniation of the discs in the cervical spine region or neck region. The condition can be caused by normal aging or by traumatic injury to the spine. The condition results in painful, burning, tingling or numbing sensations in the neck. 
  • Cervical spondylosis: Cervical spondylosis refers to the abnormal degeneration of the cartilage and bones in the neck region. The condition results in neck pain radiating to arms or shoulder and neck stiffness that gets worse over time.
  • Cervical stenosis: Cervical stenosis refers to the narrowing of the spinal canal that protects the spinal cord and its branching nerves. The condition causes neck pain radiating to your arms and hands. 
  • Degenerative disc disease: Degenerative disc disease refers to the gradual deterioration of the disc between the vertebrae and is caused due to aging. As people age, intervertebral discs lose their flexibility, elasticity and shock absorbing characteristics, resulting in neck pain. 

Diagnosis of Neck Pain

The diagnosis of neck pain is made with a review of your history, physical examination and other imaging techniques including electromyography (EMG), X-ray, MRI scan, CT scan, blood tests, and bone density assessment. 

Treatment Options for Neck Pain

The treatment options for neck pain may include rest, ice application, use of a soft neck collar and neck immobilization using a splint, cast or sling. Medications such as anti-inflammatory drugs, analgesics, and muscle relaxants may be prescribed to reduce pain and inflammation. Certain stretching and strengthening exercises may be recommended to strengthen the neck muscles. 

Surgical treatment by anterior cervical discectomy with spinal fusion is typically recommended only after non-surgical treatment methods fail to relieve the pain. An anterior cervical discectomy is a surgical procedure performed to remove a herniated or degenerative disc in the cervical (neck) spine. Spinal fusion may be performed to provide stability to the spine. 

Prevention of Neck Pain

The following steps may help you prevent or improve your neck pain:

  • Practice relaxation exercises to prevent undesirable stress and tension to the neck muscles.
  • Perform stretching exercises for your neck before and after exercise.
  • Maintain good posture if you work at a computer and adjust the monitor to your eye level. Stretch your neck frequently. 
  • If you use the telephone a lot, use a headset. 
  • Use a pillow that keeps your neck straight.
  • Wear seat belts and use bike helmets to reduce injuries.

What is Arm Pain of Spinal Origin?

Arm pain of spinal origin can be described as discomfort or pain felt anywhere in the arm including the wrist, elbow, or shoulder as a result of a pinched nerve (nerve compression) or irritated nerve in the spinal cord. The pain can occur as a dull constant pain or a sudden sharp pain that can develop suddenly or over time. The pain may be confined to one area of the arm or may radiate to other areas of the arm such as the hand, wrist, elbow, or shoulder.

What are the Risk Factors of Arm Pain of Spinal Origin?

In general, men are affected slightly more than women by this condition. Risk factors include:

  • Neck trauma
  • Spinal nerve injury
  • Heavy manual labour
  • Operating vibrating equipment
  • Driving
  • Smoking
  • American Board of Orthopedic Surgery
  • The George Washington University
  • University of Wisconsin–Madison
  • UC San Francisco
  • Alpha Omega Alpha Honor Medical Society
  •  North American Spine Society
  • AO Spine
  • SMISS-Society for Minimally Invasive Spine Surgery
  • The Wisconsin Orthopaedic Society
  • American Academy of Orthopaedic Surgeons