Pain extending from the shoulder down to the hand is a common symptom. This discomfort can manifest as a dull ache, sharp, or burning sensations, and may also involve numbness, tingling, or weakness. The path of this radiating pain often provides clues about its origin, which can range from conditions affecting the neck to those localized within the arm and hand. Understanding these potential sources helps identify the underlying issue.
Causes Originating in the Neck
Pain radiating from the shoulder to the hand often stems from issues within the neck. A common condition is cervical radiculopathy, often called a “pinched nerve.” This occurs when a nerve root in the neck becomes compressed or irritated where it branches off the spinal cord.
Compression can be caused by herniated discs, where the inner material of a spinal disc pushes outward. Bone spurs, which are bony growths, or spinal stenosis, a narrowing of the spinal canal, can also impinge on nerve roots. Symptoms include sharp, burning, or aching pain that travels from the neck or shoulder down into the arm, forearm, and sometimes into the fingers. This pain can be accompanied by numbness, a “pins and needles” tingling sensation (paresthesia), or muscle weakness in the affected limb.
Causes Originating in the Shoulder
The shoulder joint and its surrounding structures can also cause pain radiating down the arm. Rotator cuff injuries are a frequent cause, involving the muscles and tendons that stabilize the shoulder joint. Tendinitis (inflammation of these tendons) or tears can lead to pain radiating down the outer arm. This pain may worsen with overhead movements or at night.
Bursitis, another common condition, involves inflammation of the bursae (small fluid-filled sacs that cushion the shoulder joint). This inflammation can result in pain spreading down the arm. Frozen shoulder, characterized by stiffness and pain, can also cause discomfort extending into the arm. Degenerative changes from shoulder arthritis can also lead to chronic pain radiating from the joint.
Causes Originating in the Arm and Hand
Pain radiating from the arm down to the hand can also originate from conditions affecting peripheral nerves or tendons within the arm, distal to the shoulder. Peripheral nerve entrapment syndromes occur when nerves are compressed at specific points along their path. Thoracic Outlet Syndrome (TOS), for instance, involves the compression of nerves or blood vessels between the collarbone and the first rib, causing pain, numbness, tingling, or weakness in the arm and hand.
Cubital tunnel syndrome arises from compression of the ulnar nerve at the elbow, leading to numbness and tingling in the ring and little fingers, with pain that can radiate up the forearm. Carpal tunnel syndrome involves compression of the median nerve at the wrist, resulting in pain, numbness, and tingling in the thumb, index, middle, and part of the ring finger, which can sometimes extend up the arm. Tendinitis in the arm or elbow, such as biceps tendinitis or epicondylitis (“tennis elbow”), can also cause localized inflammation and pain radiating down the forearm.
When to Seek Professional Guidance
Seek medical attention for pain radiating from the shoulder to the hand, especially if symptoms are sudden or severe. Seek medical attention if pain appears after an injury or trauma, or if it is accompanied by weakness, numbness, or loss of function in the arm or hand. Signs of infection, such as fever, redness, or swelling, also require immediate medical evaluation. If the pain is severe and accompanied by chest pain or shortness of breath, seek immediate medical help, as these could indicate a serious underlying condition.
A healthcare professional will conduct a physical examination to assess your range of motion, strength, and sensation. They may also recommend imaging tests, such as X-rays, MRI scans, or CT scans, to visualize the bones and soft tissues. Nerve studies, like electromyography (EMG) or nerve conduction studies (NCS), might be performed to evaluate nerve function and pinpoint the source of compression or irritation. Early diagnosis and appropriate management can help prevent worsening symptoms and improve outcomes.