Arm pain when coughing can be concerning, but it often results from the body’s physiological responses or underlying conditions. Coughing is a forceful action that strains various anatomical structures. This strain can cause discomfort that extends beyond the chest, potentially manifesting as arm pain.
How Coughing Impacts the Body
Coughing is a complex reflex involving multiple muscle groups and a rapid increase in internal pressure. It begins with an inhalation, followed by a compression phase where the glottis closes and chest, diaphragm, and abdominal muscles contract forcefully. This coordinated contraction significantly raises intrathoracic pressure.
Finally, the glottis opens, leading to a sudden, explosive expulsion of air at speeds that can exceed 100 miles per hour. This forceful expulsion and the preceding muscle contractions create considerable strain and movement throughout the trunk. The pressure generated and the rapid muscle actions can transmit force to surrounding areas, including the shoulders and arms, causing discomfort.
Common Musculoskeletal and Nerve-Related Causes
Arm pain with a cough often originates from issues involving muscles, bones, or nerves in the upper body. Coughing can strain chest wall muscles, specifically the intercostal muscles between the ribs. These muscles stabilize the rib cage and assist with breathing. Severe or prolonged coughing can cause them to stretch, pull, or even partially tear, with pain radiating to the arm. Similarly, pectoral muscles, connected to the shoulders, can become fatigued and tight from repetitive coughing, leading to referred pain.
Nerve irritation or impingement in the neck or upper back can also cause arm pain that worsens with coughing. Cervical radiculopathy, often called a “pinched nerve,” occurs when a nerve root in the neck is compressed. The sudden movements and increased pressure from coughing can aggravate this, leading to sharp, electric-like, or throbbing pain that shoots down the arm and into the hand, sometimes with numbness or tingling. Thoracic outlet syndrome (TOS) involves the compression of nerves and blood vessels between the collarbone and first rib. Symptoms of TOS, including arm pain, numbness, and tingling, can be exacerbated by coughing due to changes in chest pressure or posture.
Direct injury to the rib cage can also cause arm pain during a cough. Severe coughing can lead to stress fractures in the ribs. Pain from a fractured or bruised rib is typically sharp, worsens with deep breaths or coughing, and can radiate to the shoulder or arm due to proximity. Costochondritis, an inflammation of the cartilage connecting the ribs to the breastbone, is another potential cause. This condition causes chest pain that can radiate to the arms and shoulders, often worsened by movements such as deep breathing, sneezing, or coughing.
Other Medical Conditions to Consider
While musculoskeletal and nerve issues are frequent culprits, arm pain with coughing can also indicate other medical conditions. Lung conditions, such as pleurisy, can cause chest pain that extends to the arm, especially when coughing. Pleurisy, an inflammation of the lung lining, causes sharp chest pain that intensifies with breathing or coughing and can spread to the shoulders and back. Pneumonia and bronchitis, respiratory infections, can lead to persistent coughing and chest soreness felt in the arm due to inflammation.
Cardiac issues, though less common for isolated arm pain with coughing, require consideration. Angina, chest pain from reduced blood flow to the heart, can cause pressure or a dull ache in the chest that radiates to the arms, neck, jaw, or back. While coughing does not cause angina, its strain can worsen existing cardiac discomfort. Cardiac pain is usually accompanied by other symptoms like shortness of breath, dizziness, or nausea. Rarely, a diaphragmatic hernia, where an organ protrudes through the diaphragm, could lead to referred arm pain.
When to Consult a Doctor
Arm pain when coughing often resolves on its own, but certain signs indicate a need for prompt medical evaluation. Consult a healthcare provider if the pain is severe, progressively worsening, or does not improve after several days. Seek immediate medical attention if arm pain is accompanied by shortness of breath, chest tightness, pressure, squeezing, dizziness, or fainting, as these could signal a cardiac event or other urgent condition.
Other concerning symptoms include fever, chills, persistent coughing with phlegm, or coughing up blood, which may suggest an infection or significant lung issue. Numbness, weakness, or tingling in the arm or hand, especially if sudden or severe, points towards potential nerve involvement. If the pain significantly interferes with daily activities or sleep, or if it follows a notable injury, medical consultation is recommended to determine the underlying cause and ensure appropriate management.