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Dr. Mark
Dr. Mark, Doctor (MD)
Category: Health
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Experience:  U.S. Physician/Surgeon in Neurosurgery
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My upper arm is extremely painful. I can move it ...

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My upper arm is extremely painful. I can move it forward/backward but only limited laterally from my body. The pain starts approx. 6" from my shoulder. Additionally, it is difficult to lift without severe sharp pain or if a movement causes me to bring my arm across my chest or behind my back. I had thought perhaps burstis but this has continued for more than 2 weeks. I have used Lidocaine patches to reduce the pain with little relief and an ace bandage the past week. Do you think this is tendinitis or something else? Please help with any additional treatment options. what I am doing is not working!
Submitted: 6 years ago.
Category: Health
Expert:  Dr. Mark replied 6 years ago.
Do you have pain on top of the shoulder, and does it radiate from the neck? Or down the arm?

Do you have numbness at all?

And if you press on your shoulder, do you have the same pain?
Customer: replied 6 years ago.
At first I had pain around the upper shoulder area but with Lidocaine patches that has stopped. There is no numbness currently. The pain is located in my upper arm and with certain movements causes extreme pain that seems to radiate out from the pain about 6" down from my upper shoulder. This pain actually causes me to become sick to my stomach, and headaches have increased. Pressing on the top of shoulder causes no pain but under my arm in the armpit area pressing there does cause the pain. Hope this helps!
Expert:  Dr. Mark replied 6 years ago.
There are a bit of unusual things with your pain.

Typically the pain associated with tendinitis or bursitis of the shoulder would be painful as well as you press on the shoulder, and not the armpit. The fact that moving your shoulder causes the pain, though, suggests the pain is within something in the shoulder.

Rotator cuff injuries can also cause increased pain with attempts to "lift" your arm laterally, as you describe, or over your head.

Pain in the shoulder that radiates outwards over the upper arm can also come from a "pinched nerve" in the neck, from cervical disc disease. The fact that you have trouble lifting it laterally also could represent weakness in the deltoid, which can also occur from the cervical disc disease "pinching" the nerve (specifically either the C4 or C5 nerve root).

Given your symptoms, I think a physical exam by a orthopedic surgeon may be necessary to evaluate this, especially if your pain isn't improving as it should with rest in tendinitis/bursitis.   Should they find inflammation in the shoulder, steroids may be of value. They also will be able to recommend further imaging studies, like shoulder x-rays and perhaps a MRI of the shoulder, or cervical spine, to evaluate your pain.
Customer: replied 6 years ago.
I do not think you understood my location of pain. It is not in the top of my shoulder or around the area of the rotator cuff, I had been concerned about that at first but discarded that diagnosis with the reduced pain in that area. I do have cervical disc problems but the pain is not located anywhere near where that has been a problem prior nor does it seem the same. This pain is located more down on the humerus, as I have indicated about six (6) inches down from the top of the shoulder. I would think around where the triceps brachii muscle is located or the where the deltoid and the brachialis seem to come together. I did not mean to give you the impression that my headaches,etc. where caused by radiating pain, they are only caused by the continued extreme pain in my arm, and I am getting to the point of low tolerance. I am sorry I was unable to open your e-mail questions but I will continue to try. I hope my further discriptions help you understand better the location. My daughter had a rotator cuff injury and surgery so I am fairly sure that is not the answer.
Expert:  Dr. Mark replied 6 years ago.
Pain in this region can be due to cervical disc disease, more so the C6 nerve root, which would affect the mid arm into the forearm and thumb area, or one of those areas.

Given that your pain is not a rotator cuff injury, and that your pain does not seem to be directly related to your shoulder now, it would be best to pursue a MRI of the cervical spine, to see if there is a C5-6 herniated disc.
Customer: replied 6 years ago.
Yes, I do have herniated cervical disc, which has caused me severe pain for the last 10 years, I believe the last 3 cervical disc are herniated. I deal with that pain and the headaches on a daily basis. I believe I am frustrating you but this pain is not radiating from any source but my upper midarm. It hurts at rest like there is an open wound inside and to move it in the ways I have indicated can cause me to gasp in pain. The arm is not weak it hurts to lift but I can lift if I protect the movement. It would be stupid of me to lift when it causes me such pain so I have tried to reduce the heavy items I carry in that arm but continue to carry those items in the other arm. I am not trying to argue with you but I not sure I agree.
Expert:  Dr. Mark replied 6 years ago.
You are free to disagree, but the C6 nerve root can cause pain anywhere along its innervation, which includes the part of your upper arm.

The fact that you have cervical disc disease makes it even more likely that your pain is coming from cervical radiculopathy, or irritation of the nerve root in the neck.

If you haven't had a MRI of the cervical spine recently, then it may be worthwhile, especially if the pain in the arm doesn't improve over the next 3-4 weeks.
Dr. Mark, Doctor (MD)
Category: Health
Satisfied Customers: 11946
Experience: U.S. Physician/Surgeon in Neurosurgery
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