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Susan Ivy
Susan Ivy, Nurse (RN)
Category: Health
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Experience:  BSN, MSN, CNS
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My left arm pains while lifting up. The pain is on the outer

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My left arm pains while lifting up. The pain is on the outer side below the deltoid. It is not relapsing. The pain is not unbearable. When the hand is not moving, I feel some uneasiness. Did not try any medication. Doing pushups is impossible. What could be the reason?
Hello and thank you for using JustAnswer Health today.
It is possible that you have a nerve compression syndrome. This can occur when a nerve becomes irritated or compressed.
The nerve that passes on the outside of the elbow is the Radial nerve. Symptoms of radial tunnel syndrome include tenderness and pain on the outside of the elbow, similar to what one feels with tennis elbow. Tenderness may occurs about two inches further down the arm, where the radial nerve goes into the supinator muscle. The supinator muscle tallows you to twist the hand clockwise.
Radial tunnel syndrome is often caused by using a computer, long-distance driving, racket sports, and playing a musical instrument. Sometimes even sleeping in an unusual position can cause the irritation.
Recommendations include resting the arm, and paying attention to alignment of the arm so as to prevent further irritation. Keeping the arm straight while sleeping is also suggested.
Tests can be performed to determine whether or not this is the actual problem you are experiencing or not. Testing will include physical examination of the nerve and muscle, possibly x-ray or other imaging studies, and sometimes nerve conduction studies.
Treatment may involve non steroidal anti-inflammatory medication, steroid injection, bracing or splinting, and physical therapy exercises. Rarely surgical treatment is required.
The type of physician that you would see for this is an orthopedic physician, although some general physicians may be able to evaluate you and decide if referral is necessary.
Please reply and let me know if this does fit with what you are experiencing or if you have any additional questions or comments.
Susan Ivy and 2 other Health Specialists are ready to help you
Customer: replied 5 years ago.
Thanks for quick and prompt reply.

The pain is felt in the upper arm close to the deltoid. It is not close to the elbow. Therefore I doubt if I have Radial tunnel syndrome. The tenderness is also felt in the upper arm. Are there other possibilities. The middle finger test is not positive.

I do long distance cycling regularly. I haven't stopped cycling.
Good for you, I love cycling, I don't have a road bike yet though.
Sorry if I misunderstood the location.
So this is mainly about the deltoid?
You mentioned your hand is uneasy. Could you describe this in further detail? Do you mean that it is weaker than usual?
But if mostly the discomfort is in the area of the deltoid, well then it may be that the muscle is strained, or possibly a ligament is sprained.
The most common cause of deltoid strain is overuse without enough rest.
No problems with rotating the arm correct?
For strain, the PRICE protocol: Protection, Rest, Icing, Compression, Elevation is implemented. Anti-inflammatory medications (such as ibuprofen) can be used to treat the pain, and can also help decrease inflammation.
Do you cycle every day? Are you able to take a few days off? Depending on the severity of the strain, a few days may be helpful, or more time off may be needed (perhaps a short period of indoor cycling, so that there is no weight on the shoulder/upper arm) and the area can be rested. It is usually recommended that the deltoid be rested until all strength is regained.
Physical therapy may be recommended, depending on the severity.
It is still recommended that you be evaluated in person, so that the grade of strain can be verified. As an athlete, early intervention is especially important in order to prevent a worsening situation.
Customer: replied 5 years ago.
I confirm, it is about the deltoid.

Ibuprofen does gives me relief. How many mg of ibuprofen should I take. the one took is 400mg. (my body weight is 68kg.) Should I take twice a day?

No problem in rotating the arm.

Yes. I cycle six times to commute to office, about 26km each trip.

The hand is weak, as I said I cannot do a push up, when I try I feel pain at the deltoid. As you say it may be that the muscle is strained, or possibly a ligament is sprained. I have similar strain on both the arms while cycling, this did not cause any problems with the right hand, may be because this hand is strong since I am a right hander.

I will go and see orthopedic physician soon.

The recommended dose for mild to moderate pain in adults is 200 to 400 mg orally every 4 to 6 hours as needed. Take with food or milk to prevent upset stomach.

The weak hand points to nerve involvement, most likely a separate issue from the deltoid pain.

I wonder if experimenting with different positions on the handle bar while riding might provide some relief for the hand issue which could possibly be due to either ulnar or radial nerve irritation (especially if you don't already change up your hand positions) If the wrist is bent when grasping the bars, see if there is a position where you can keep the wrist straight. A soft brace at the wrist (which are found in most any drug store) would help remind you to keep the wrist straight.

Definitely a physical evaluation is needed to determine the cause of what sounds to be two separate issues.

Please feel free to update with findings when you see the orthopedist.