Why do I have neck and arm pain?

Neck and arm pain are common complaints for a large portion of the population at any age. This can be debilitating and can make performing even simple tasks extremely difficult. Problems in the cervical spine, or the section in your neck, can cause pain in the neck as well as numbness and weakness in the arms.

Not every person with neck pain develops arm pain, however if it does occur it is called cervical radiculopathy (arm pain and numbness) which is also known as a ‘pinched nerve’.

What causes the condition?

Potential causes of neck and arm pain include:

• Aging
• Accidents
• Simple daily strain
• Injury to the neck or head
• Prolonged neck problems 
• Problems in the cervical spine, or the section of the spine in your neck, can cause pain in the neck as well as numbness and weakness in the arms
• Whiplash injuries

More complicated causes of neck and arm pain include:

Herniated and bulging discs:

• Wear on a disc can cause the outer layer to rupture, creating a hernia
• The herniated disc can push on the spinal canal and nerve roots, causing pain, numbness, and weakness
• A bulging disc can also put pressure on the nerve, but the disc does not actually rupture as with a herniated disc

Bone spurs:

• Wear on the vertebrae can cause bone spurs, which are bony malformations that can put pressure on discs and inflame the nerves, causing pain
• Since bone spurs can put pressure on discs, the discs can flatten, dehydrate, and become degenerate

Cervical spinal stenosis:

• Cervical spinal stenosis is a narrowing of the spinal column or foramen due to bone spurs or disc protrusion. It is sometimes referred to as a “pinched nerve”
• Central stenosis can pinch the spinal cord, and foraminal stenosis can pinch the nerve roots that exit through the foramen
• This pinching can cause back, shoulder, and arm pain. It can also cause numbness and weakness in the arms and hands

What are the typical signs?

It depends on the cause of the pain, in the majority cases, the pain of cervical radiculopathy starts at the neck and travels down the arm in the area served by the damaged nerve. This pain is usually described as burning or sharp. Certain neck movements—like extending or straining the neck or turning the head—may increase the pain. Other symptoms include:

• Tingling or the feeling of "pins and needles" in the fingers or hand
• Weakness in the muscles of the arm, shoulder, or hand
• Loss of sensation

Some people report that pain decreases when they place their hands on top of their head. This movement may temporarily relieve pressure on the nerve root.

How is it diagnosed and treated?

Diagnosis

Your consultant will discuss your symptoms with you and perform a medical examination, which may be followed up by an X-ray or MRI scan. This will help to determine the location and cause of your pain.

Treatment

Non-surgical treatment: Your consultant may recommend anti-inflammatory medicine and a programme of exercises to stretch and strengthen your muscles. If your symptoms do not improve, a spinal injection of steroid can help to reduce pain and swelling, allowing the nerve time to recover.

Surgery: This depends on what is causing the pinched nerve, but can include anterior cervical discectomy and spinal fusion or disc replacement.

Recovery

This depends on the type of treatment you’ve had. The average stay in hospital is one to two nights and by discharge, you should be mobilising freely and able to climb a flight of stairs. Full soft tissue recovery normally takes about six weeks.

When can I return to normal activities?

• Work - this depends on your individual employment and lifestyle, however if your job mainly involves sitting then an approximate guide is around four weeks post-surgery. If you have a more active role, your consultant will be able to advise you on a suitable period of time, however it could take up to two months.
• Driving – usually about two weeks.
• Exercise – usually just walking for six weeks, then low impact exercise 6 to 12 weeks.