Pain in one's arm can be caused by a variety of conditions located in the upper extremity including joint sprain, muscle strain or tear, tendonitis, bursitis, arthritis, or nerve entrapment conditions such as carpal tunnel syndrome.  Arm pain can also be generated from a source located away from the location of the pain, most notably, the neck.  Pain generated from the neck that is felt in one or more areas of the arm is a symptom of a type of condition that is often successfully treated in physical therapy.  This condition, commonly referred to as a “pinched nerve”, is called a cervical radiculopathy. 

Causes: Cervical radiculopathy is caused when a nerve in the neck is compressed, irritated, or inflamed.  This can occur for several reasons. Most commonly a pinched nerve results from wear and tear of the spine as we age which results in inflammation of the joints of the spine around the nerve and reduced space for the nerve to exit the spinal column.  Cervical radiculopathy in younger people is often a result of a herniated disc related to a traumatic injury such as a car accident or a fall.

Anatomy and physiology:  Your neck (cervical spine) consists of 7 bones, or vertebrae, that are stacked on top of each other. Each vertebrae is separated from the other by a disc in-between.  A key role of the spine is to act as a sturdy column, to protect the spinal cord and its nerve branches.  The spinal cord in the cervical spine branches into 8 nerve roots that exit the spinal column between two vertebrae.  These nerve roots join to form peripheral nerves that course from the neck to the shoulder, arm, and hand.  The job of this network of nerves is to provide movement information to the muscles of the upper extremities. They also function to provide sensory information (pain, temperature, touch, pressure) received from receptors in the upper extremity, and carry it back to the spinal cord and brain for interpretation.  Cervical radiculopathy, as described above, occurs when the nerve root is compressed or irritated where it leaves the spinal column.  This can cause distinct symptoms. 

Symptoms:  Pain felt in the arm can be described as radiating, sharp, or dull over a region.  Other symptoms can include numbness, tingling (like pins and needles), loss of sensation, and potentially weakness of muscles.  The location of symptoms is dependent on which of the 8 nerve roots are being pinched.  Symptoms are often reproduced with movement or certain position of the neck.  This information helps the healthcare provider establish an accurate diagnosis and treatment plan. 

Physical therapy can help.  Cervical radiculopathy is one of many nervous system conditions that can be effectively treated by a physical therapist with the goal of restoring pain free function by restoring space for the nerve.  It is important to note that cervical radiculopathy can be a serious condition and seeing your doctor as soon as possible is recommended. Your doctor will help to determine if physical therapy is appropriate for you.

Nick Monday, DPT

Orthopedic Manual Physical Therapist

Mid- Michigan PT Clinical Team

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