What Are the Most Common Causes of Upper Arm Pain?

1. Primary pathogenic cause The primary pathogenic cause is outside the blood vessel. Generally, the position of the upper extremity changes or the strong movement causes the blood vessel to be compressed, which may be accompanied by or without thoracic outlet compression signs caused by anatomical abnormalities, such as When the subclavian vein passes through the costal clavicle triangle, it is oppressed by the costal clavicle ligament, the subclavian muscle, the anterior oblique muscle, and the protruding oblique nodules.When the upper limbs do powerful activities (swimming, climbing, weightlifting, softball) , Tennis, etc.), or unaccustomed movements of the upper limb due to some occupations, etc., can cause repeated damage to the subclavian vein and endometrial thickening, which eventually leads to thrombosis. This is the traditionally called Paget-Schroetter syndrome. Also known as frustrated venous thrombosis (effortthrombosis).

Sudden swelling and pain in the upper limbs

Sudden swelling and pain in the upper limbs is one of the symptoms of deep vein thrombosis in the upper limbs. Swelling of the upper limbs is the earliest symptom that extends from the fingers to the upper arms to the entire upper limbs, but is more severe near the side. Pain can occur at the same time as swelling, or it can only be expressed as soreness, which is exacerbated when the upper limbs are moved, and sometimes it can touch cord-like, tender veins. About two-thirds of patients have purple or blue-violet changes in the affected limb due to venous congestion.

Affected area

Limbs

Related diseases

Fractured upper extremity deep vein thrombosis swelling

Related symptoms

Weakness, sensitization, limited shoulder movement, varicose veins, edema in the upper limbs, sudden swelling in the upper limbs, soreness, slow growth, numbness on the far side of the limb

Affiliated Department

Other departments

Related inspections

Thromboelastography

1. Primary pathogenic cause The primary pathogenic cause is outside the blood vessel. Generally, the position of the upper extremity changes or the strong movement causes the blood vessel to be compressed, which may be accompanied by or without thoracic outlet compression signs caused by anatomical abnormalities, such as When the subclavian vein passes through the costal clavicle triangle, it is oppressed by the costal clavicle ligament, the subclavian muscle, the anterior oblique muscle, and the protruding oblique nodules.When the upper limbs do powerful activities (swimming, climbing, weightlifting, softball) , Tennis, etc.), or unaccustomed movements of the upper limb due to some occupations, etc., can cause repeated damage to the subclavian vein and endometrial thickening, which eventually leads to thrombosis. This is the traditionally called Paget-Schroetter syndrome. Also known as frustrated venous thrombosis (effortthrombosis).

2. Secondary causes There are many secondary causes, such as the insertion of catheters, wires in blood vessels, and injection of irritating drugs. After venous catheterization, thrombosis can occur in about one-third of patients, and 1% to 5% of them have clinical symptoms. In addition, there are heart failure, pregnancy, oral contraceptives, coagulation and fibrinolytic dysfunction, arteriovenous fistula of hemodialysis and so on. Other causes are extravascular, such as cancer, radiation therapy, fracture of the first rib or clavicle.

Onset is male, female and any age. Secondary causes often have traceable causes; Paget-Schroetter syndrome is more common in young and middle-aged men, and two thirds of the lesions occur in the right upper limb, which may be related to more force in the right upper limb. 4/5 of the patients had a history of frustration 24 hours before the onset, such as strong activities of the upper limbs or prolonged upper limbs in an unaccustomed posture, about 1/10 of the patients had no incentive, but only after waking up in the morning after sleeping overnight Find.

Swelling of the upper limbs, pain, bruising of the skin, and superficial varicose veins are the four main symptoms. Swelling of the upper limbs is the earliest symptom that extends from the fingers to the upper arms to the entire upper limbs, but is more severe near the side. Pain can occur at the same time as swelling, or it can only be expressed as soreness, which is exacerbated when the upper limbs are moved, and sometimes it can touch cord-like, tender veins. About two-thirds of patients have purple or blue-violet changes in the affected limb due to venous congestion. Superficial varicose veins usually develop after 1 to 2 days, with the shoulders and upper arms being the most obvious. Most patients with acute symptoms such as swelling and pain can resolve on their own within a few days or weeks, but it is still difficult to achieve complete recovery. About 2/3 of patients have residual sequelae, which show swelling and soreness to varying degrees, or Swelling and pain occurred after the activity.

A preliminary diagnosis can be made based on sudden swelling and pain in the upper limbs, but venography is the most reliable diagnostic method at present. Although non-invasive examination technology has developed rapidly in recent years, due to the subclavian veins being covered by the clavicle, it is often difficult to accurately determine the thrombotic lesions in the subclavian veins with dual power Doppler scanning and magnetic resonance imaging. Suspicious patients are screened using various non-invasive tests. Patients whose direct signs do not show lesions should be examined at the same time and compared with the affected side. Passman performed a comparative study of the upper extremity veins of a group of hemodialysis patients with dual-function color Doppler ultrasound and venography, and proved that the sensitivity and specificity of dual-function color Doppler ultrasound in diagnosis of venous occlusive lesions of the upper limbs were 81% and 97%, respectively. If the result of ultrasound examination is not clear, venography is performed.

Differential diagnosis of sudden swelling and pain in the upper limbs:

1. Upper limb edema: Breast cancer is one of the most common malignant tumors in women in China. With the advancement of medical technology, the treatment effect of breast cancer has been significantly improved, and a considerable number of patients are expected to achieve long-term survival. However, it cannot be ignored that the sequelae of treatment have affected the quality of life of patients to varying degrees. Among them, upper limb edema is the most common. After edema, it can cause upper limb dysfunction such as limited shoulder movement, limb weakness, numbness, pain and other paresthesias, which seriously affects the daily life of patients.

2. Frequent numbness on the far side of the limb: Frequent numbness on the far side of the limb is a symptom of neuroma. Neuroma clinically refers to schwannoma from nerve sheath tissue, most of which are located in the limbs, axillary, or on the collarbone, neck and other parts. It is a benign tumor with slow growth and generally no recurrence after resection. It is located in a limb mass and has a spindle shape. The nerves on the far side of the inner limb are often numb, painful, and allergic. Compression of the tumor can also cause numbness.

Onset is male, female and any age. Secondary causes often have traceable causes; Paget-Schroetter syndrome is more common in young and middle-aged men, and two thirds of the lesions occur in the right upper limb, which may be related to more force in the right upper limb. 4/5 of the patients had a history of frustration 24 hours before the onset, such as strong activities of the upper limbs or prolonged upper limbs in an unaccustomed posture, about 1/10 of the patients had no incentive, but only after waking up in the morning after sleeping overnight Find.

Swelling of the upper limbs, pain, bruising of the skin, and superficial varicose veins are the four main symptoms. Swelling of the upper limbs is the earliest symptom that extends from the fingers to the upper arms to the entire upper limbs, but is more severe near the side. Pain can occur at the same time as swelling, or it can only be expressed as soreness, which is exacerbated when the upper limbs are moved, and sometimes it can touch cord-like, tender veins. About two-thirds of patients have purple or blue-violet changes in the affected limb due to venous congestion. Superficial varicose veins usually develop after 1 to 2 days, with the shoulders and upper arms being the most obvious. Most patients with acute symptoms such as swelling and pain can resolve on their own within a few days or weeks, but it is still difficult to achieve complete recovery. About 2/3 of patients have residual sequelae, which show swelling and soreness to varying degrees, or Swelling and pain occurred after the activity.

A preliminary diagnosis can be made based on sudden swelling and pain in the upper limbs, but venography is the most reliable diagnostic method at present. Although non-invasive examination technology has developed rapidly in recent years, due to the subclavian veins being covered by the clavicle, it is often difficult to accurately determine the thrombotic lesions in the subclavian veins with dual power Doppler scanning and magnetic resonance imaging. Suspicious patients are screened using various non-invasive tests. Patients whose direct signs do not show lesions should be examined at the same time and compared with the affected side. Passman performed a comparative study of the upper extremity veins of a group of hemodialysis patients with dual-function color Doppler ultrasound and venography, and proved that the sensitivity and specificity of dual-function color Doppler ultrasound in diagnosis of venous occlusive lesions of the upper limbs were 81% and 97%, respectively. If the result of ultrasound examination is not clear, venography is performed.

Venous thrombosis daily care:

1. Closely observe the changes in the circumference and color of the affected limb: if the circumference of the affected limb is increasing, it means that the venous return is blocked; if the color is darker and the temperature is higher, it means that an infection has occurred, and the doctor should be notified in time to deal with it.

2. Raising the affected limb: When bed rest, the affected limb is raised slightly above the level of the heart, which promotes blood flow, relieves pressure in the superficial veins, and reduces pain. Acute patients were instructed to rest in bed and raise the affected limb 30deg; to facilitate venous return and reduce edema.

3. Avoid collision of injured limbs: In the nursing process, ask patients to pay attention to safety and prevent collision injuries again. . Soft toothbrush for brushing, shave with electric shaver.

4. Strengthen the protection of venous blood vessels: patients in the acute phase need a large amount of intravenous injection of vasodilators, anticoagulants and thrombolytic drugs, and fever patients need infusion of antibiotics. In order to protect the venous blood vessels, hot puncture sites are applied twice a day to prevent the occurrence of superficial phlebitis.