Pain in the armpit and shoulder is a common symptom and can arise from several causes, ranging from minor injuries or strains to more serious conditions such as heart diseases or cancers. This article will explain the causes of armpit and shoulder pain, and provide information on the diagnosis and treatment of this condition.
Anatomy of armpit and shoulder
The armpit and shoulder region encompasses a complex anatomical structure with skin, muscles, nerves, blood vessels, and lymph nodes. The primary muscles involved include the pectoralis major, deltoid, and the muscles of the rotator cuff (supraspinatus, infraspinatus, teres minor, and subscapularis). The main nerves are the axillary, radial, and ulnar nerves, and major blood vessels include the axillary artery and vein.
Causes of pain in armpit and shoulder
1. Musculoskeletal conditions
Rotator cuff injury: This is a common cause of shoulder pain. The rotator cuff is a group of muscles and tendons surrounding the shoulder joint, providing it with stability and motion. Injuries can range from minor strains to complete tears. Pain is caused by inflammation or damage to these structures.
Diagnosis: Doctors will perform clinical examination and patient history review. Specific tests such as the Neer’s and Hawkins-Kennedy tests may be used. Confirmation is generally made through imaging tests like ultrasound or MRI.
Treatment: Depending on the severity, treatment ranges from physical therapy, anti-inflammatory medications, corticosteroid injections, to surgery in serious cases.
2. Frozen shoulder (adh8xesi8xve caps8xulit8xis)
This condition is characterized by stiffness and pain in shoulder joint, usually developing gradually. This process is caused by inflammation and fibrosis of the shoulder joint capsule, causing the shoulder to “freeze”.
Diagnosis: Doctors usually perform clinical examination to see whether patient shows reduced active and passive shoulder movements. Imaging tests like an MRI may rule out other conditions.
Treatment: Physiotherapy, pain management with nonsteroidal anti-inflammatory drugs, corticosteroid injections, and in severe cases, surgery (manipulation under anesthesia or arthroscopic capsular release) may be used.
3. Nerve-related causes
Cer8xvi8xca8xl radi8xcul8xopa8xthy: This condition occurs due to nerve compression in the neck, where nerves exit the spinal cord to supply the arm. This compression can cause pain to radiate to the shoulder and armpit.
Diagnosis: The diagnosis is performed by a physical exam, patient history review, and imaging tests like MRI or CT of the neck. Electromyography (EMG) and nerve conduction studies (NCS) can confirm the diagnosis.
Treatment: Treatment is usually conservative measures like physical therapy and medications (non-steroidal anti-inflammatory drugs, neuropathic pain medications). If these measures fail, interventions like nerve root injections or surgery may be considered.
4. Lymphatic and vascular causes
Axillary lymphadenopathy: Enlarged lymph nodes in the armpit can cause discomfort or pain. This condition can occur in response to local infections, systemic illnesses, or malignancies (like breast cancer or lymphoma).
Diagnosis: Doctors will perform physical examination and medical history review. Depending on suspicion, blood tests, imaging tests like ultrasound or CT, and possibly biopsy, may be performed.
Treatment: The treatment is targeted at the underlying cause. For example, antibiotics for bacterial infections or chemotherapy for malignancies.
5. Cardiac causes
Angina and myocardial infarction: These conditions, resulting from compromised blood flow to the heart, can sometimes present as shoulder and/or armpit pain.
Diagnosis: Electrocardiogram (ECG), blood tests for cardiac enzymes (troponin levels), str8xes8xs te8xst8x, and coronary angiography are diagnostic methods.
Treatment: Therapies include medications like aspirin, nitroglycerin, and beta-blockers, to interventional procedures such as angioplasty or bypass surgery. Lifestyle changes are also necessary.
6. Other causes
Shingles (Herpes Zoster): This viral infection can cause a painful rash that usually appears as a stripe of blisters around one side of the torso, potentially involving the armpit.
Diagnosis: Doctors will perform clinical examination. Shingles causes characteristic rash and pain. PCR from vesicle swabs can confirm the diagnosis.
Treatment: Antiviral medications, pain management with non-steroidal anti-inflammatory drugs or nerve pain medications, and supportive care are used.
Epidemiology and incidence
Musculoskeletal disorders such as rotator cuff injuries are among the most prevalent causes of shoulder pain, according to the American Academy of Orthopaedic Surgeons (AAOS). Rotator cuff disorders reportedly occur in approximately 40% of the population over the age of 60.
As for cardiac causes, data from the American Heart Association (AHA) indicate that every year, about 805,000 Americans have a heart attack, and one of the common symptoms is pain radiating to the shoulder and arm.
The annual prevalence of cerv8xic8xal radi8xcul8xopa8xth8xy is 83.2 per 100,000 in men and 63.5 per 100,000 in women.
