Since many people with newly appearing pain ask "Could this be MS?" I want to describe few causes of chronic pain other than MS.
A. NON-SYMMETRICAL PAIN
1. Pinched nerve in the neck
- Shooting or burning pain in the neck, shoulder, arm, hand or fingers; rarely in the trunk, not in the face
- Pain is affected by moving and sleeping position: either triggered or relieved
- Tingling or numbness
- No problems with vision, hearing, balance, urination
Pinched nerve in the elbow can cause pain and tingling in the inner side of the forearm, hand and in the 4th and 5th finger.
Pinched nerve in the wrist (carpal tunnel syndrome from wrist overuse) can cause pain and tingling in the wrist, outer side of the hand and first 4 fingers.
2. Osteoarthritis (joint damage due to wear and tear)
- Joint pain and stiffness (wrists) that worsens through the day
- Eventual bone spurs in the wrist
- Only minimal visible signs (swelling)
- NO fatigue, muscle weakness, fever, rash, nausea
3. Serratus anterior muscle overuse (due to arm overuse during sprints or lifting heavy objects) causes pain on one or both sides of the chest and down the inside of the arm, aggravated by deep breathing.
4. Shoulder disorders can cause pain and tenderness in the shoulder radiating down the upper arm.
5. Heart anxiety neurosis can cause central chest pain that radiates down the inside of the left arm.
6. Angina pectoris (in coronary heart disease)- Pain (triggered by exercise or stress, lasting for <5 min) behind the breastbone that can radiate down the inside of the left arm. In women, pain can radiate into both arms.
B. SYMMETRICAL PAIN
1. Rheumatoid arthritis
- Symmetrical joint pain, swelling, warmth and redness (last finger knuckles, wrists or shoulders)
- Stiffness is worst in the morning and improves through the day
- Common: skin rash, underskin nodules, fatigue
- Other: dry mouth, low-grade fever
Other autoimmune diseases, such as systemic lupus erythematosus (SLE) and Sjogren's syndrome can have similar symmetrical pattern as rheumatoid arthritis.
2. Peripheral neuropathy (in diabetes, nutrient deficiency, alcoholism, as side effect of drugs...)
- Burning pain, tingling or numbness, initially usually in the feet and later in the hands (stockings and gloves pattern)
3. Fibromyalgia
- The only typical tender point in the arm is on the outer side of the elbows (on both sides).
- Fatigue
4. Transverse myelitis (due to Lyme disease, shingles, vaccination or autoimmune disorders)
- Shooting pain in the neck, back and limbs, abnormal sensations, urinary incontinence
Arm pain in detail
A. NON-SYMMETRICAL PAIN
1. Pinched nerve in the neck
- Shooting or burning pain in the neck, shoulder, arm, hand or fingers; rarely in the trunk, not in the face
- Pain is affected by moving and sleeping position: either triggered or relieved
- Tingling or numbness
- No problems with vision, hearing, balance, urination
Pinched nerve in the elbow can cause pain and tingling in the inner side of the forearm, hand and in the 4th and 5th finger.
Pinched nerve in the wrist (carpal tunnel syndrome from wrist overuse) can cause pain and tingling in the wrist, outer side of the hand and first 4 fingers.
2. Osteoarthritis (joint damage due to wear and tear)
- Joint pain and stiffness (wrists) that worsens through the day
- Eventual bone spurs in the wrist
- Only minimal visible signs (swelling)
- NO fatigue, muscle weakness, fever, rash, nausea
3. Serratus anterior muscle overuse (due to arm overuse during sprints or lifting heavy objects) causes pain on one or both sides of the chest and down the inside of the arm, aggravated by deep breathing.
4. Shoulder disorders can cause pain and tenderness in the shoulder radiating down the upper arm.
5. Heart anxiety neurosis can cause central chest pain that radiates down the inside of the left arm.
6. Angina pectoris (in coronary heart disease)- Pain (triggered by exercise or stress, lasting for <5 min) behind the breastbone that can radiate down the inside of the left arm. In women, pain can radiate into both arms.
B. SYMMETRICAL PAIN
1. Rheumatoid arthritis
- Symmetrical joint pain, swelling, warmth and redness (last finger knuckles, wrists or shoulders)
- Stiffness is worst in the morning and improves through the day
- Common: skin rash, underskin nodules, fatigue
- Other: dry mouth, low-grade fever
Other autoimmune diseases, such as systemic lupus erythematosus (SLE) and Sjogren's syndrome can have similar symmetrical pattern as rheumatoid arthritis.
2. Peripheral neuropathy (in diabetes, nutrient deficiency, alcoholism, as side effect of drugs...)
- Burning pain, tingling or numbness, initially usually in the feet and later in the hands (stockings and gloves pattern)
3. Fibromyalgia
- The only typical tender point in the arm is on the outer side of the elbows (on both sides).
- Fatigue
4. Transverse myelitis (due to Lyme disease, shingles, vaccination or autoimmune disorders)
- Shooting pain in the neck, back and limbs, abnormal sensations, urinary incontinence
Arm pain in detail