How to diagnose and
treat arm pain

How do clinicians diagnose arm pain?

When you see a clinician about arm pain, the visit usually starts with your story. They will ask when the pain began, what you were doing at the time, and how it affects daily life, like lifting a pan, working at a keyboard, or sleeping on your side^{1 3}.

Because “arm pain” can come from the neck, shoulder, elbow, forearm, or nerves, your clinician will usually think in “regions” instead of just one joint^{3 4 5}.

1. Your history and symptoms

Your clinician will usually ask about^{3 4}:

• Where the pain is and what it feels like, such as aching in the upper arm, sharp pain near the elbow, or burning into the forearm
• What makes it worse, for example overhead reaching, gripping, typing, or sport
• Whether you feel tingling, numbness, or weakness in the hand or arm
• Sleep, mood, stress, and general health, since these can change how strongly pain shows up^{2 14}
• Any sudden injuries, infections, or weight loss that might signal a more serious problem^{3 4}

They may also ask about work and hobbies, like repetitive tools, vibration, or heavy lifting, because these are known risk factors for upper limb disorders^{1 16}.

2. Physical examination

Next, they usually check several areas in a set order^{3 4 5 6}.

• Neck check: Gentle neck movements and nerve tension positions can help spot cervical nerve irritation that sends pain into the arm.
• Shoulder check: Lifting the arm in different directions, checking a “painful arc,” and testing specific muscles can point to rotator cuff related shoulder pain^{3 5}.
• Elbow and forearm check: Resisted gripping, wrist movements, and tender spots over the elbow or forearm help identify tendon disease such as “tennis elbow.”⁶
• Nerve tests: Simple strength and sensation checks, plus tapping or pressing near nerve pathways, can look for nerve entrapment at the elbow or forearm^{6 7}.

Your clinician is usually trying to answer three questions:

1. Is this coming from the neck, shoulder, elbow/forearm, or a mix?
2. Are there signs of serious problems like severe nerve or blood vessel trouble?
3. Is imaging or further testing actually needed right now?

3. When tests and imaging are used

Most people with arm pain do not need scans at the first visit^{3 4 5}.

• X-ray or ultrasound may be used if there was a fall, concern for fracture, or to look at tendons and bursa (liquid-filled sac that acts like a cushion) around the shoulder or elbow after symptoms have persisted^{3 5 6}.
• MRI is usually reserved for cases where symptoms do not improve with good care, or when a large tear, stress injury, or other internal problem is suspected^{3 6}.
• Nerve tests may be used when it is hard to tell if symptoms are from nerve compression in the neck or around the elbow and forearm^{4 6}.
• Compartment pressure testing is sometimes used for people with exercise-triggered forearm tightness and weakness, to check for chronic exertional compartment syndrome (exercise-induced high pressure inside the arm)^{7 13}.

4. Red flags that change the plan

If you have sudden swelling and color change in the arm, extreme pain with stretching the muscles, major weakness, fever, or a recent big injury, clinicians focus first on ruling out emergencies such as upper extremity deep vein thrombosis or acute compartment syndrome^{8 9 12}. In these situations, hospital care and urgent imaging or surgery may be needed.

Clinical insight

Guidelines for shoulder, elbow, and neck conditions all highlight a similar message: careful history and examination usually give enough information to start treatment, and routine early imaging rarely changes the plan for most people^{3 4 5 6}.This is important because focusing less on “scan findings” and more on symptoms, function, and goals helps you stay active, build confidence in using the arm, and avoid unnecessary procedures that may not improve long-term outcomes^{3 4 6 14}.

What are the treatment options for arm pain?

Most arm pain is treated with a step-by-step plan that starts with the simplest, safest options. For many people, a mix of education, activity changes, and targeted exercises is enough to calm symptoms and restore strength.^{3 5 6}

1. Education and activity changes

You and your clinician or physical therapist will usually work together to:

• Adjust painful tasks, such as changing how you lift, grip, or position your keyboard
• Use “relative rest,” which means easing back from painful loads rather than total rest
• Add micro-breaks for repetitive work or sport
• Improve sleep routines and stress management, both linked to pain sensitivity and recovery^{2 14}

These changes are strongly supported in guidelines for shoulder, elbow, and neck pain and are considered first-line care^{3 4 5 6}.

2. Exercise-based rehabilitation

Exercise is the foundation for most arm pain conditions.[5][6]

Depending on your main pain driver, your plan may include:

• Shoulder-focused work for rotator cuff related shoulder pain: slow, progressive strengthening of the shoulder blade and rotator cuff muscles, plus mobility and posture drills⁵.
• Elbow and forearm loading for tendinopathy: eccentric and concentric (with and without muscle elongation) exercises for wrist muscles, grip training, and sometimes isometric (without moving joint) holds for short-term pain relief⁶.
• Nerve-gliding and mobility work for nerve entrapments or cervical radicular symptoms, combined with gradual strengthening^{4 6}.
• Sport or job specific practice to help you return to overhead work, tool use, or racket and throwing sports^{5 6}.

Most guidelines recommend building load gradually over weeks to months, with exercises adjusted to your irritability and goals^{5 6 14}.

3. Medications

Short courses of pain relievers or anti-inflammatory medications may be offered to help you cope with flares or sleep better, but they do not “fix” tendon or nerve issues by themselves^{3 5 6}.

Any medication plan should be discussed with your clinician, especially if you have other health conditions.

4. Bracing and supports

Some people get short-term relief from:

• Counterforce straps or braces around the forearm for tennis elbow
• Wrist supports for repetitive keyboard or tool use

Studies suggest these can improve pain-free grip in the short term, but they work best alongside exercises and load changes, not on their own^{6 11}.

5. Injections

Injections are sometimes used, but their role varies by condition and time frame:

Shoulder injections can provide short-term relief in some people, especially when pain is blocking progress with exercise, but repeated injections are discouraged as they may not improve long-term outcomes^{3 5}.

• Corticosteroid injections for tennis elbow (overuse of the muscles and tendons in the elbow) often help early pain but are linked with more recurrences and worse one-year results than placebo or exercise-based care^{10 11}. Because of this, guidelines increasingly recommend caution, especially for chronic cases⁶.
• Nerve-related injections near entrapment sites are sometimes used as diagnostic tools or temporary pain relief, but evidence is limited^{6 7}.

6. Surgery

Surgery is rarely the first step and is usually reserved for specific situations^{5 6 7 8 9 13}

• Persistent, function-limiting shoulder, elbow, or nerve symptoms after 6 to 12 months of well-guided rehabilitation
• Clear nerve compression with progressive weakness
• Confirmed chronic exertional compartment syndrome of the forearm in high demand athletes
• Vascular problems such as upper extremity deep vein thrombosis or thoracic outlet related compression (either the blood vessels or nerves are compressed)

Even when surgery is used, structured rehabilitation before and after is crucial for good outcomes^{5 6 7 13}.

Recovery timelines vary. Many shoulder and elbow problems improve meaningfully within 6 to 12 weeks of consistent exercise and activity changes, while more persistent or high-demand cases may need several months^{5 6 14}.

Sword's approach

Sword Health helps people manage pain and movement issues with expert-guided AI care you can use from home. Our model combines clinical support with modern technology, designed to work around your life.

Sword makes recovery easier and more accessible. You get high-quality care at home, guided by clinicians and supported by smart technology.

• Care that adapts to your progress in real time
• Licensed experts guiding every step
• Simple, non-invasive, evidence-based programs
• Proven results for pain relief, movement, and satisfaction

How can I find relief for arm pain?

While diagnosis and treatment plans should be personalized, there are several low-risk strategies that many people find helpful alongside professional care.

1. Keep the arm gently moving

Most guidelines now encourage continued movement rather than full rest for most arm conditions^{3 4 5}.

• Use smaller, more frequent bouts of movement instead of long, intense bursts.
• Stay within a “tolerable” pain range rather than forcing through severe pain.
• Change positions often if you sit or stand for long periods.

2. Adjust everyday tasks

Simple changes can reduce strain on irritated tissues:^{3 614}

• Bring objects closer to your body instead of reaching far away.
• Use two hands instead of one when possible.
• Switch mouse hands or try an ergonomic mouse or keyboard.
• Vary your grip and take short breaks during repetitive tasks.

3. Build gradual strength

If you have access to guided exercise, a physical therapist or digital program can design a plan that starts at your current level and progresses safely.^{5 6 15}

• Begin with lighter loads or easier positions.
• Increase weight, repetitions, or complexity slowly over weeks.
• Include both general fitness (like walking) and arm-specific strength work, which supports overall recovery and mood^{2 14}.

Digital physical therapy programs have shown that structured, remote exercise and education can provide similar pain and function improvements to conventional in-person care for some long-term musculoskeletal conditions¹⁵.

4. Support sleep and stress

Poor sleep and high stress can turn the “volume” of pain up and make flares feel worse^{2 14}.

• Aim for a regular sleep schedule and a winding-down routine.
• Try relaxation techniques such as breathing exercises, gentle stretching, or short walks.
• Notice if pain feels worse on high-stress days and plan helpful breaks or coping strategies.

5. Know when to seek more help

Talk with a clinician if:^{3 4 8 9 12}

• Pain is not improving after several weeks of active care
• You notice increasing weakness, numbness, or clumsiness
• Swelling, color change, or shortness of breath appear
• You develop fever, feel generally unwell, or have pain after a major injury

These signs may mean you need a different approach or tests to rule out serious causes.