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Have you ever asked, “Why is my arm throbbing?” Does your arm feel tight, and can you see the pulsations, little areas that jump around randomly, sometimes? You might be convinced that you must have an arm problem. But most likely this issue is being driven by the nerves in your neck. When those nerves are irritated, this irritation can present itself through the muscles in the arm. To understand why this happens, you have to first understand that your arm muscles get instructions from the nerves in your neck.

Sometimes the only symptom of irritated neck nerves is tightness or throbbing in the arm muscles. Many patients don’t actually experience much neck pain, so the arm throbbing can be a warning signal of a much bigger neck problem. Over time, issues with your neck can cause arm problems, like shredded tendons that can lead to tennis elbow or golfer’s elbow. It’s important to address the neck issue when the throbbing arm, the warning signal, first presents itself.

How Can My Neck Cause My Arm Throbbing?

The muscles attach to the bones they move by a tendon. The muscles are told to move by nerves, and when the nerves aren’t happy, the muscles malfunction ever so slightly. Parts of them shut down, developing trigger points. These areas are tight bands that don’t contract and relax normally like a healthy muscle. This causes too much pulling on the areas where the tendons attach or tendonitis. So how does a nerve in the neck impact a muscle or tendon all the way down the line and cause arm throbbing?

When we grow in our mother’s womb, these areas grow out of one another and the wiring of the neck, shoulder, and arm are all connected. So injured neck nerves can lead to referred throbbing, tightness, and pain not only in the arm but also in the shoulder. In fact, on a side note, problems in the neck can refer pain all the way down to the hip. Hence, even though a neck nerve is the culprit, to the patient it feels like a shoulder or arm problem.

For example, in our experience, chronic tennis elbow that won’t easily respond to treatment may be an indication of a pinched nerve in the neck. The C6 or 7 nerves in the neck supply these forearm muscles and can malfunction in small areas when these nerves are irritated. So what the patient believes is an elbow problem is really a warning signal from the neck. To learn more about how the nerves in your neck could be causing issues in your arm, refer to the “Tendonitis” sections on pages 9 and 14 of my free-download book Regenexx ProActive.

The Referred-Pain Phenomenon

The referred-pain phenomenon, regrettably, has launched many unnecessary surgeries through the years. In tennis elbow, for example, a surgeon would go in and surgically cut the tendon in the elbow to release the tightness in the arm. But what happens when the problem is actually due to a nerve in the neck? The patient, after undergoing this unnecessary invasive surgery, will continue to have pain or tightness in the same spot because the arm wasn’t the true source of the issue. Who wants to have a surgery they don’t really need?

Even if the problem truly is just the elbow, and you don’t respond to good physical therapy, there is still no need for surgery for tennis elbow, as research, and our experience, has shown platelet-rich plasma (PRP) or stem cell injections to be an effective elbow treatment for most patients.

It’s important to understand that where it hurts may or may not be where the damage is located. If you have throbbing or tightness in the arm and treatment there is having no effect, ask your doctor to take a closer look at your neck before you make the drastic decision to undergo invasive surgery.

Examination and Treatment

Treating the small things before they blow up to become big problems, and certainly before they are taken to the extreme of an unnecessary surgery, should be your goal. While most patients who have been raised in today’s modern surgical orthopedics system know about joints, tendons, and ligaments—nerves and muscles are sometimes a bit foreign.

First, you need a proper exam that includes all of the muscles and nerves from the neck through the arm. In particular, this is not the 20-second “Can you feel this?” quick neurologic exam performed 95% of the time. Instead, it’s a thorough exam determining if you can feel the same amount of sensation at one site as compared to the opposite side or a different site on the same side and tracking the arm throbbing to its nerve source in the neck. With the Regenexx ProActive program, we use a simple method called the SANS approach, which looks at stability, articulation, neuromuscular status, and symmetry (you can read about this in more detail in “Regenexx ProActive Exam and Imagine” on pages 22–24 of Regenexx ProActive).

Second, ProActively treating those small issues when they begin to complain, such as the nerve in the neck causing arm throbbing and tightness, with a great physical therapy or program to improve your biomechanics like Egoscue is a great first step. If that doesn;t work, then autologous biologic injections, like platelet growth factors, in our clinical experience, can address the problem before it blows up. In the case of a throbbing arm caused by a nerve in the neck, we would likely use a precise fluoroscopic guided minimally invasive injection of the growth factors isolated from your own blood platelets. Growth factors found in platelets are the active ingredient in platelet rich plasma (PRP). It’s the growth factors that stimulate the local stem cells to wake up and do their job.

On Being ProActive

The ProActive program provides practical advice on understanding these warning signs and taking action to maintain peak performance through middle-age and beyond. You want to be able to stay as active as possible as you age, and in my experience, staying ahead of your aging joints using advanced injections may make all the difference. Regenexx ProActive explains how the use of biologic treatments, such as stem cells and blood platelet procedures, can help your joints before things go awry, ensuring that small problems don’t go from bad to worse.

The upshot? You probably pay more attention to the status updates or texts on your phone than you do to the warning signals coming from your body. Yet paying attention to your body’s warning signals may make the difference between being that 80-year-old who is active and one who can barely walk. To be ProActive, you need to catch small problems like arm throbbing before they snowball into big issues, and prevent them when possible. The first step is to try and use conservative therapies like good physical therapy or Egoscue. If that doesn’t work, then using your own platelets or stem cells may be just what you need to address the cause and quiet those warning signals. There’s nothing like that moment when the right stuff gets injected into the right spot and you finally know you’re on the mend!

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile