Home › Blog › Why Is My Arm Throbbing?

In this article:

• What’s causing the throbbing or pulsing
• The referred-pain phenomenon
• Examination and treatment

Does your arm feel tight? Do you sometimes see pulsations or little areas that jump around randomly? Although you might think that you have a muscle twitch, it’s most likely caused by the nerves in your neck. When those nerves are irritated, it can present in the arm muscles. To understand why this happens, you first have to 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 to come.

Over time, issues with your neck can cause arm problems, such as 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.

Neck Nerves and Arm Throbbing

The muscles attach to the bones they move by a tendon. The muscles are signaled to move by nerves. When the nerves aren’t happy, the muscles malfunction ever so slightly. Parts of the muscles shut down, developing trigger points. These areas are tight bands of muscle that don’t contract and relax like normal healthy muscle. This causes too much pulling on the areas where the tendons attach, eventually resulting in tendinitis.

So how does a nerve in the neck impact a muscle or tendon all the way down the line and cause arm throbbing?

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. Referred pain basically means that the pain you feel in one part of your body originated in another part of your body and may be perceived as worse than the origin of the pain. For example, problems in the neck can refer pain all the way down to the hip.

For example, in our experience, a chronic tennis elbow that won’t easily respond to treatment may be an indication of a pinched nerve in the neck. The C6-C7 nerves in the neck supply these forearm muscles and can malfunction in small areas when these nerves are irritated. So what may feel like an elbow problem could be a warning signal from the neck.

The Referred-Pain Phenomenon

The referred-pain phenomenon, regrettably, has launched many unnecessary surgeries over 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 physical therapy, there is still no need for surgery for tennis elbow (1), as research (and our experience) has shown platelet-rich plasma (PRP) to be an effective elbow treatment for most patients (2, 3).

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 directed at the area 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

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. This is not the quick “Can you feel this?” neurologic exam that’s performed 95% of the time.

Instead, it’s a thorough exam to determine 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. Regenexx physicians use a method called the SANS approach, which looks at stability, articulation, neuromuscular status, and symmetry.

Second, proactively treating those small issues (such as the nerve in the neck causing arm throbbing and tightness) when you first notice them with physical therapy or a program to improve your biomechanics 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.

Being Proactive

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 the 80-year-old who is active or one who can barely walk.

Here’s a guide to help you stay proactive and catch small problems like arm throbbing before they snowball into big issues:

ProActive The regenerative orthopedics program designed to ensure peak performance well beyond middle-age.

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References

(1) Kroslak M, Murrell GAC. Surgical Treatment of Lateral Epicondylitis: A Prospective, Randomized, Double-Blinded, Placebo-Controlled Clinical Trial. Am J Sports Med. 2018 Apr;46(5):1106-1113. doi:10.1177/0363546517753385

(2) Gupta PK PRP versus steroids in a deadlock for efficacy: long-term stability versus short-term intensity-results from a randomised trial. Musculoskelet Surg. 2019 Aug 26. doi:10.1007/s12306-019-00619-w

(3) Barnett J, Bernacki MN, Kainer JL, Smith HN, Zaharoff AM, Subramanian SK. The effects of regenerative injection therapy compared to corticosteroids for the treatment of lateral Epicondylitis: a systematic review and meta-analysis. Arch Physiother. 2019;9:12. doi:10.1186/s40945-019-0063-6 

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