Pain, numbness, tingling or weakness in the arm often means involvement of a spinal nerve, though other causes must be considered. For instance, muscle spasm in the neck can sometimes cause tingling in the arm, usually toward the little finger. Nerve entrapment in the wrist (carpal tunnel) or elbow (cubital tunnel) can cause pain and numbness in the arm and hand. However, when a nerve is pinched in the neck, the pain will radiate into the arm, associated with numbness and weakness in a specific pattern.

A “pinched nerve” is usually the result of a disc herniation, also referred to as a “ruptured” or “slipped” disc. The disc lining gives way, allowing a piece of the softer center of the disc to push out against the nerve. While this can be due to an injury, more commonly the disc lining has simply become weak over time (similar to a worn tire). In about 80% of cases, the fragment of disc that has ruptured out against the nerve will be dissolved or shrunken by the body’s own healing processes, thus relieving the symptoms. For this reason, symptoms from herniated discs will be treated with medication, therapy, and traction for at least 4 to 6 weeks, with the expectation that the symptoms will probably get better. This can occur even in the face of severe, debilitating pain at the onset of the problem. If the arm symptoms persist beyond that time without improvement, then surgery may be recommended. The goal of the surgery is to remove pressure from the nerve. This can be done from the front or from the back, depending on the patient’s individual situation. This surgery is often done as an outpatient, or with an overnight hospital stay, followed by a few weeks of restricted activity and cautious exercise.

At times, X-rays and scans will show degenerative changes as well as a disc herniation. These cases can still be treated successfully without the need for surgery. However, there will be times when the pain persists. Usually this type of pain is not intense, and while there may be some numbness or tingling, muscle weakness is uncommon. Cortisone injections in the neck may help, but some of these more chronic cases will ultimately require surgery to achieve pain relief.