Pathophysiology of non-specific arm pain

Abstract

Background: Non-specific arm pain (NSAP) is a vague clinical entity which may constitute up to 53% of work related upper limb disorders. The pathophysiology of NSAP is poorly understood with hypotheses ranging from disturbance of muscle function and neuropathic arm pain to central sensitization.Objectives: The purpose of this review was to investigate the current level of evidence to support three main classifications of pain (peripheral neuropathic pain, nociceptive pain and central sensitization) in NSAP. Major findings: There is evidence in the literature to support each of the three classifications of pain; however, this evidence is weak. No one classification of pain is better supported than another. It is also likely that overlap exists between pain classifications which present in NSAP. Conclusion: Different pain classifications are likely to exist in NSAP and indeed may co-exist. In the absence of definitive support for one classification over another, clinicians should be encouraged to perform thorough pain assessments in individuals with NSAP in order to optimize clinical decision making.

Sensory Hyperalgesia is Characteristic of Nonspecific Arm Pain

“…1,2 It is defined as diffuse pain in the forearm, which can also involve the neck, upper arm, wrist, and hand, in the absence of evidence of a specific disorder. [4][5][6] Previous studies of NSAP have identified hyperalgesia in response to clinical tests of neural tissue sensitivity. [4][5][6] Previous studies of NSAP have identified hyperalgesia in response to clinical tests of neural tissue sensitivity.…”

Barriers and facilitators to engaging with a digital self‐management programme for painful distal upper limb musculoskeletal disorders: A qualitative exploratory study

“…Some people also experience pain in the forearm that is undiagnosed and is described as having ‘non‐specific arm pain’, previously known as repetitive strain injury. 2 The prevalence of DUL‐MSDs varies with the specific disorder, with hand OA affecting 27% of the population, 3 carpal tunnel syndrome affecting between 1% and 16% 4 , 5 and tenosynovitis and epicondylitis affecting between 1% and 3%. 6 , 7 MSDs account for 21% of years living with a disability, a measure that considers the prevalence of the disease and how disabling the disease is.…”

“…Common DUL‐MSDs include hand and thumb osteoarthritis (OA), epicondylitis, tenosynovitis and carpal tunnel syndrome. Some people also experience pain in the forearm that is undiagnosed and is described as having ‘non‐specific arm pain’, previously known as repetitive strain injury 2 . The prevalence of DUL‐MSDs varies with the specific disorder, with hand OA affecting 27% of the population, 3 carpal tunnel syndrome affecting between 1% and 16% 4,5 and tenosynovitis and epicondylitis affecting between 1% and 3% 6,7 .…”

Current synopsis of assessment and management of shoulder disorders

“…Various classifications of these exist, such as nociceptive pain, peripheral neuropathic pain and central sensitisation. Moloney et al 6 provide a review of the evidence for these mechanisms for patient presenting with non-specific arm pain. It is often seen in clinical practice that patients present with symptom patterns indicating central sensitization, in addition to more defined nociceptive pain.…”