What is causing my upper limb pain?

Finding out what's wrong

Upper limb problems are incredibly common. Symptoms can include aches, pains, tension, tingling, numbness, tenderness and swelling in any part of the arm from the fingers to the wrist and elbow up to the shoulder and neck. Common causes include work-related repetitive movements, sports injuries and degenerative changes due to arthritis.

The pain and discomfort from upper limb problems can result in time off work and be very debilitating, so prompt investigation, diagnosis and treatment is crucial. Ultrasound scans can be very useful for investigating upper limb pain. A sonographer with specific expertise in musculoskeletal problems performs these scans.

Shoulder problems

Common causes of shoulder problems include:

Frozen shoulder

Up to one in 20 people in the UK are estimated to have a frozen shoulder at some point in their lifetime. The medical name for this is adhesive capsulitis. It leads to pain and increasing stiffness of the shoulder and it happens when the capsule of flexible tissue that surrounds the shoulder becomes inflamed and thickened. It usually gets better on its own taking on average between 18 months and two years, but sometimes longer. Usual treatment includes painkillers and physiotherapy.

Rotator cuff tendonitis

Rotator cuff problems are one of the most common causes of shoulder pain. The rotator cuff is a group of four interlocking muscles that surround the shoulder joint. One of the most painful causes of rotator cuff tendonitis is calcific tendonitis, where calcium deposits build up in the rotator cuff and cause pressure on the tendon. Symptoms include pain in or around the shoulder and pain when moving the shoulder. Treatment options include painkillers, icepacks, physiotherapy, steroid injections and surgery for tears.

Elbow problems

Common causes of elbow problems include:

Tennis elbow

This is a condition that affects the tendon on the outside of the elbow. The medical name for it is lateral epicondylitis. The tendon becomes inflamed and painful and there may be some mild swelling. As the name suggests it can occur when playing tennis, but it's more common with everyday activities that require repetitive gripping and twisting movements such as painting, or a sudden strain caused by lifting. The pain is felt on the bony outer side of the elbow and often worse with wrist or elbow movements. Pain can be relieved by avoiding repetitive movement, applying heat or ice packs, taking non steroidal anti inflammatory drugs (NSAIDs) or applying NSAID gels and physiotherapy. In most cases it will clear up within a few weeks, but some cases of tennis elbow may persist and you may need surgery to relieve the tendon.


Bursae are fluid-filled sacs which act as cushions and prevent friction between tendons, ligaments and bones. Sometimes they can become red, swollen, inflamed and painful. Bursae in the knee are most commonly affected (a condition called Housemaid's Knee), but there are also 150 other bursae sites in the body including in the elbow and shoulder joints. They can develop as a result of repetitive movements such as playing darts or as a result of an infection or a complication of gout or rheumatoid arthritis. Pain usually disappears within weeks and can be managed with rest and NSAIDs. Sometimes though a steroid injection is needed to reduce the inflammation or even surgery. If a bursa becomes infected it may have to be treated with antibiotics and drained.

Wrist and hand pain

Common causes of wrist and hand pain include:

Carpal tunnel syndrome

This is the medical name for tingling and pain in the hand due to nerve compression. The carpal tunnel is a narrow space in the wrist enclosed by bones and a fibrous band. The median nerve, which carries sensory information from areas of the hand to the brain and controls specific muscles in the hand, runs through the carpal tunnel space and carpal tunnel syndrome symptoms begin when the median nerve is compressed. The symptoms include weakness in the hand, impaired hand function and altered sensation. The tingling and pain tend to be worse at night. Treatment options include steroid injections, supportive wrist splints and carpal tunnel release surgery to release the pressure on the median nerve.

Osteoarthritis of the hand

This usually affects the base of the thumb and joints at the end of your fingers, although other finger joints can also be affected. Symptoms include swelling and tenderness and gradually over the years the finger joints become hard and knobbly. Treatments include NSAIDs painkillers, stronger painkillers, capsaicin cream (derived from peppers), steroid injections, TENs machines and surgery.

Finding out what's wrong

Ultrasound Direct offers an Elbow and Forearm Scan, Shoulder and Upper Arm Scan and Wrist and Hand Scan. These scans use ultrasound to get a detailed picture of the area and identify any abnormalities that could be causing your pain. Ultrasound is a dynamic tool, which means that a sonographer can scan while you are moving the body part. The sonographer can also compare the painful area to the other limb to perform a full diagnostic check.

Ultrasound Direct provides a comprehensive diagnostic scan report that you can show to your healthcare provider and decide on the best treatment for you.