Shoulder and arm mobility can be impeded by injury, disease, or even aging. The shoulder is the most injury-prone joint, due to its extreme mobility and complexity relative to your other joints. No other joint offers freedom of movement to the same degree as the shoulder, but as a result, it is more likely to struggle with nerve impingement or swelling.
Are you struggling to keep your arms raised? Losing freedom of movement can feel frustrating and worrisome. Is it a sign of muscle weakness? A nerve issue? Aging? Or something entirely different? The importance of arm muscles in maintaining mobility and preventing issues cannot be overstated. Pinpointing the cause is the first step toward effective relief.
In this guide, we’ll explore the differences between musculoskeletal and neurological issues, the signs of each, and common causes of arm and shoulder weakness. We’ll also provide tips to improve strength and mobility at home while highlighting when it’s crucial to see a healthcare professional.
Understanding Muscle Weakness and Nerve Issues
What Is Muscle Weakness?
Muscle weakness occurs when your muscles cannot generate normal levels of strength. The deltoid muscles, located in the upper arm, play a crucial role in arm movement and should be stretched to relieve muscle tightness and pain in the surrounding areas. Stretching is important to alleviate muscle tightness caused by repetitive motions in daily activities, helping to maintain mobility and prevent stiffness in the upper body. This can happen due to injuries, fatigue, or underlying conditions that affect the muscles directly. Sarcopenia, or the age-related loss of muscle and strength, can make certain movements such as raising your arms over your head more difficult later in life.
Muscle weakness is often neurological, but to help distinguish muscle weakness from nerve issues, it’s important to know that myopathies (muscle disorders) can also cause sudden loss of strength. Such causes of muscle weakness include hereditary muscle disorders or severe endocrine conditions such as rhabdomyolysis.
What Are Nerve Issues?
Nerve issues occur when the communication between your brain, spinal cord, and muscles is disrupted. This can lead to weakness, numbness, or even paralysis in the affected areas, and can be a common cause of sudden and inexplicable weakness in the arm or shoulder, especially when coupled with numbness, tingling, and/or radiating pain.
Differences Between Muscle Weakness and Nerve Issues
Symptoms of Muscle Weakness
- Inability to exert force, loss of strength
- Muscle fatigue after minimal exertion
- Localized pain or tenderness in muscles
- Significant loss of muscle mass (wasting)
Symptoms of Nerve Issues
- Numbness or tingling (paresthesia)
- Partial paralysis
- Loss of coordination
- Radiating pain or a “pins and needles” sensation
Overlap and Complexity
Nerve problems can cause muscle weakness indirectly. For instance, a compressed nerve might reduce the signals reaching your muscles, leading to both a loss of strength and altered sensation. Many instances of sudden muscle weakness tend to be neurological, including spinal nerve root, brain, or motor neuron problems. Tight muscles can also contribute to both muscle and nerve issues, exacerbating the problem. Physical therapists play a crucial role in guiding individuals through effective stretches to prevent and relieve muscle tightness and pain.
Meanwhile, certain conditions that may also affect the nervous system can attack the muscles themselves, including viral or alcoholic myopathy, burns, or cancers.
Not all cases of mobility loss are caused by illness or severe musculoskeletal or nerve-related problems. Lack of adequate exercise can also cause a loss of mobility, especially in overhead movement. Tight shoulder muscles can restrict movement and cause pain, particularly when stretching arms overhead.
As we age, our body is less likely to preserve our muscle mass without considerable activity, and as our activity levels drop, our muscles are more likely to atrophy. Frequent movement – including overhead movement, through low-impact exercises such as swimming, Tai Chi, or yoga – can greatly improve overhead strength and mobility even at an advanced age.
But aging alone isn’t always at fault for muscle weakness.
How Nerve Impingement Can Mimic Muscle Weakness
The Role of Nerves in Muscle Function
Nerves control muscle movement. When a nerve is pinched or damaged, such as in cases of herniated discs or spinal stenosis, the affected muscles may feel weak or unresponsive. Learning to identify signs of a herniated or impinged nerve can help distinguish between a nerve problem and other conditions.
Common Examples of Nerve Impingement
- Cervical Radiculopathy: Compression of a nerve in the neck that causes weakness, pain, and numbness down the arms.
- Thoracic Outlet Syndrome: Pressure on nerves and blood vessels between the collarbone and first rib, leading to arm fatigue and weakness.
Signs to Help Identify the Cause of Arm Weakness
Simple Tests for Muscle Weakness
- Difficulty lifting or holding objects steadily
- Muscle cramps or twitching
- Noticeable loss of muscle mass (atrophy)
Signs of Neurological Issues
- Burning or shooting pain radiating from the spine
- Inability to detect changes in temperature or touch
- Inconsistent strength levels that vary day-to-day
Common Causes of Shoulder Pain and Difficulty Holding Your Arms Up
Musculoskeletal Causes Including Rotator Cuff Issues
- Rotator Cuff Injuries: Tears or strains in the shoulder muscles can limit arm mobility. A torn or strained muscle or tendon swells, and the pain can make certain movements prohibitively uncomfortable.
- Frozen Shoulder: Also known as adhesive capsulitis, this condition results in stiffness and severe pain in the shoulder joint. Physical rehabilitation may be necessary to help overcome this condition. Poor posture can exacerbate tightness in the shoulder and arm muscles, leading to irritation and pain in the neck and down the arm. Maintaining good posture is crucial to prevent these issues and ensure overall functional movement.
- Arthritis: Joint inflammation can reduce the range of motion and cause pain during arm lifting.
Neurological Causes
- Thoracic Spinal Issues: Problems in the middle spine can impact nerves that control upper-body strength. This can result in pain, tingling, and loss of strength throughout one arm specifically.
- Pinched Nerves: Compression in the neck or upper back can lead to arm weakness.
- Peripheral Neuropathy: Often caused by diabetes, alcohol, or infections, this affects nerves outside the brain and spinal cord by destroying nerve cells in the arms and legs.
Improving Strength and Mobility, Managing Pain
Gentle Stretches and Exercises to Loosen Tight Shoulder Muscles
- Wall Angels: Stand against a wall and slowly raise and lower your arms, keeping them as close to the wall as possible to improve shoulder mobility and rotator cuff strength. Stretching the arms overhead is crucial for enhancing shoulder flexibility and preventing tightness. Allowing the muscles to glide smoothly during overhead activities is essential for optimal shoulder function.
- Shoulder Rolls: Gently roll your shoulders forward and backward to release tension and improve flexibility.
- Resistance Band Workouts: Incorporate resistance bands for light strengthening exercises, focusing on arm and shoulder muscles to loosen tight muscles and improve range of motion.
- Swimming: Swimming can be easier on the joints than resistance band training or weightlifting while encouraging full use of the arms and shoulders, and the development of stronger supportive back muscles. Using a door frame for stretches, such as the Doorway Stretch, can effectively target the pectoral muscles and improve the range of motion.
Maintain Good Posture
Correct posture can reduce strain on your muscles and nerves, particularly if you sit or work at a desk for long periods. Use ergonomic supports, if necessary, especially during acute phases of pain after an injury or flare-up. Repetitive motions, such as typing or gardening, can lead to muscle tightness and pain in the arms, making stretching essential to alleviate discomfort and maintain mobility.
Warm Compresses and Massage
Warm compresses and gentle massage can alleviate stiffness and improve blood flow, helping reduce discomfort and promote mobility. Avoid cold compresses or ice baths, especially right after an injury or onset of pain.
When to See a Physical Therapist or Healthcare Professional
It’s crucially important to contact a doctor if:
- Weakness or pain persists or worsens despite at-home efforts.
- You experience sudden or severe weakness, numbness, or difficulty breathing.
- Issues with the left arm, especially after an injury, should be addressed promptly, and professional advice for rehabilitation and strength training is essential.
- The symptoms are accompanied by chest pain or trauma to the area.
Conclusion
Difficulty holding your arms up can stem from various causes, including muscle weakness, nerve problems, or a combination of both. While there are simple strategies to improve strength and mobility at home, persistent or severe issues should always be evaluated by a healthcare professional. Identifying the root issue requires careful observation of symptoms and often professional evaluation. Whether the cause is musculoskeletal, neurological, or something else, the good news is that treatments are available to restore strength and mobility.
Take the First Step Towards Pain-Free Living Today
