Pain in the left arm that comes and goes is a possible sign of a heart attack. However, other conditions, such as an injury or a pinched nerve, can also cause this type of pain.

If a person feels short of breath or has discomfort or pain in their chest or upper body, they should call 911 immediately.

In this article, we look at some of the causes of left arm pain that comes and goes, along with the symptoms and treatments.

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Although dull pain in the left arm is sometimes a sign of a heart attack, it can also indicate an injury, a pinched nerve, or carpal tunnel syndrome.

Several conditions can cause pain or discomfort in the left arm, which may sometimes come and go. These conditions include:

Heart attack

A heart attack happens when blood vessels around the heart become blocked, stopping the blood flow. Usually, this blockage is a buildup of a fatty substance in the arteries.

According to the American Heart Association (AHA), pain or discomfort in one or both of the arms is one possible warning sign of a heart attack. Other symptoms of a heart attack include:

  • shortness of breath
  • pain, squeezing, or pressure in the center of the chest
  • pressure or pain in the upper body, which may affect the back, neck, jaw, stomach, or arms
  • fatigue
  • dizziness
  • lightheadedness
  • fainting
  • nausea or vomiting
  • a cold sweat

Males and females may experience different heart attack symptoms. For instance, females are more likely to experience shortness of breath, jaw pain, back pain, nausea, or vomiting. However, the feeling of weight on the chest is common for both sexes.

If someone has these symptoms, they need to seek emergency medical help.

Rotator cuff injuries

The rotator cuff is a group of muscles and tendons in the shoulder that attach the upper arm to the shoulder blade. The rotator cuff’s purpose is to allow the arm to move freely within the shoulder joint while keeping the arm bone in place.

Although the rotator cuff is in the shoulder, it can cause pain that radiates down the arm, according to the American Academy of Orthopaedic Surgeons (AAOS). There are several types of rotator cuff injuries, including:

  • Tendinitis: This condition involves inflammation or damage to the rotator cuff tendons.
  • Bursitis: Bursitis is inflammation and swelling of the bursa, a fluid filled sac next to the rotator cuff that allows the arm to move freely.
  • Torn rotator cuff: The muscles or tendons within the rotator cuff can become damaged, causing one or more tears that can range from mild to severe.
  • Impingement: Impingement occurs when the shoulder bone rubs against the rotator cuff. The pain from this type of injury may occur when a person raises their arm above shoulder height.

Rotator cuff injuries can happen to anyone, but they are especially common in athletes who frequently raise their arms overhead, such as tennis players or swimmers. They also affect people with jobs that involve repetitive lifting, such as construction work.

The symptoms of a rotator cuff injury include pain and stiffness when lifting or lowering the arm, as well as pain that radiates from the front of the shoulder to the arm. Over time, the pain may become continuous, limiting a person’s movement.

Pinched nerve

A pinched nerve occurs when a nerve becomes compressed. The pressure causes nerve signals to misfire, resulting in pain that can radiate down the arms.

A slipped disk in the upper spine is a common cause of pinched nerves, according to the AAOS. A slipped disk occurs when a disk in the spine moves out of place or becomes swollen, putting pressure on the nerves nearby.

Other symptoms of a pinched nerve in the spine include:

  • numbness or tingling
  • pins-and-needles sensation
  • pain that feels sharp or burning and that radiates to nearby areas
  • muscle weakness

Carpal tunnel syndrome

Carpal tunnel syndrome (CTS) also occurs due to nerve compression, but only when it affects the median nerve, which runs from the forearm to the palm of the hand.

CTS causes numbness that starts in the fingers and can radiate up the arm. This condition can sometimes also cause pain and make it difficult to grip objects.

The symptoms may get worse with certain activities that require a person to bend their wrist, such as reading a book or driving.

If a person seeks emergency care for a possible heart attack, doctors will check their blood pressure and pulse first. They may then use tests to check whether the person is having a heart attack.

The AHA note that the tests may include:

  • electrocardiogram (EKG), which looks at the heart’s electrical signals
  • blood tests
  • X-rays
  • CT or MRI scans

If doctors determine that the person is not having a heart attack, they may look at the arm for signs of injury. X-rays, MRI scans, and ultrasound tests can allow them to look at the bones and tissues in the arm to check for physical injuries.

To check for CTS, doctors will ask the person to perform specific movements to see whether these trigger symptoms. They may use ultrasound to check for enlargement of the median nerve or electromyography (EMG) to measure electrical activity in the arm.

The treatment that someone needs for dull pain in the left arm depends on the cause. If doctors determine that a person is having a heart attack, they will work quickly to restore the blood flow.

The approach that doctors use for a heart attack will depend on the severity of the attack and a person’s overall health. According to the AHA, heart attack treatment may include:

  • Medications: Some medicines can help dissolve blood clots and clear the blockage.
  • Angioplasty: During this procedure, doctors insert a tube in the blocked artery and attempt to open it. In some cases, they may insert a stent, which is a mesh tube that helps prop the artery open.
  • Heart valve surgery: A surgeon removes the damaged heart valve and replaces it with an artificial valve.
  • Bypass surgery: A surgeon creates a new passage for blood to flow through to the heart, bypassing the blocked artery. In some cases, this surgery may be minimally invasive.
  • Heart transplant: Severe cases may necessitate a heart transplant, which involves replacing a person’s heart with a heart from an organ donor.

For injuries, the AAOS recommend the RICE approach, which stands for rest, ice, compression, and elevation. A person can use the RICE approach by:

  • avoiding using the arm and resting it whenever possible
  • applying an ice pack several times a day to relieve pain and swelling
  • wrapping the area with a bandage
  • elevating the arm higher than the heart to bring down swelling

The AAOS also recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, for short-term pain management, and physical therapy. Rotator cuff injuries that do not respond to these treatments may require corticosteroid injections or surgery.

Treatments for CTS include:

  • wearing a splint to keep the wrist straight
  • avoiding activities that cause symptoms
  • corticosteroid injections to reduce inflammation
  • yoga, which can improve pain and grip strength
  • surgery to relieve pressure on the median nerve

Although dull left arm pain can be due to an injury or a pinched nerve, there is a chance that it is a sign of a heart attack. A person should go to the emergency room or dial 911 right away if this is a possibility.

If the pain is mild or occurs after an injury, a person can call their doctor for advice on how to proceed.

Dull pain in the left arm that comes and goes is a potential warning sign of a heart attack. It is important that people seek emergency treatment if they have the symptoms of a heart attack.

If the arm pain results from an injury or a pinched nerve in the spine or wrist, a person may find relief by resting the arm, applying ice, and taking over-the-counter pain medication. Physical therapy and yoga may help reduce pain and improve strength in people with injuries or CTS.

However, the root cause of the pain will determine the more effective treatment. A doctor can identify the cause of arm pain and recommend the best treatments.