Arm pain when I cough

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People often ask if I’ve suffered from the same problems that I treat. Fortunately I have been quite lucky, suffering only from short episodes of nasty back pain and the usual minor aches and pains everyone has.

For the last week I have had a very bad cough. By the end of the week, the cough had started to give me sharp shooting pain in my arm each time I coughed. The pain was into my right arm just inside the triceps muscle.

This was an interesting experience for me as I have never before had anything like that. A quarter of my patients come with a similar condition. I found myself driving home and behaving just like any one of my patients, immediately considering the worst possible case.

In the 30 minute drive I had gone through the cancers, blood clots, disc prolapses and nasty neurological problems.

Fortunately common things are common and rational thought prevailed.

I had no pain in my neck or on neck movement, which rather excluded any disc injury. I had no loss in power or sensation in the arm, my pulses were good and the pain only came when I coughed.

I had a good poke around in my neck and shoulder and found a very severe pain on pressing on the joint between the very bottom of my neck and the top of my back at the C7 – T1 vertebrae and particularly over the first rib on the right hand side. Pressing on that gave me a vague sense of the pain in my arm.

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Most likely the pain in my arm was caused by the rib and neck strain. The nerve that supplies that part of the arm is the Medial Brachial Cutaneous nerve (the yellowish-brown bit on the diagram). This joins the spine at exactly the same point as my neck tenderness. So the nerve was probably getting irritated by the coughing and the stuck rib. I was able to take this information to an osteopath colleague who examined and diagnose the fact that I had strained the 1st rib through coughing. With some very simple osteopathic treatment and simple manipulation of the C7 – T1 and some deep muscle work they were able to “switch off the pain”.

So what began as a life changing worry was quickly sorted out. As an osteopath I know it was a fairly simple fix for my colleague. But as a patient I feel deeply relieved and very grateful for the expert attention.

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