Causes of armpit pain and treatment options

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There are many possible causes of armpit or armpit pain (medically called armpit pain), which can range from unpleasant to severe. Deodorant irritation, sweat gland infections, injury, nerve compression, or even cancer are just a few of the options. The pain can occur on its own or be associated with a rash, swollen lymph nodes, or other signs.

Diagnosis often begins with a complete medical history and physical exam, but blood tests and imaging tests may be needed to determine the cause and choose the best treatment. Even when armpit pain is accompanied by swollen lymph nodes in the armpit, advanced breast cancer is not the most common cause .

Illustration by Alexandra Gordon, Get Meds Info

Anatomy and structure of the armpit

Before discussing the possible causes of armpit pain and what your doctor might recommend to relieve it, it helps to think about the anatomy of the armpit (armpit) and what structures "live" in it.

Structures and tissues found in the armpit include:

  • Muscles: Closer to the back of the armpit are the large round muscle and the latissimus dorsi muscle . The pectoralis major muscle enters this area from the chest. Coracobrachialis runs centrally through the armpit and the muscles of the arms, including the deltoid, the long head of the triceps, and the biceps, are close.
  • Blood vessels: both veins and arteries run through this region.
  • Nerves: The brachial plexus is located just above the armpit, and the median, ulnar, radial, and musculocutaneous nerves pass through this area.
  • Sweat Glands: The armpit houses many sweat glands that are responsible for the general odor of the armpits and frequent infections in this area.
  • Lymph nodes: Each armpit contains approximately 20 to 40 axillary lymph nodes . These lymph nodes, in turn, receive drainage from the lymphatic vessels in the arm, chest, and part of the neck, chest, and upper abdomen.
  • Bones: Below the armpit are the upper ribs, and just above the armpit is the head of the humerus (upper arm bone) where it connects to the scapula (scapula).
  • Skin – There are a number of skin conditions that can affect different layers of the skin . Within these layers are hair follicles, sweat glands, fat, connective tissue, and more.

The armpit is very warm compared to many parts of the body (one reason the temperature was often measured in the armpit in the past), which, combined with the overlapping of tissues when the arms hang from the body, makes this a place where infections can thrive.

Causes of armpit pain

There are several different causes of armpit pain. Pain can be caused directly, but conditions that affect structures in and around the armpit can be attributed to pain (pain that occurs elsewhere in the body where it is felt) from more distant areas. Some causes can only cause pain in one armpit, while others (such as enlarged lymph nodes due to a viral infection) can cause pain on both sides .

Muscle tension

The underarm muscles are subject to excessive muscle strain and tension, especially during activities such as lifting, pulling, throwing, or pushing. Activities like lifting weights and playing sports (like baseball) can cause strains and sprains .

Local pressure on the muscles and other structures in the armpit, such as when using crutches, can also cause severe pain in the armpit.

Trauma

There are several ways to injure the structures of the armpit and cause pain. The network of nerves above the shoulder forms the brachial plexus. Brachial plexus injuries can occur when the arm is extended or flexed and can lead to armpit pain and loss of shoulder mobility, weakness, numbness, or tingling in the arm or arm. Other injuries to this area, including a dislocated shoulder, can cause armpit pain .

Skin irritation and rash

The skin in the armpit can become irritated and painful. Tight clothing and rough fabrics can cause irritation. Irritation is also common when shaving. Additionally, irritant and allergic contact dermatitis can be caused by deodorants, soaps, lotions, laundry detergents, and more .

Other non-infectious rashes that can occur in the armpit (and cause discomfort) include acanthosis nigricans, a velvety rash often found in people with diabetes or obesity, and psoriasis .

Hidradenitis suppurativa is a chronic condition that affects the sweat glands (usually in the armpit or groin), similar to severe acne. Treatment options can range from acne medications to antibiotics, immunomodulators, and sometimes surgery. Without treatment, boils (see below) and fistulas can form between the infection and the surface of the skin .

Infections

Both local and systemic (throughout the body) infections can cause armpit pain. Some of them cause local swelling, while others affect the lymph nodes in the armpit, causing pain.

Yeast infections, including yeast infections ( yeast infections), are common. Intertrigo usually causes a very red, bright, and scaly rash where the skin touches, such as the armpits. Ringworm (tinea corporis) can occur anywhere on the body and often causes an itchy rash with red bumps in a circle.

Some common bacterial skin infections can cause armpit pain, often accompanied by redness or swelling. Erythrasma begins with a pink rash that turns brown and scaly and is usually found in the armpit. Erythrasma, which is often mistaken for a fungal infection, is caused by a bacteria known as Corynebacterium minutissimum . It is often associated with humidity and diabetes. Other infections such as cellulitis, folliculitis, boils (boils), and carbuncles can occur. If the boil is not treated, it can turn into an abscess .

Some generalized infections can cause swollen lymph nodes in the armpit (see below), resulting in pain.

Enlarged axillary lymph nodes

Armpit pain may be accompanied by swollen lymph nodes, although there may be no obvious lumps or swelling in the early stages. Lymph nodes in the armpit (armpit) can become enlarged for a variety of reasons, with some more common causes being enlarged on one side (unilateral axillary lymphadenopathy) and others with both armpits. Possible causes of enlarged axillary lymph nodes include:

  • Infections: Viral infections such as infectious mononucleosis and HIV, bacterial infections such as cat scratch disease, syphilis, tuberculosis, and parasitic diseases such as toxoplasmosis can lead to enlarged and painful axillary nodes (lymphadenitis). Infections of the breast (mastitis), hand, arm, neck, part of the chest, and upper abdomen can also drain the lymph nodes in the armpit and cause pain and swelling .
  • Autoimmune disease: Conditions like rheumatoid arthritis and lupus can lead to enlarged painful lymph nodes in the armpit .
  • Cancer: There are several cancers that can spread to the axillary lymph nodes. Lymphomas (such as Hodgkin lymphoma ) can develop in these lymph nodes. Although many people are familiar with the spread of breast cancer as a cause of lymph node metastases, almost any cancer can spread to these nodes, including lung cancer and melanoma. In some cases, an enlarged and painful lymph node in one armpit may be the first sign of cancer .

Enlarged lymph nodes associated with infection are usually tender, soft, and mobile, compared to cancer lymph nodes, which are often not painful, fixed, and tight, but there are many exceptions.

Nerve compression

Compression of any of the nerves in the armpit ( pinched nerves ) can cause armpit pain, which is often burning. It may be accompanied by tingling or numbness in the hand or arm, or weakness. Compression of a nerve can be caused by injury or pressure on the nerves as a result of swelling or swelling. One type of lung cancer, Pancost tumor, can cause pain in the armpit. It can be due to swelling of the face, neck, or shoulders and is easily missed on a chest X-ray .

Herpes

Shingles is a condition that occurs when chickenpox reactivates in the nerve root where it persists. Over time, the rash usually develops along the area supplied by the nerve (dermatome), but is usually only sore at first.

Benign formations

In addition to cancerous (malignant) tumors, there are several benign tumors and conditions that can cause armpit pain. These can be cysts, lipomas, and fibroadenomas .

Lymphedema

Lymphedema is a condition in which the normal flow of lymph is disturbed, often associated with breast cancer surgery. This can lead to severe pain in the armpits, often accompanied by swelling in one arm .

Acid reflux

Acid reflux can sometimes cause pain that is only felt in the armpit.

Heart disease

We usually think of chest pain when we think of heart disease , but symptoms of coronary heart disease, especially heart disease in women, can be very nonspecific and vague and may only include symptoms of armpit pain. The pain is usually dull and aching and may be accompanied by back or jaw discomfort, nausea, and a general feeling that something is wrong .

Peripheral Artery Disease (PAD)

Just as narrowing of the blood vessels in the heart can cause chest pain and heart attacks, narrowing of the main blood vessels supplying the arm ( peripheral artery disease ) can cause pain that is felt in the armpit.

Pain associated with the menstrual period.

Many women experience breast tenderness just before and during menstruation, which can radiate into the armpit, but some may only experience this discomfort in the armpit.

When to contact a healthcare provider

The decision about when to see a doctor will depend on the severity of your pain, whether you restrict your daily activities, the symptoms associated with it, and more.

Seek immediate help if armpit pain is accompanied by chest pain, shortness of breath, tingling in the hands or fingers, nausea, and vomiting. It is also important to seek immediate medical attention if you have signs of infection such as fever and chills, redness, or drainage. Symptoms of night sweats, chest tightness, or unintentional weight loss are also reasons to schedule an appointment right away.

If your symptoms are mild but persist, make an appointment with your doctor. Pain is our body's way of telling us that something is wrong.

Questions Your PCP Asks

Your healthcare provider may ask you a series of questions to help determine the source of your pain. They may include:

  • Quality of pain: sharp or dull and painful, is it tingling, burning, or stinging in nature?
  • Duration: when did the pain start? Is it persistent or intermittent? It is getting worse?
  • Intensity: How severe is the pain on a scale of 1 to 10, where 1 is almost painless and 10 is the worst pain you can imagine?
  • What other symptoms do you have? For example, fever or chills, night sweats, pain elsewhere, or swollen lymph nodes elsewhere?
  • Have you had a rash, redness, or noticed any other changes in your armpit?
  • Have you had scratches or cuts on your arm or arm?
  • Have you started any new sports or activities?
  • Have you had any injuries lately?
  • Have you used new deodorants, lotions, bath soaps, or laundry detergents?
  • If you are a woman, when was the last time you had a mammogram? Do you have a family history of breast cancer? Did you notice lumps in your breasts during the exam?
  • How much does pain interfere with your daily life?

Diagnostics

To properly diagnose armpit pain and make sure you're not missing anything subtle, it's important to see your doctor. They will study history thoroughly and ask many of the questions above. They will then conduct a medical exam. This will include looking for redness, a rash, lumps, or enlarged lymph nodes in the armpit.

They will also examine areas around the armpit, such as the head and neck, arms, and chest, perform neurological exams to rule out nerve compression, and perform a complete breast exam (even if you are male, as men can). have breast cancer). More tests can be done depending on what they find.

Laboratories and tests

If you have signs of infection (a localized infection or a whole-body infection that can cause swollen lymph nodes), you may need a complete blood count.

Display

Visual tests may also be necessary. These may include ultrasound, CT scan, MRI, or PET scan if you have a history of cancer. A mammogram (or breast MRI if you have a serious family history of breast cancer or very tight breasts) may also be recommended .

Procedures

Imaging studies can suggest possible diagnoses, but if cancer is suspected, a biopsy is needed to make an accurate diagnosis. If you have a large boil or abscess, you may need an incision and a drain. Additionally, seeking immediate medical attention for many of the above causes can reduce the risk of complications or worsening of the condition.

Watch out

Treatment for armpit pain will depend on the underlying cause.

If your pain is caused by a muscle strain, ice, rest, and light movements may be recommended. If your armpit is irritated, you will be advised to avoid whatever is causing the problem. If the lymph nodes are swollen from a benign cause, warm compresses may be recommended .

Regardless of the reason, wearing loose clothing and avoiding shaving or using lotions, creams, or deodorants in the underarm area can help relieve pain.

Prophylaxis

Many causes of armpit pain cannot be prevented, but some can. Be careful with personal care products to reduce the risk of irritation. It is also advisable to warm up properly before playing sports and avoid undue stress on the arm and shoulder.

Frequently asked questions

What can cause armpit pain while breastfeeding?

Breast swelling and mastitis are two reasons why you may feel pain in your armpit while breastfeeding. A full breast fills with milk and pressure and discomfort can be felt in the armpits. Mastitis is an infection caused by a blocked milk duct that often begins with engorgement and can cause swollen lymph nodes in that area and cause pain, including in the armpit.

Can the muscles in and around the armpit be stretched to avoid injury?

Yes! Before exercising, you can do some stretches to avoid injury. Stretching the armpits can also reduce pain and soreness. According to the American Board of Exercise, the underarm muscles to stretch are the latissimus dorsi and triceps.

Get the word of drug information

There are many potential causes of armpit pain, and while many people think of breast cancer, especially if there is an enlarged lymph node, the most common causes are muscle sprains or irritation associated with deodorants and other foods. However, armpit pain can sometimes be a sign of something more serious, and it's important to see your doctor for an accurate diagnosis and treatment recommendations.

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