144 FAMILY ILLNESS
 Arm or hand pain
 If you have joint pain, see p. 146 Pain in the arm or hand is often caused by injury or a problem in the neck or shoulder. Rarely, pain in the arm is due to a heart attack or a serious neck disorder. Consult your doctor if the pain is severe, recurrent, or persistent.
 ACTION
 MAKE AN APPOINTMENT TO SEE YOUR DOCTOR You may have repetitive strain injury.
 • Take an analgesic such as acetaminophen.
 START
 Did the pain start during or soon after either of the following?
 An injury or fall
 Repetitive arm or hand movements
 Neither
 ACTION
 CALL YOUR DOCTOR NOW if you are in severe pain. You may have either fractured a bone or damaged a muscle.
 • Follow the first-aid advice for a broken arm( p. 44).
 TRY SELF-HELP MEASURES if not in severe pain.
 • Follow the first-aid advice for sprains and strains( p. 47).
 ACTION
 MAKE AN APPOINTMENT
 TO SEE YOUR DOCTOR You may have a compressed nerve in the wrist( carpal tunnel syndrome).
 Is the pain associated with any of the following?
 Chest tightness
 Shortness of breath
 Nausea, sweating, or feeling faint
 None of the above
 What are the features of the pain?
 Localized in upper arms or shoulders
 Extends from the wrist into the palm and lower arm
 Shoots down the length of the arm
 None of the above
 ACTION
 DIAL 911 OR CALL EMS
! You may be having a heart attack.
 • While waiting, chew half an aspirin, unless you are allergic to it.
 ACTION
 MAKE AN APPOINTMENT TO SEE YOUR DOCTOR You may have inflammation of a tendon or polymyalgia, in which muscles become inflamed, particularly if you are over 60 years old.
 ACTION
 SEE YOUR DOCTOR
 WITHIN 24 HOURS You may have a pinched nerve in your neck.
 ACTION
 MAKE AN APPOINTMENT
 TO SEE YOUR DOCTOR if you cannot identify a possible cause for your arm or hand pain from this chart.