Armpit pain

Pain in the armpit indicates pathology of the skin, lymph nodes, hair follicles, sebaceous glands, other nearby soft tissue structures, distant organs. They can be blunt, acute, permanent, periodic, prolonged, short-term, intense, insignificant. To clarify the cause of pain, a survey, an objective examination, instrumental and laboratory tests are conducted. Treatment is recommended to begin after diagnosis.

Causes of armpit pain
Injuries
Pyoderma
Insect and leech bites
Inflammatory diseases of lymph nodes
Tumors and tumor-like formations
Breast diseases
Cosmetic problems
Other reasons
Diagnostics
Treatment
Assistance at the pre-hospital stage
Conservative therapy
Surgical treatment
Prices for treatment
Causes of armpit pain
Injuries
Pain in the armpit of traumatic origin may occur due to stretching or tearing of ligaments during a fall, a sharp jerk by the arm. They are manifested by moderate pain, which increases with movements. The pain is not very deep, localized within the soft tissues, gradually decreases and disappears over several days or weeks. The axillary area is slightly or moderately swollen, sometimes bruises are detected.

In some cases, the cause of pain is a bruise due to a direct blow to the axillary region. The pain at the moment of injury is sharp, then dull, gradually fading. Local edema is found in the area of the injury, sometimes hematomas, subcutaneous hemorrhages. The function of the limb is preserved or slightly limited.

In athletes, especially beginners engaged in bodybuilding, pain in the armpits often occurs against the background of excessive load on previously inactive muscles. The pain is symmetrical, aching, pulling, sharply increasing with muscle tension. They appear the next day after training, disappear within a few days.

Pyoderma
Due to excessive sweating, unfavorable conditions for self-cleansing of the skin of the armpits, superficial and deep pyoderma often develop in this area. With superficial pyoderma, itching is first noted, then burning, stinging, bursting pains are added to it, increasing with movements, pressure on the affected area, tissue friction. A pustular rash is detected on the skin.

The most common variant of deep pyoderma in this anatomical zone is hydradenitis. At first, slight soreness appears in the armpit, small dense nodules form. The nodules quickly increase, acquire a blue hue. The pains increase, become intense, twitching, bursting, pulsating, remain at rest, accompanied by a violation of the general condition.

With a boil, pains occur simultaneously with the formation of a dense focus of crimson color, quickly intensify, acquire a bursting, twitching, pulsating character, deprive of night sleep. The armpit is edematous, the skin around the hearth is hot, hyperemic. After the opening of the boil and the discharge of pus with a necrotic rod, the pain syndrome quickly subsides. With carbuncle, the clinical picture is the same as with a boil, but all the symptoms are more pronounced, with deep folliculitis, the symptoms, on the contrary, are smoothed out.

Armpit pain
Insect and leech bites
In late spring, early summer in endemic areas, armpit pain after being outdoors may be associated with a tick bite, for which the delicate skin of the armpit area is one of the favorite areas. At the time of the bite, there are no unpleasant sensations, subsequently, a pinpoint stabbing pain, a burning sensation appears in the area of the lesion. The skin around the bite turns red, swells. A tick filled with blood is found in the center of the affected area.

Inflammatory diseases of lymph nodes
Nonspecific acute lymphadenitis of the axillary lymph nodes is provoked by osteomyelitis of the shoulder and forearm bones, purulent wounds, carbuncle, abscess, phlegmon of the upper limb, chest. It is manifested by an increase and soreness of the lymph nodes. With suppuration, the pain increases, becomes twitching, weakness, fever is noted.

The spread of infection to the surrounding tissues is accompanied by the development of adenophlegmon. The condition worsens even more, the pain intensifies, deprives sleep. A dense tumor with a fluctuation site is found in the axillary region. With the transition of nonspecific lymphadenitis to a chronic form, the general symptoms disappear, the soreness of the lymph nodes decreases, the nodes remain enlarged, thicken. A prolonged course can potentiate the degeneration of lymphoid tissue into connective tissue with the development of lymphostasis.

Tuberculous lymphadenitis is diagnosed with osteoarticular tuberculosis of the upper limb and tuberculosis of the mammary gland, proceeds with the formation of conglomerates, diffuse pain caused by the involvement of surrounding tissues, intoxication, hyperthermia. Lymphadenitis in actinomycosis is accompanied by a lesion of the breast or upper limb, the formation of fistulas.

Tumors and tumor-like formations
The cause of pain in the axillary area may be an atheroma (cyst of the sebaceous gland). By themselves, atheromas are painless, but when located in this anatomical zone, the formation is often injured, which causes the appearance of pain during movements and pressure of clothing. Cysts are rounded, soft, easily displaced formations up to several centimeters in size. When palpation occurs in cases of permanent mechanical irritation, soreness can be determined.

Minor pains, itching, unpleasant sensations are sometimes observed with benign tumors of the sweat glands, usually – syringoadenomas and eccrine spiradenomas. Neoplasia are dense nodules with slow growth. Axillary lymph nodes are often affected by blood diseases and metastasis of malignant neoplasms, but soreness is usually absent or insignificant, the exception is advanced cases with the development of necrosis.

Breast diseases
Pain due to irradiation into the armpit or direct damage to the axillary lymph nodes is observed in many breast pathologies:

Mastopathy. Pain and tightness in the mammary gland occur in the second half of the cycle, in 10-15% of cases are accompanied by soreness, an increase in lymph nodes.
Premenstrual syndrome. As in the previous case, soreness is detected at the end of the cycle, combined with pain in the mammary glands. The pain is caused by irradiation or the presence of an additional lobule of the gland in the armpit.
Lactation mastitis. The lymph nodes are sore and enlarged on one side. On the same side, swelling, redness, pain in the breast area are detected. Hyperthermia, intoxication syndrome are noted.
Breast cancer. Lymph nodes are affected by metastasis. In the early stages, they are painless, sometimes slightly painful on palpation. Against the background of injury to surrounding tissues, necrosis, hemorrhages, pain syndrome may occur.
Cosmetic problems
The soreness of the axillary area is explained by the development of dermatitis due to the use of deodorants and antiperspirants or ingrown hairs after shaving and epilation. In the first case, the pain is diffuse, usually not intense, combined with itching and burning. In the second case, local pains, stabbing or bursting, when examined, an area of inflammation is found, in the center of which an ingrown hair is located.

Other reasons
Sometimes painful sensations occur in diseases of the skin and internal organs, mental disorders. Pain can be observed in the following pathologies:

Hayley-Hayley’s disease. Bubbles form in the axillary areas, which are then opened with the formation of painful erosions. Similar rashes are detected under the mammary glands, in the inguinal folds, on the abdomen, the inner side of the thighs.
Angina pectoris, myocardial infarction. Pain in the left armpit is reflected, combined with chest pain, often also radiate into the shoulder, collarbone, neck. There is excitement, weakness, a feeling of fear.
Hypochondria. Complaints of armpit pain are often made by patients with carcinophobia who suspect breast cancer. Lymphadenopathy in this case may be absent or provoked by other reasons.
Diagnostics
General surgeons and oncologists are most often engaged in determining the causes of pain in the armpit. Depending on the etiology of the disease, consultations of a traumatologist, dermatologist, and other specialists are prescribed. The survey program includes:

Survey. The doctor finds out when and under what circumstances the pain syndrome first appeared, what symptoms it was accompanied by, how the pathology developed, whether the pain is related to external circumstances, whether it has a cyclical character.
External inspection. During an objective examination, a specialist evaluates the appearance of the axillary zone, detects swelling, hyperemia, skin defects, determines the volume of movements, palpates bones, muscles, ligaments and lymph nodes.
Ultrasound examination. Soft tissue sonography confirms inflammation or damage to ligaments and muscles, the presence of bulky formations. During ultrasound of the lymph nodes, lymphadenopathy is detected, the size and contours of lymphoid tissue clusters, their connection with other structures are examined.
Radiography. In case of injuries, an X-ray examination of the shoulder joint is prescribed, with lymphadenopathy, mammography is performed for middle-aged and older women. Young patients are more likely to have ultrasound of the mammary glands.
Puncture biopsy. It is carried out if tumor formations are suspected. Allows to establish the structure and degree of differentiation of cells, to confirm the presence of regional lymphogenic metastases.
Laboratory tests. They indicate the presence of inflammatory processes, allow us to assess the state of the body in severe diseases.

Ultrasound of the lymph nodes of the axillary region
Treatment
Assistance at the pre-hospital stage
In case of traumatic injuries, rest is recommended. Patients with intense pain syndrome are recommended to use a kerchief bandage, it is recommended to apply analgesic ointments outside the hair growth zone. You should not remove insects with bites yourself. Signs of inflammation, severe pain, general hyperthermia are indications for immediate medical attention. Lymphadenopathy, even in the absence of pain or a minor pain syndrome, may indicate the presence of a serious disease, therefore, in such cases, a specialist examination is also required.

Conservative therapy
In case of traumatic injuries, a protective regime with limited physical activity is necessary, physiotherapy is possible. For some other diseases, drug therapy is required:

Pyoderma and nonspecific lymphadenitis. Antibiotics are prescribed taking into account the sensitivity of the pathogen. Antibiotic therapy is often performed against the background of surgical measures.
Tuberculous lymphadenitis. Long–term treatment with tuberculostatics, immunomodulators, sometimes in combination with corticosteroids, plasmapheresis, and other methods is indicated.
Diseases of the mammary glands. Hormonal drugs are used for mastopathy, hormone therapy is supplemented with sedatives, antiallergic, diuretics for premenstrual syndrome. Antibiotics are used for mastitis. With cancerous tumors, hormone therapy is carried out, chemotherapy drugs are administered.
Surgical treatment
Taking into account the nature of the pathology , the following operations and open manipulations are performed:

Insect bites: tick removal.
Purulent processes: opening of boils, carbuncles, hydradenitis, mastitis.
Tumors, tumor-like formations: surgical excision of atheroma, excision or minimally invasive removal of sweat gland tumors, breast resection, mastectomy.

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