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Pain in the Ascella

Generality

Armpit pain is a very common symptom, the presence of which can depend on more or less serious conditions.

Fortunately, in most cases, this common disorder is related to passenger health problems or, in any case, easily treatable.

Some of the main causes of axillary pain are: enlargement of axillary lymph nodes, hyperhidrosis, suppurative hydrosadenitis, some fungal or bacterial infections, fatigue and injuries to the chest or arm muscles, the psoriasis and irritative contact dermatitis.

The recognition, through an appropriate diagnostic research, of the causes of axillary pain is fundamental for the planning of the most appropriate treatment.

Short anatomical reference of the axilla

The armpit is the area of ​​the human body located below the joint that connects the arm to the trunk; the axilla is actually a cavity, which results from the particular arrangement of: chest wall, bones and muscles of the shoulder, and proximal portion of the upper limb.

Among the warmest anatomical areas of the human body, the axilla is the site of transit of numerous blood and lymphatic vessels, as well as of important nerves (median nerve, radial nerve, ulnar nerve etc.); moreover, it hosts more than 20 lymph nodes (not perceptible to the touch) and has a high concentration of hair follicles and sweat glands.

Scientific studies have shown that the axillary region (ie where the axilla resides) produces and emits most of the characteristic odor of a human being; smell that, among other things, according to the same scientific studies, seems to contain a large number of pheromones related to mating.

What is Ascella Pain?

Armpit pain is a widespread symptom, which, although it may also derive from clinically important conditions, is almost always the result of mild health problems and a transitory nature.

Also known as axillary pain, axillary pain is such a common ailment that it is rare to meet people who have never suffered at least once in their life.

Causes

Among the possible causes of axillary pain, they deserve a mention:

  • The enlargement of axillary lymph nodes;
  • Hyperhidrosis;
  • Fatigue or injuries affecting the muscles related to the axillary region;
  • Allergic contact dermatitis and irritative contact dermatitis;
  • Psoriasis;
  • Herpes zoster infections ;
  • Some bacterial infections (eg: erythrasma);
  • Some fungal infections (eg: tigna corporis and candida);
  • The intertrigo;
  • Malignant tumors located on the trunk and their metastases, lymphoma and leukemia;
  • Peripheral arteriopathy;
  • The suppurative hydrosadenite;
  • Axillary folliculitis;
  • The axillary pimples;
  • The lipoma in the axillary region;
  • Acanthosis nigricans ;
  • Axillary abscesses;
  • Diabetic neuropathy;
  • Rheumatoid arthritis;
  • Systemic lupus erythematosus.

The following sections of this article describe, with some extra details, some of the aforementioned causes of axillary pain.

Axillary lymph nodes enlargement

Lymph nodes are small organs of the lymphatic system, comparable to biological filters, whose purpose is to intercept and destroy possible germs, foreign substances and / or neoplastic cells circulating in the lymph (the lymph is a fluid derived from the blood, in which the substances are collected of refusal); the lymph nodes act as a collection point for some cells of the immune system, so as to be even more efficient in providing protection to the human body.

The most important causes of enlargement of the axillary lymph nodes - and like them of other lymph nodes present in the upper part of the human body - are:

  • Influenza (infection of viral origin);
  • The cold (infection of predominantly viral origin);
  • Measles (infection of viral origin);
  • Mononucleosis (infection of viral origin);
  • Otitis (usually depends on a bacterial infection);
  • Pharyngitis or sore throat (usually depends on viral or bacterial infections);
  • Skin infections, especially those combined with skin wounds;
  • AIDS (viral infection);

In all the circumstances just mentioned, the lymph nodes become enlarged because the lymph discharges the waste substances (ie infectious agents) inside, with the intent to expose them to the action of the lymph node immune cells.

Short study

In medicine, the enlargement of the lymph nodes (axillary and not only) due to the presence of an infection is called lymphadenopathy .

Hyperhidrosis

In medicine, the term " hyperhidrosis " indicates an excess of sweating compared to what is normal.

Idiopathic (that is, present without obvious causes) or due to very specific causes (eg: obesity, hyperthyroidism, menopause, etc.), hyperhidrosis is responsible for pain in the axilla, when the sweat in excess, at the axillary level, induced the development of a skin infection or sweat dermatitis.

Fatigue and muscle injuries that cause axillary pain

The muscles that, if subjected to fatigue or injury, can cause pain in the armpit are the chest muscles having relations with the shoulder and the arm muscles. Among the muscles in question, the pectoralis major muscle (predominantly muscle of the thorax) and the coracobrachialis muscle (arm muscle) are particularly noteworthy .

Armpit pain due to fatigue or muscle injury is, in most cases, related to sports (the most risky sports are tennis, weightlifting and baseball).

Allergic and irritative contact dermatitis

Allergic contact dermatitis is the inflammation of the skin resulting from an abnormal immune reaction to a substance (which takes the name of allergen), in predisposed subjects.

Irritative contact dermatitis, on the other hand, is the inflammation of the skin that arises from repeated contact with solvents, soaps, shower gel, deodorants, cleaning detergents or industrial materials capable of damaging the skin.

Between allergic contact dermatitis and irritative contact dermatitis, the one most often related to axillary pain is the second; in particular, this correlation has, as the main culprits of skin inflammation and the consequent painful sensation, the excessive washing of the armpits with poor quality soap or shower gel and the excessive use of deodorants.

Psoriasis

Psoriasis is a chronic-relapsing inflammatory disease of non-contagious skin that occurs as a result of hyperproliferation of epidermal keratinocytes and is mainly due to reddish patches / plaques on knees, feet, elbows, hands, scalp and / or armpits.

Various forms of psoriasis exist; among these forms, what is most commonly associated with axillary pain (in addition to the classic symptoms of any psoriasis) is the so-called reverse psoriasis .

Short study

Inverse psoriasis mainly affects the armpits, the inguinal region, the lower part of the breast and the areas closest to the genitals; in these locations, it is responsible for an erythema characterized by small painful red plaques, which worsen with sweat and rubbing.

Shingles

Herpes zoster, or Saint Anthony's Fire, is an infectious disease caused by the same virus that causes chickenpox: the varicella-zoster virus or human herpes virus 3 .

It is a typical infection of adults, which causes typical itchy red spots on the trunk, first of all, and on the neck, arms, face, eyes and armpits, secondly. These red spots are often also very painful and this explains the correlation between herpes zoster and axillary pain.

Intertrigo

Intertrigo is that particular form of dermatitis (skin inflammation) that results from the continuous rubbing of two contiguous skin surfaces. Intertrigo is a morbid condition that affects the folds of the skin, as these are the anatomical areas of the body that lend themselves to the aforementioned rubbing.

Where it takes place (armpits, groin, between the fingers, under the breasts, neck, etc.), the intertrigo tends to cause, thanks to sweat, irritation and maceration of the skin, whose consequences consist mainly in a localized pain.

The intertrigo-pain axillary binomial is quite widespread, as the armpits are - as has already been said on several occasions - areas rich in sweat glands.

Malignant tumors of the trunk, lymphomas and leukemias

Premise: to understand the following, it is good to keep in mind what was said previously about the role of lymph nodes.

Axillary pain is often associated with malignant tumors of the trunk (in particular, breast cancer and lung cancer are reported), metastases of these tumors, lymphomas and leukemias, because all these serious diseases subject the lymph nodes axillary to a workload, such that they are extremely painful, especially by touch.

Hidradenitis suppurativa

Suppurative hydrosadenitis is a chronic disease of the skin, which is associated with axillary pain, because it produces in the axillary region (as well as in other areas of the body, where it has the same consequences) small particularly painful subcutaneous nodules.

The suppurative hydrosadenite has the big drawback that, with the passage of time, it can worsen, to the point of strongly compromising the quality of life of the patients.

Short study

In addition to causing pain in the armpit, suppurative hydrosadenitis can cause, due to the aforementioned subcutaneous nodules, pain in the groin, pain between the buttocks and pain under the breast.

Peripheral arterial disease

Mainly due to atherosclerosis, peripheral arterial disease is a vascular disease that involves the reduction of blood flow within the arteries of the upper and lower limbs. This reduction has the effect of compromising the oxygenation of the tissues (muscles, skin, etc.) belonging to the limbs involved and causing pain to the latter.

In a context of peripheral arterial disease of the upper limbs, axillary pain, together with arm pain, is one of the most common symptoms.

Lipoma

The lipoma is a benign tumor made up of adipose tissue, which grows under the skin and has the appearance of a small soft and mobile ball.

Axillary lipomas can cause axillary pain when they grow near those nerves and blood vessels that pass through the axillary region.

Axillary boils and axillary folliculitis

Furuncles are bacterial infections affecting the hair follicle and peri-follicular tissue. Folliculitis, on the other hand, is an acute inflammation, almost always infectious, which affects the upper part of a hair follicle.

Pimples and folliculitis are quite often responsible for axillary pain, as, as readers will remember, the axillary region is a region rich in hair follicles.

Symptoms and Complications

The characteristics of axillary pain vary depending on the cause.

There are causes of axillary pain that produce an acute painful sensation at the first moment, but which then tends to diminish in a short time; there are causes of axillary pain that induce mild pain, but with a chronic / persistent character; there are causes of axillary pain that determine an alternation between strong painful pangs and moments of apparent healing; finally, there are causes of axillary pain that produce some sort of electric shocks.

Associated symptoms

Armpit pain almost always occurs in association with other symptoms and some particular signs; strictly dependent on the triggers, these symptoms and signs may consist of:

  • Redness of the skin, itching, burning, vesicles, scales, papules, blisters, scabs and / or plaques. Summed up with the medical term of " cutaneous eruptions ", these manifestations can take place limitedly to axillary level or to axillary level and in other sites of the body.

    Examples of when they can be observed together with axillary pain: irritative contact dermatitis, allergic contact dermatitis, intertrigo and psoriasis.

  • Alterations in the shape of the breast.

    When it can be observed together with axillary pain: breast cancer.

  • Swollen lymph nodes positioned in locations other than the underarm.

    Examples of when one can observe together with axillary pain: breast cancer and bacterial or fungal infectious diseases.

  • Fever, chills, stomach pain, headache, etc.

    Examples of when they can be observed along with armpit pain: Herpes zoster and viral or bacterial infections.

Complications

Possible complications that may affect an individual with an axillary pain may depend on:

  • A very serious cause (eg: breast cancer, leukemia, lymphoma etc.);
  • Failure to treat the triggering condition.

When should I go to the doctor?

Armpit pain is a symptom not to be underestimated but, on the contrary, to be submitted to the attention of the attending physician, when:

  • It is accompanied by skin eruptions (eg redness, blotches, blisters etc.);
  • It is accompanied by an enlarged swollen lymph node;
  • It is accompanied by symptoms such as fever, chills, stomach problems;
  • It is accompanied by a pain in the breast.

Diagnosis

When we talk about the diagnosis of pain in the armpit, the object of discussion is clearly the identification of the triggering cause, that is the origin of the pain sensation.

Except for the clinically less severe cases (for which it is not always necessary to consult a doctor), research to establish what triggered the appearance of a worrying axillary pain begins with a thorough physical examination and an in-depth medical history ; therefore, based on what emerges from these investigations just mentioned, it can continue with:

  • Dermatological examinations ;
  • Generic blood tests and blood tests for cancer markers ;
  • An axillary ultrasound examination for soft tissue assessment;
  • Radiological examinations (eg: X-rays, nuclear magnetic resonance, CT scans, etc.) related to the axilla and neighboring anatomical areas (chest, neck and shoulder);
  • A biopsy of axillary lymph nodes .

Physical examination and medical history

Physical examination and anamnesis serve to delineate in detail the symptomatic picture; for example, clarify:

  • If the patient suffers from other symptoms and what these symptoms are;
  • From what pain in the armpit is in place;
  • What is the precise site of axillary pain;
  • Whether and what arm movements worsen the axillary pain;
  • If the axillary pain appeared later at a certain particular event.

This information allows the doctor to get an idea of ​​the possible causes of axillary pain and to understand which diagnostic tests are most useful to establish the above causes.

Why is it important to find out the causes?

The knowledge of the causes of axillary pain is very important, because it allows to plan the therapy through which it is possible to obtain healing (or, at least, an improvement in the symptoms).

Therapy

The treatment adopted in the presence of axillary pain varies in relation to the triggering cause .

In practical terms, this means that an axillary pain due to suppurative hydrosadenitis requires treatment other than axillary pain due to fatigue of the pectoralis major muscle.

In the next section, this article will consider the therapy provided in some of the most important circumstances that cause armpit pain.

Examples of treatment for axillary pain

  • If the pain in the armpit results from an enlargement of the lymph nodes, which in turn depends on the flu, the treatment includes: rest until the entire symptomatology disappears, taking analgesic and antipyretic drugs (aspirin, NSAIDs or paracetamol) for control fever, generous intake of fluids and, finally, the consumption of easily digestible meals.
  • If axillary pain depends on breast cancer, therapy generally involves: surgical removal of the tumor mass (removal techniques are numerous), cycles of radiation therapy and chemotherapy, and finally appropriate hormone therapy.
  • If the pain in the armpit is due to the excessive use of a detergent for personal hygiene or to a deodorant (irritative contact dermatitis), the patient will find benefit from the suspension of the use of the detergent / deodorant responsible for the symptomatology and from the application of a corticosteroid with topical administration.
  • If the axillary pain is related to a mycosis (fungal infection), the treatment involves the administration of an antifungal topical or systemic, depending on the fungal triggering agent.
  • If axillary pain depends on hyperhidrosis, the therapy is based on all those remedies that reduce the production of sweat at the axillary level; among the remedies in question, there are non-invasive remedies (eg: preference for loose-fitting clothes and not in synthetic fibers), of medium invasive (eg: use of anxiolytic or sedative drugs) and, finally, of considerable invasiveness (eg : surgical removal of the axillary sweat glands).

Prognosis

Generally, an axillary pain of modest clinical relevance heals quickly, without aftermath; on the contrary, axillary pain, the result of a serious health problem or a condition that is difficult to treat, has a more uncertain, sometimes unpleasant or long-term course.

In essence, therefore, the prognosis in case of axillary pain is strictly dependent on the triggering factor.

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