Axilla Pain: Why does My Armpit Hurt?
Apart from the ever-present question of whether to shave, the armpit is not the first place we think of as being a source of pain. However, the armpit—or axilla—is an important junction where the arm meets the rest of the body, and pain can arise here.
Various muscles and ligaments of the shoulder, chest, and upper back converge there, and the armpit contains important neurovascular structures including the axillary vein, the axillary artery, the nerves of brachial plexus, and several clusters of lymph nodes at both deep and superficial levels. Pain associated with any of these structures can sometimes arise in the armpit.
The word axilla comes from Latin and is the technical, medical term for “the cavity under the shoulder joint, or armpit”; axillary means “having to do with the armpit” (this is not to be confused with the word auxiliary, which means “additional or supplementary help or support”). Axillary pain can come from a multitude of potential causes, most of which are not too serious. However, there are situations when medical intervention is needed. This article will discuss various conditions that can affect your armpits.
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Why does my axilla hurt?
While there are many potential causes for armpit pain, the most common—and least worrisome—is muscle strain, or overexertion. In most cases, the effects can be alleviated at home with rest and gentle stretching, and no further medical treatment is necessary.
Muscle strain in the armpit occurs when the one or more muscles in the region are stretched too far or even torn. Commonly affected muscles include the pectoralis major (the largest muscle in your chest wall), the pectoralis minor (thin, triangular muscle at the upper part of the chest), and the subscapularis (a muscle in the shoulder’s rotator cuff).
Typical symptoms accompanying muscle strain in the armpit include:
- pain and tenderness
- swelling
- muscle spasms
- limited range of motion
Any repetitive or strenuous activities that involve the arms—such as weightlifting, throwing, rowing, and similar movements—can strain the muscles in the armpit quite easily, especially if you aren’t warmed up or aren’t used to exercising those muscles.
Sudden arm movements can sometimes affect the axillary nerve and cause discomfort. The axillary nerve begins in the armpit and innervates the deltoid muscle, which gives our shoulders their rounded contour, and the teres minor, one of the four muscles of the rotator cuff that hold the head of the humerus bone in the upper arm in the shoulder socket, allowing us to rotate our shoulders 360 degrees. Injury to the shoulder area can also affect the axillary nerve, causing pain in the armpit region.
Poor posture can influence nerves in the surrounding region and cause pain in the armpits. Habitual slouching or rounded shoulders can cause an imbalance in the way the shoulder muscles are used, increasing the risk of armpit muscle strain.
Treatment for muscle strain in the armpit
If you are experiencing axillary muscle strain or injury to the muscles in the region of the armpit, first rest and reduce inflammation, then resume gentle exercise.
Rest. Avoid moving your arm and shoulder while the pain persists (and then a little longer for good measure). Giving the affected muscles adequate time to heal is essential.
Reduce inflammation. A cold compress or ice pack applied to the armpit for 15–20 minutes several times a day can help reduce pain and inflammation. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may also be used.
Once the pain is no longer acute, start doing some gentle exercises to help restore strength and flexibility. If the pain returns, stop exercising immediately and give yourself more time to heal. If the pain is severe, consult a physical therapist for exercise recommendations that are suitable for your body and support healing from the particular injury you have sustained.
What else might be causing armpit pain?
Many conditions can affect the structures of the armpit. Problems in areas close to armpit—for example the neck and shoulders or the breasts—can also cause radiating or referred pain in the axilla.
Injuries that occur near the surface of the body tend to be easy to identify, but pain from problems in deeper body structures can sometimes be difficult to localize. Radiating pain is felt at the point of origin and spreads out to the surrounding tissues. Referred pain is pain that is felt somewhere else in the body than where it actually originates.
Some other conditions that can cause armpit pain include:
- axillary intertrigo and other topical skin conditions
- hidradenitis supperativa or blocked sweat glands
- any conditions and medications that affect the lymphatic or immune system
- hormonal fluctuations
- more serious conditions such as cancer, lupus, or heart disease
Small, painful bumps in the armpit
Skin rashes can appear for many, many different reasons, but two that are more common in the armpit area are razor burn from poor shaving technique and axillary intertrigo, a condition that results from folds of skin rubbing and chafing in warm, moist conditions. While this can happen to anyone, people who live or work in hot, humid environments are more susceptible, as are people who suffer from obesity and diabetes. Both conditions can be made worse by any sort of viral, bacterial, or fungal infection.
To avoid razor burn, using a clean, sharp razor shave freshly washed armpits that have been lubricated with soap or shaving foam in light, short strokes. After shaving, rinse with cool water and apply a cold compress to close the pores. This is a temporary condition but can take several weeks to heal if continually irritated. Any steps you take to sooth the skin and reduce inflammation will help.
Intertrigo is a common condition that can appear anywhere there are folds in the skin that rub against each other. Friction damages the skin, allowing bacteria or fungus to get in and multiply. Secondary infections for axillary intertrigo can be fungal, such as with the candida yeast, or bacterial, such as with staphylococcus aureus.
Intertrigo can be painful and unpleasant, especially if it progresses from itching-stinging-burning bumps to raw, cracked, oozing or bleeding skin to pussy, bad-smelling infected skin. However, the condition is treatable.
To help your skin heal from intertrigo, you must keep it dry, clean, and cool. Wear loose, breathable clothing; pat your skin to dry it instead of rubbing; use a fan or hairdryer set on cool 2–3 time/day to eliminate moisture; use a mild antiperspirant to reduce sweating. If there is no infection, you can use a cream or gel to reduce chafing or cover the affected area with gauze or thin cotton.
If the area has become infected, consult a medical professional as soon as possible. The only way to tell for sure if an infection is fungal, viral, or bacterial is to have it tested. Once you have a diagnosis, you can start using an oral or topical anti-fungal or anti-bacterial medication.
Large, painful bumps in the armpit
If you notice one or several large bumps forming in your armpit, you may be suffering from swollen or infected sweat glands. This condition is called hidradenitis suppurativa (HS); it is also known as acne inversa even though it isn’t technically acne.
HS is a chronic inflammatory skin disease that affects the apocrine sweat glands, which are found wherever there are hair follicles, especially in the armpits and the groin. Researchers have yet to understand why the sweat glands become blocked, but once they are, the sweat they produce remains inside the body, creating an excellent environment for bacteria and fungus to breed. This is a systemic inflammatory condition related to the immune system, although it is not considered an auto-immune disorder. HS may have a genetic component as it sometimes runs in families.
HS tends to first appear at puberty and can progress from small, red, painful itchy bumps that smell and ooze when they pop to large cysts that become leaky, open sores that scar when they heal; sometimes a cluster of blackheads also appears in the area. A blocked apocrine gland can grow into a cyst or boil the size of a marble. These lumps tend to resolve in 1–2 weeks and should NOT be popped, as this will only make things worse.
Unfortunately, there is currently no known cure and the while to condition can be managed, it does tend to recur. If left untreated it can lead to permanent skin damage, reduced lymph drainage, reduced mobility in the affected area, and other complications.
If you suffer from HS, be kind to yourself. It is a painful condition to live with, made worse by the smell of trapped sweat and bacteria that drain from the sores. The condition is systemic and does not arise from poor hygiene, but a self-care routine that includes certain hygiene measures can help. As usual, eat well, exercise, and get plenty of sleep. If you smoke, quit. Some people find eliminating dairy products and taking a zinc supplement helps. An Epsom salt bath can also soothe the skin and give you some relief.
Be gentle with your skin when you wash. Avoid skin care products with harsh detergents, chemicals, preservatives, and perfumes, and deodorant that contains aluminium salts. Over-the-counter antiseptic washes, such as those containing benzoyl peroxide, reduce the number of bacteria on the skin, which helps manage both smell and infection. Shaving can damage the skin, so trim your hair instead.
The problem can flare up and become difficult to manage at home. Maintain an open dialogue with you doctor, so they can prescribe treatments as needed. The most common include oral and topical antibiotics, corticosteroids for pain and inflammation, oral retinoids for skin support, biologic therapies, and negative wound pressure therapy to draw infected fluid away from the wound.
Should I be concerned about armpit hair?
Unfortunately, armpit hair remains a controversial topic for women, even though this is a natural aspect of the human body. Shaving or waxing your armpits (or any other body part) is an aesthetic choice and has little to do with health and hygiene.
We often conflate having armpit hair with being sweaty, but these are not necessarily connected. Humans sweat with or without hair, and shaving or waxing can contribute to developing ingrown hairs or an infection from being cut with a dirty razor, making it slightly more likely that the sweat glands in your armpits become swollen or infected.
You can read more about body hair here.
How can I tell if the pain in my armpit is in the lymph nodes?
Lymph nodes are small, kidney-shaped structures distributed throughout the body, which filter lymphatic fluid and identify and fight infections. Most of our many lymph nodes are located deep in the trunk of the body, but some are closer to surface, for example in the armpits, along the sides of the neck, and in the groin. When an infection is present in the body, the lymph nodes nearby may swell and become tender to the touch.
Lymph nodes can be different sizes depending on where they are in the body. The nodes in the armpit tend to be the size of a small bean—a 1 cm long oval encased in fatty adipose tissue. When they are dealing with infection or inflammation they can swell to the size of grape. Any enlargement of the lymph nodes is called lymphadenopathy; when lymph nodes are swollen or enlarged because of a viral or bacterial infection, the condition is referred to as lymphadenitis.
Lymph nodes can become tender and swollen from something as benign as the common cold, but can sometimes indicate a more serious condition, for example an immune disorder such as HIV/AIDS, lupus, various cancers including breast cancer, rheumatoid arthritis and other inflammatory conditions, and a vast variety of bacterial, viral, and fungal infections.
If you notice that your lymph nodes are swollen, scan your body for other symptoms and pay close attention to your overall health. “Swollen glands” are a symptom of some other underlying condition, which needs to be identified so the proper antibiotic, antiviral, or antifungal treatment can be prescribed.
Can armpit pain be hormonal?
Yes, in some cases armpit pain is associated with hormonal changes. During certain times in the menstrual cycle, particularly at ovulation and in the premenstrual phase, it is common to have sore or tender breasts. The sensation can extend to nearby areas where lymph nodes are present, including the armpits. Breast tenderness is also common during pregnancy and in perimenopause.
Can armpit pain be heart related?
Visceral pain—pain that comes from the internal organs—can sometimes be difficult to localize. In rare cases, pain in the left armpit can signal a heart-related issue due to the proximity of the heart on the left side of the chest.
Referred pain from various heart conditions, including severe pain from heart attack, can sometimes occur in the left arm, shoulder, jaw, or armpit. If you experience persistent or severe armpit pain associated with other symptoms such as chest discomfort, shortness of breath, dizziness, or nausea, seek immediate medical attention.
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