Warning signs: when to get help
These are the site's lines from our shoulder pain, neck pain, wrist, arm and yoga guides, word for word, apart from lines marked as our suggestion. This is general information, not a diagnosis. A&E means accident and emergency; in the US, call 911 for 999, and use your doctor's urgent line or urgent care for NHS 111.
Chest pain or fainting while exercising: call 999
Call 999 if:
- You get sudden pain or discomfort in your chest that doesn't go away; it can feel like squeezing or pressure, burning or indigestion.
- The pain spreads to your left or right arm, or your neck, jaw, stomach or back.
- You have chest pain and feel sweaty, sick, light-headed or short of breath.
- Someone faints while exercising, can't be woken within 1 minute, or has chest pain or a pounding, fluttering or irregular heartbeat.
Sources 58, 59
Call 999
- Call 999: shoulder or arm pain with chest pain that feels tight or squeezing, or chest pain that spreads to your arms, neck or jaw, especially with shortness of breath, sweating or feeling sick. It could be a heart attack.
- Call 999: you suddenly can't fully lift both arms and keep them there, because of weakness or numbness in one arm, especially if one side of your face droops or you slur your words or sound confused. It could be a stroke. Call even if the signs have stopped.
- Call 999 or go to A&E: after a fall or injury, your shoulder looks out of place or has changed shape, you cannot move your arm, or your shoulder is painful, bruised or swollen. Do not drive yourself, and do not try to put it back in yourself.
- Call 999 or go to A&E: new problems walking, loss of bladder or bowel control, or a sudden loss of coordination, such as difficulty doing up buttons. These can be signs of pressure on the spinal cord.
Sources 61, 58, 62, 63, 64
After a fall or injury to the arm, wrist or hand
Call 999 or go to A&E after an injury (don't drive yourself) if the arm, wrist or hand is numb, tingling or has pins and needles; a bone is sticking out or a bad cut is bleeding heavily; or the wrist, thumb or a finger has changed shape, is at an odd angle, or has turned blue, grey, white or cold.
Sources 68, 62
Get help from NHS 111
Get help from NHS 111: pain or tightness in your chest, neck, shoulders, jaw or arms that comes and goes, often brought on by exercise, stress, emotion or cold and easing after a few minutes' rest. It can be angina, a sign of a heart problem. If you've been diagnosed with angina, get help from NHS 111 too if it feels worse than before, is happening more often, lasts longer or happens when you're resting.
Source 58
New weakness lifting the arm, or a hot, swollen shoulder: the same day
- Same day (GP or NHS 111): sudden weakness lifting the arm after an injury or fall. A rotator cuff tear caused by an injury needs urgent referral to a shoulder specialist. After a dislocation in anyone over 40, the rotator cuff should be checked: about 40% have a tear.
- Same day (GP or NHS 111): sudden or very bad shoulder pain; you cannot move your arm; the arm or shoulder is badly swollen or has changed shape; pins and needles that do not go away; no feeling in the arm; the arm is hot or cold to the touch; pain that started after an injury such as a fall; or severe pain in both shoulders.
- Same day (GP or NHS 111): the shoulder or arm is hot, swollen or red, or you have a high temperature (although not everyone has one) or feel unwell. A joint infection needs same-day care.
Source 63
Neck pain with numbness or pins and needles in an arm: the same day
- Same day (urgent GP appointment or NHS 111): severe neck pain that starts suddenly or gets worse quickly; heaviness or weakness in the arms or legs; pins and needles in an arm along with neck or arm pain; or pain between the shoulder blades.
- Same day: clumsiness in your hands, or numbness, pins and needles or weakness in one or both arms, that is getting worse; problems with balance or walking since the neck pain started; or neck pain with a severe headache.
- Arm weakness or numbness that keeps getting worse, severe pain that painkillers and rest do not touch, or an unexplained fever.
Source 64
Numb or clumsy hands: the same day
- Same day: you have lost the feeling in part or all of your hand.
- Same day: both hands numb or clumsy (dropping things, trouble with buttons or handwriting), especially with unsteady walking or falls. Pressure on the spinal cord in the neck can do this, and it is often first mistaken for carpal tunnel syndrome.
Sources 67, 68
See a GP or physiotherapist
- Pain that is getting worse or has not improved after 2 weeks of looking after it yourself, or it is very hard to move your arm. In many areas you can refer yourself to physiotherapy.
- Your shoulder has partly or fully come out of joint, or you worry it might.
- Pins and needles or a cold arm alongside neck pain, or a new loss of strength or feeling in the arm that you cannot explain (a possible nerve problem).
- Neck pain or stiffness that has not eased after a few weeks, or after 8 weeks of looking after it yourself; painkillers are not helping; or you are worried. In many areas you can refer yourself to NHS physiotherapy.
- No improvement after 6 weeks of exercise, or arm symptoms still there beyond 6 to 12 weeks.
- See a GP if you have pain and stiffness for more than a week, especially if you're over 50, it's in both shoulders (often the neck and hips too) and the stiffness lasts longer than 45 minutes in the morning. It can be polymyalgia rheumatica.
Sources 63, 64, 65
Wrists and hands: see a GP
- Not improved after 2 weeks of looking after it at home, getting worse, keeps coming back, or stopping you doing normal activities. In many areas you can refer yourself to NHS physiotherapy.
- Any tingling or loss of feeling in the hand or wrist.
- Carpal tunnel symptoms that are getting worse, not going away, or not helped by treatment at home; sooner if the thumb is weak or the muscle at the base of the thumb looks thinner.
- You have diabetes and a hand problem: the NHS says hand problems can be more serious if you have diabetes.
Sources 67, 69, 68
Pins and needles
Pins and needles that you have all the time, or that keep coming back: see a GP.
Sources 63, 66
Unusual breathlessness
Call 999 or go to A&E (accident and emergency) straight away for severe difficulty breathing (gasping, choking or not able to get words out), a chest that feels tight or heavy, pain that spreads to your arms, back, neck and jaw, lips or skin turning very pale, blue or grey, or sudden confusion. If you're more short of breath than usual, or your heart is racing, fluttering or skipping beats, contact NHS 111.
Source 60
Neck circles
Stop if neck circles bring on dizziness, light-headedness or tingling into an arm. Make the movement smaller, with separate turns and nods, and see a GP if it keeps happening. Our neck pain guide has more.
Stop and get medical help
If you get chest pain or pressure, feel faint or dizzy, are unusually breathless, or your heart races or beats irregularly during exercise, as our plans advise.
During yoga
A joint pain that is sharp, gets worse during a session, lingers into the next day or changes how you move is a reason to use an easier version, and to see a GP or physiotherapist if it keeps happening (the rule in our plans). Muscle soreness for a day or two after something new is normal. In a hot class, stop if you feel dizzy, sick or unwell; our hot yoga guide lists the signs of heat illness.
You can say no to any hands-on adjustment, and a teacher registered with Yoga Alliance must get your explicit consent each time.
Sources 55, 56
Head-down poses, bones and pregnancy
With glaucoma, or high blood pressure that isn't under control, skip headstands, shoulder stands and long head-down holds. With osteoporosis, swap deep forward folds for a flat-back hinge from the hips, and twist smoothly. In pregnancy, our yoga in pregnancy guide covers the changes. NCCIH advises beginners to avoid headstands, shoulder stands, the lotus position and forceful breathing.
Sources 57, 55
Before you start
The NHS advises getting advice from a healthcare professional first if you have a health problem, an injury or symptoms, or have recently had a heart attack or an operation.
If you have a heart, lung or joint condition, are pregnant or have recently been unwell, start gently and read our guide for your condition. Muscle soreness for a day or two after a new exercise is common and fades as you repeat it.
If you have a heart condition, follow your cardiac team's advice on how hard to work, and stop for the warning signs above. People with long-term conditions may wish to ask their specialist before starting. With uncontrolled high blood pressure, avoid straining against a held breath; the high blood pressure guide has more.