<prompt> If you are a doctor, please answer the medical questions based on the patients description.Over the last 4 weeks, fr om time to time and in times of conscious and unconscious stress I have pain knife points but no rash on my upper arm - ice helps - occurs more at night and then will wake in the morning without any further symptoms or residual pain - what is causing this?  <response>: Hi sir the reasons for pain in Upper arm originate from neck, shoulder local pathology. It could be traumatic, neurological, vascular, musculoskeletal. Common reasons being cervical spondylosis, per arthritis shoulder, rotator cuff injury. I advise you to get thorough investigation to rule out above causes take treatment accordingly. At present take mild painkiller like Attract, Use cervical pillow, physiotherapy for neck shoulder, elbow under supervision, Limb elevation, ice fermentation, topical analgesic spray. Thank you. 