Problems With Shoulders, Arms, Elbows and Wrists.
Shoulder girdle pain/dysfunction
Shoulder pain is defined as soreness, tension and/or stiffness in shoulder region. There are many potential causes and while your chiropractor will usually be able to identify the underlying problems by undertaking a careful history and clinical examination, imaging (x-rays) may be required to confirm the diagnosis.
Your Chiropractor may offer manipulation and mobilisation treatment for your condition since there is evidence to suggest that this approach can aid the mid-term and long-term recovery of shoulder girdle pain and dysfunction.
Lateral epicondylitis (tennis elbow)
Elbow/forearm pain, in the form of Lateral epicondylitis (tennis elbow), is common among professional and amateur sportspeople, although almost anyone can acquire the condition. It is defined as pain in the region of the lateral epicondyle – the point of origin of the ‘extensor’ muscles of the forearm. The problem tends to arise over time by repeated overuse but it can happen following a direct knock. Your chiropractor will diagnose tennis elbow from your history and a clinical examination.
While there are effective medical treatments for tennis elbow, including corticosteroid injections, the addition of elbow mobilization with exercise, directed by your Chiropractor, can improve the long-term outcome of the condition.
Other effective non-invasive physical treatments for tennis elbow include ultrasound and acupuncture which are available at your chiropractic clinic.
The carpal tunnel is a restricted place at the front of the wrist, bounded by ligaments, through which pass the tendons that flex the fingers and wrist. This space is roofed over by a tough ligament (flexor retinaculum), which prevents the tendons from pulling away from the wrist when it is bent. One of the two sensory nerves to the hand, the median nerve, also passes through the carpal tunnel and there is little or no room for expansion.
Any swelling in the region, from any cause, will, therefore, tend to compress the median nerve and interfere with the conduction of nerve impulses. The result is numbness and tingling, sometimes even pain, in the half of the hand on the thumb side which is supplied by the nerve.
Carpal Tunnel Syndrome can affect both wrists, and typically affects women more than men. It usually favours the dominant hand first, often producing more severe pain.
What are the symptoms?
Early symptoms begin as pain and tingling in the thumb and first two fingers, occurring more frequently at night or early in the morning. Numbness in these fingers makes the handling of small objects difficult, and weakness of the muscles in the hand will start to show as wasting of the fleshy part of the thumb.
If you suspect you have carpal tunnel syndrome, you should consult with your chiropractor or GP as it needs to be differentiated from other conditions such as the beginnings of multiple sclerosis and arthritis which can present in a similar fashion. It can be compared to RSI which has similar symptoms e.g. tingling, coldness, sensory and motor loss and numbness sensation felt in the fingers.
Your chiropractor will take a thorough history and physical examination to rule out fracture or dislocations, and reach a diagnosis to enable them to treat you more effectively.
How can it be treated?
Once the diagnosis has been made, the treatment may consist of splinting of the wrist during the day and if possible the night also. This not only relieves the symptoms but breaks the cycle of swelling and pain.
Gentle chiropractic mobilisation or manipulation of the wrist bones, combined with ultrasound therapy at the wrist can be useful to help disperse swelling and help establish space in the tunnel which has been lost due to prolonged swelling.
Other joints such as elbows and shoulders, the neck (cervical) and upper back (thoracic) spine should also be assessed for secondary or associated problems.
Your chiropractor may ask you further questions about your working posture to identify ways to reduce the stresses placed on your wrists whilst at the work place.
Anti-inflammatory drugs have also been shown to be of some assistance during this period. Always seek the advice of a healthcare specialist first.
Are there any reoccurrences?
There should not be, but if this treatment fails, surgery to cut the overlying carpal ligament should be considered.
Steroidal injection into the carpal tunnel has been used as an alternative but has not proven to give any lasting therapeutic benefit.