Shoulder, Elbow, Wrist and Hand pain
The shoulder, elbow wrist and hand are complex structures and often a common site for muscle, tendon, nerve and joint pain to occur. Normal function in these structures is vital to carry out everyday lifestyle habits as a dysfunctional impairment affected by activities e.g. - work, injury, (spinal) posture and exercise - may severely comprise quality of life. This is why many people seek our services as dysfunctional impairments are often complex which may often take time to resolve based on severity. As well as providing treatment depending on assessment findings, Nick will make every effort to try and help you to understand the cause of your problem and where possible advise you how best to manage and treat your problem often enhanced by exercise prescription.
Described briefly are some common conditions that frequently present a condition in the shoulder, elbow, wrist and hand (although not an exhaustive list as there are many others) which may help you to identify your problem.
Shoulder
Frozen Shoulder (Adhesive Capsulitis)
Frozen Shoulder may occur following shoulder injury or gradually develop over a period of time. Stiffness in the shoulder can be very uncomfortable particularly at night due to the pain, loss of motion and inflammation as it affects the synovial joint capsule - the tissue surrounding the shoulder joint (glenohumeral joint). Rehabilitation involving manual therapy and other therapeutic techniques supplemented by exercise are often recommended to help reverse the effects. In some cases if left untreated the condition may well last for months or worst still years reducing the ability to use your arm effectively for everyday activities.
Rotator Cuff Injuries
Rotator cuff injuries can affect any combination of the rotator cuff muscles which may also refer pain down the arm and even to the wrist and hand. You may experience pain at night lying on your affected shoulder or experience pain and difficulty when lifting the arm or using the sore muscles. A rotator cuff tear often follows with immediate pain as a result when the deep muscles of the shoulder are strained. Similarly a related rotator cuff injury or bicipital tendinopathy complaint may develop with a gradual onset of worsening pain in the deep tendons of the shoulder either caused by repetitive shoulder use, ageing process or without any obvious causes.
Shoulder Impingement
Impingement of the shoulder is a clinical sign not a diagnosis but very similar in many ways to a tendonitis rotator cuff complaint. The soft tissues of the affected shoulder are repeatedly pinched causing mechanical irritation of the rotator cuff tendons which may lead to swelling and damage of the tendons.
Acromioclavicular Joint Pain
Typically caused by bumps and falls onto the tip of the shoulder or may result from repeated minor injuries. Pain is often localised at the tip of the shoulder (where the collarbone and shoulder blade meet) but may also radiate into the arm.
Trapped Nerve (Referred Shoulder Pain)
Referred Pain (trapped nerve) in the shoulder is typically experienced away from the actual injury site due to pain often being referred from the neck and upper back. The shoulder and upper arm are common sites for referred pain caused by a variety of influences. These may include local abnormalities, tissue tension, stiffness in the neck and upper back causing neck and shoulder pain and/or when lifting objects.
Rod Leung
Nick's experience and in depth clinical knowledge is second to none in both conventional and orthodox medicine. His no nonsense approach is thorough and I was very pleased with the treatments and after-care he provided for my aches and pains and injuries.
Nick was professional friendly and honest. I felt involved in all decisions he was making as my views were considered and incorporated into my rehabilitation plan. I would highly recommend Nick and his pain relief clinic services.
Jane Burton
I sought Nick's expertise for a debilitating frozen shoulder. Nick took the time to listen to my symptoms and examine me and to thoroughly explain his diagnosis and treatment plan. After just one session of gentle manipulation and massage, I was much improved with an increased range of motion and a reduction in pain.
Nick selected and demonstrated specific exercises and followed this up periodically with emails to check my progress before introducing other exercises. He always included either videos or diagrams to make sure I was performing them correctly. After 3 sessions, I was able to forget about my shoulder for the first time in months. My range of motion is returning to normal and pain now infrequent. I am confident that with continuation of the exercises prescribed I will continue to improve and restore my full range of motion.
I recommend Nick for his knowledge, skills and thoughtful aftercare.
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Elbow Wrist and Hand Pain
Pain in the elbow, wrist and hand are common. Frequent causes are forms of tendinopathies (tennis elbow, golfers elbow), nerve irritation (cubital tunnel syndrome and carpal tunnel syndrome), arthritis and injury amongst others.
Tennis and Golfers Elbow
Tennis elbow causes irritation, pain and tenderness surrounding the outside of the elbow joint and forearm and often referred to as an extensor injury. Golfers elbow causes similar symptoms but around the inner side of the elbow joint and generally referred to as a flexor problem. The injury is typically described as an repetitive overuse injury and not just from the name it implies such as sports. Wear and tear from everyday habits such as daily activities, work, and unexpected tug from the forearm or a pre-existing injury may also cause the symptoms. Once the onset of pain begins the pain can be persistent through everyday activities and habits particularly if left untreated.
Cubital Tunnel Syndrome
Cubital tunnel syndrome is a very common entrapment neuropathy complaint at the elbow. Elbow movements such as flexing and extending the elbow causes increased traction on the nerve by restricting the space in the cubital tunnel for the ulnar nerve to move and glide.
Wrist and Hand Injuries
There are many injuries and causes that affect the wrist and hand. However overuse injuries of the wrist and hand are very common typically described as micro-traumatic injuries due to damage to bone, tendon or muscle due to repetitive overuse without adequate rest to allow sufficient time to heal.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is nerve irritation and compression of the median nerve and flexor tendons that pass through the carpal tunnel space - caused by narrowing within the carpal canal space in the wrist. People may often experience symptoms of burning, numbness, volar wrist pain that may also radiate to the forearm and shoulder. Pain may also be experienced on the thumb, index finger, middle finger and radial side of the ring finger.
The list continues so if you would like more information please don't hesitate to get in touch or make an appointment if you experience shoulder, elbow, wrist or hand pain that concerns you.
