Arm Pain

Through evolution our arms were designed for constant movement. The static positions and repetitive motions we expose our arms to can create problems.

Referred pain in the arm most often comes from the neck and shoulders. The front of your neck consists of many strand-like muscles between which all the nerves, arteries and veins pass which then travel further on to the shoulder and arm. These muscles can compress the blood vessels and cause swelling in your hands - usually worse first thing in the morning. They can also compress the nerves which would lead to tingling, numbness or pain in the shoulder or arm region. Otherwise disc problems from the neck can send pain into the arm too - and often you will feel very little or no pain in the neck.

In cases where a neck disc is a major problem the pain in your arm will be worse when you look up for example. It will generally feel more comfortable laying on a thicker pillow too as it will relieve some of your arm pain. In such cases we can take a lot of pressure off the neck by loosening muscles and showing you particular stretches and exercises so you can get involved with your recovery. We also tend to try and mobilise your shoulders and mid back movement in order to take pressure off your neck.

We rarely see organ pain referring into the arm simply because when it does it tends to be serious. Left sided pain is the most common arm pain when someone is suffering from heart problems and will always be worse when you exert yourself - such as climbing stairs etc. Also there is generally left sided jaw ache and chest discomfort at the same time.

In rare cases an enlarged thyroid gland can also cause compression of neighbouring nerves which will in turn cause arm referral on the affected side or both sides. In both of these cases we can help you identify the cause and refer you for the appropriate medical attention.

The wrist has a lot of moving parts and its problems can be quite complex. There are very few muscles around the wrist, so most issues tend to be ligament, tendon or joint related. The most common issues are carpal tunnel, joint restrictions and fractures. Carpal tunnel is a very particular condition which gets misdiagnosed often. Tingling, numbness or swelling in the hand can all be indicators of carpal tunnel, but for example the numbenss has to have a very particular distribution. There are also a few simple clinical test which can be done to distinguish whether this is what you are suffering from.

Two common joint problems in the wrist area are either one of the many interactions of one of the small hand bones, or where you two forearm bones meet. A restriction between either of those leads to a much more restriction range through which your hand can move and this makes your forearm muscles work a lot harder. This can then in turn lead to forearm pain too, which gets diagnosed as the main problem, when in fact it is just a symptoms. It is easy to mobilise these little joints and restore normal movement.

A common tendon issue which affects the wrist is called De Quervain's tenosynovitis. This is a condition where the tendon going from the side of your thumb and down the side of the wrist becomes inflamed and very painful. This condition restricts most hand movements and causes you to feel like your hand and grip strength have greatly diminished. The solutions can range from osteopathic care, to needing a brace to needing more advanced care in either the form of anti-inflammatory medication or injections. In all such cases we would discuss all the options with you so that you could make an informed choice.

After a fall onto your hand, fractures can often remain hidden on the initial X-rays which get taken. We therefore need to keep an eye on how your symptoms progress over time. It may be necessary to repeat the X-rays again at a later stage in order to rule out a fracture if your symptoms are not improving with treatment.

Medial (golfer's elbow) and lateral (tennis elbow) epicondylitis is the inflammation of the area where your forearm muscles attach to your elbow area. This tends to take place from either overuse such as repetitive and poor computer postures or repetitive use of various tools such as hammers. Most often these muscles get overused because either your wrist isn't moving properly or your shoulder muscles aren't working properly and your forearm muscles are trying to make up for it and ending up over-worked.

There are a variety of severities of tennis and golfer's elbow. The tendons can just be tight and strained, or they can be inflamed due to the strain put on them for longer periods of time, or there can also be tearing of the muscles. The full blown version of this condition is when these muscles pull so hard on the area of bone where they attach that they pull the covering of the bone - called periosteum - up and this leads to inflammation underneath it.

There are a variety of solutions for both tennis elbow and golfer's elbow, which will be different depending on the severity of the condition. In most cases osteopathic treatment can either completely resolve the problem or almost resolve it. As the severity increases there may be a need for further imaging such as ultrasound, or there may be a need for a cortisone injection of even surgery with very bad cases. We would of course explain all these options to you and help you make a decision which will give you the best outcome and with which you are most comfortable with.

The hand is an area which has a few important muscles and many important tendons and joints. The muscles between your index finger and thumb can refer to the surrounding areas, such as the joint where your thumbs joins your wrist. It can often be mistaken for arthritic pain. This is an easily remedied problem. The most complex problems involving the hand involve the tendons. Each tendon has a covering which can swell up and become 'tangled up' in the surrounding tissues. This often leads to a finger getting stuck in certain positions.

In such cases we need to improve fluid flow through the hand to try and resolve the swelling in the tendon as well as mobilising the surrounding joints and releasing any tension in the muscles which control that particular tendon. It is also quite important to remove any offending activities or postures as well in order to prevent the problem from coming back.

Other problems which can affect the hand are strictures of the connective bands that keep your tendons in the right positions. This will commonly make certain fingers feel very hard to straighten, or you may need to use your other hand to do so. There area a variety of reasons for this condition to take place, some are to do with your metabolism, others are injury related. In all cases - if caught early - these conditions (such a Dupuytren's contracture) can be relatively easily remedied with osteopathic care - or the utility of hand supports or braces.

The triceps and biceps are big muscles which have a significant impact on arm movement as well as shoulder function. The triceps is quite a robust muscle and tends to rarely suffer from anything more than just tightness. But the other common condition which can affect the end which attaches to your elbow is inflammation of the tendon. Its tendon is quite thick and strong so when it becomes inflamed it can take a while for it to resolve, but it is very easily remedied through osteopathic treatment.

The biceps is similarly a strong muscles, but it does have a long tendon which connects its long head to the shoulder. This tendon passes through a shallow bony groove at the front of your arm and it can either swell up and get stuck in it, or it can get slightly dislocated from this groove.

The bottom end of the biceps at the elbow can also become quite irritated - usually with static held positions or very repetitive motions. Often this bottom end can actually refer to the outside of the elbow and be misdiagnosed as tennis elbow or golfer's elbow. In both of these cases we can relieve the tension being put on the ends of the muscle by releasing any tension in the muscle and showing you how to amend your actions in order to prevent it from happening again.

Over the bony aspect of the back part of your elbow you have a small fluid sac called a bursa. Either repetitive leaning on your elbow or a sudden firm impact to this part of the elbow can make the bursa swell up. It can be reasonably achey or completely painfree but very swollen. It would feel like having a small water balloon over your elbow. We can help ease this condition, but it tends to be slow to respond. In very stubborn cases it may be necessary to refer you for a cortisone injection to help it settle, and then we can help you prevent it from coming back.

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