Overuse Causes Painful Problems 
Each day we see dozens of patients come in the clinic with similar problems. One has a sore elbow, another has a sore shoulder. Then someone has pain in the forearm with numbness or tingling in the hand. What is causing these problems? Do you have pain or numbness and tingling problems? The truth is the pain can be caused by tendonitis, nerve compression or a combination of both. The challenge is to separate which is which. Tendonitis of any part of the body is usually caused by overuse of a body part with varying degrees of pain, stiffness, muscle weakness, sensory problems and loss of range of motion. Symptoms are usually improved with rest and aggravated by high force and repetitive tasks. When they get bad even lifting a coffee cup can be painful. These problems may develop over a period of weeks, months or even years. In fact, recovery may be just as lengthy, although if treated early recovery is usually quicker. The symptoms may be very specific such as pain only in the elbow or it may be general and felt in the neck, shoulder, arm and hand. Early on, the symptoms usually come and go but as time goes by the symptoms become more frequent and more intense. Often, there is more than one cause. Interestingly, since 1989 these types of injuries have accounted for more than 50% of all injuries and illness at work according to U.S. Bureau of Labor Statistics. I have found they also occur in older and occasionally younger patients who are more active. This type of person may work out frequently or is an avid gardener. In any case they are very active and develop pain or nerve problems. Another contributing factor we see is stress. A death in the family, trouble with relationships such as a spouse, family member, supervisor or boss can contribute to tightness in the muscles around the neck and shoulder. Sometimes it leads to nighttime fist clenching or jaw clenching. The process that leads to problems in tendonitis is as follows: Overuse leads to inflammation This inflammation causes pain, swelling and tenderness Scar tissue begin to form if not aggravated Proteins migrate in to strengthen the injured tissue If re-aggravated (no rest or therapy) the inflammatory phase continues and other tissues such as nerve, blood vessels, etc become injured as well (chronic pain) Chronic inflammation leads to further swelling and compression of surrounding tissues. This can compress the blood vessels and lead to dead tissues in the tendons, muscles and nerves. You cannot work out a bad case of tendonitis. You must stop the abusive activity and get treatment. Failure to do so will lead to permanent tendon, muscle and most importantly, nerve damage. What happens to the nerves that causes nerve pain, numbness or pins and needles feelings? Initially pressure on the nerve causes changes in the blood/nerve barrier. (swelling) Next, nerve attachments to connective tissue are irritated. Continued pressure leads to nerve fiber damage (reversible if not prolonged) If this continues, it can lead to permanent nerve damage with loss of sensation to the affected areas. If the pressure continues, it leads to more and more nerve fiber death and muscle weakness occurs. Time and space prevent me from describing all the different types of tendonitis and nerve problems that can occur. Generally the most common areas are: Palm of the hand Thumb side of wrist Inside and outside elbow points Shoulder Neck and upper back TREATMENT FOR ACUTE PAIN & PROBLEMS Treatment for acute pain and problems at first involves controlling inflammation and breaking the pain/swelling/spasm cycle. Modalities such as electrical stimulation, ultrasound and more recently cold laser are used to control pain and swelling. Exercises to stretch and restore blood flow and re-grow healthy tissue. Education to avoid or limit movements that are causing or aggravating the problem Home or worksite work station redesign to decrease factors contributing to the problem Splints or braces can be custom made to rest a specific area and allow it heal Avoidance of provocative postures, motions and activities. For example: The home spacer bar on your keyboard of your computer should be the same height from the floor as your elbow. Use a tape measure to check. Remember, these are problems you cannot continue to “work through”. Instead, be sensible and get expert advice and care if you let them go they can become disabling. Remember these problems do not come overnight and will take time to get better. Most of all, show respect for you and your family, get relief from your pain and problems before they become permanent or disabling. Call us today and take control of your body and stop letting it control you! Give us a call today! Our staff will be happy to answer any of your questions. For this and links to other information visit our website www.tristatehand.com |
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