The Spectrum of Nerve and Soft Tissue Injury Just a few weeks ago a woman came into my office who was frustrated. She had pain on the outside part of her shoulder which radiated into the outside part of her elbow, forearm and down into the back of her hand. She had seen an orthopedic surgeon and had an MRI and nerve test. The trouble was, all the tests were negative but she still had pain. Now, she was being told to take some pills because she might be depressed. Really? Is that where we are now? That if we don’t see it in a test then it doesn’t exist and it must be in your head? Unfortunately this really is not that unusual a story. It’s no wonder patients are afraid to mention their pain if the only options are pills or surgery. The truth is there are types of nerve injuries that fly below the radar of what diagnostic machines can detect. It won’t be found unless you physically examine the patient or take the time to get a good description of the problem. Because frankly, if you listen to the patient 90% of the time the diagnosis of the problem is in what the patient says. The lady with the shoulder and arm pain, let’s call her “Susie”, was finally told it was her rotator cuff, so she asked for therapy. Her story was she is on the computer 8-9 hours a day, had gained weight, and started to work out back in December. Then in January she mysteriously started developing this right shoulder and arm pain. It was slowly getting worse. I asked if her neck bothered her, any previous injuries etc., but she said no to all of those questions. It was right here that she said the outside part of her shoulder, in her armpit and it was radiating down the outside of her arm. Well, the radial/axillary nerve goes to exactly those places. There are two muscles which rotate the shoulder and that nerve goes between them. Her posture was “stoopy” too with rounded shoulders and a tight chest. I had seen this type of problem before! She stretched as part of her therapy that day and we worked to strengthen her ability to pull her shoulder back. As time went by we also discussed lowering her keyboard to stop her from “chicken winging” with her arms to stop the overuse of that shoulder muscle. Eventually, after she did her exercises and lowering her keyboard her pain resolved and her posture improved. Oh, and she did not need any anti-depressants either! So there is a spectrum of nerve pain which can cause pain in the arms and hands and also in the legs and feet that is not detectable by testing sometimes. These problems are real and they are usually tight soft tissue or muscle which squeeze and compress the nerves. If you think you might have a problem why not give us a call and we can check it out. We are open 8am to 6pm, Monday through Friday and can accommodate your schedule. Call 301-759-4263 for help or go online to www.tristatehand.com for more information. Try therapy first at Tristate Hand, Foot and Ankle! |
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