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February 9, 2013: Chronic Arm pain

Chronic Arm Pain

This week, Dr. Cassaro discussed Chronic arm and hand pain.

Chronic arm and hand pain affects many people...for some, it's arthritis as a cause, for others, the cause might not even be in the arm or hand! In this show we discussed causes, prevention, and treatment for conditions that may cause chronic arm and hand pain.

Q- What are some common conditions that affect the HAND?

A- Chronic hand pain can result from many things. Here are just a few:

  • Arthritis
  • Nerve entrapment/neuropathies
  • Carpal tunnel syndrome
  • Ligament injuries
  • Tendon/muscular injuries
  • Swelling/inflammation
  • Fractures
  • Referred pain

Q- What are some common conditions that can affect the SHOULDER?

A- The shoulder is a very versatile joint, with a wide range of motion. It's this ability that may allow for injury. Here are a few things that may cause pain:

  • Dislocations
  • AC separations
  • Ligament strains/sprains
  • Rotator cuff tears
  • Arthritis
  • Nerve injuries
  • Referred pain (usually from neck)
  • Bursitis

Q- What are some common chronic pain conditions in the ELBOW?

A- The elbow has a very simple range of motion. With this said, injuries are not common, most come as a result from overuse. Here are some things that may cause chronic elbow pain:

  • Tennis elbow
  • Nerve injuries (funny bone/ulnar nerve)
  • General overuse/hyperflexion
  • Inflammation/bursitis
  • Cubital tunnel syndrome

Q- Treating hand pain?

A- Here are some symptoms and treatments for chronic hand pain conditions listed above:

Arthritis- Symptoms include pain, swelling, loss of function. Pain may feel worse with colder temperatures, or periods of rest without use. Treatments include topical medications, radio frequency, injections, exercise, sugar/grains restrictions, and metabolic treatments.

Carpal tunnel syndrome- Symptoms include hand pain, wrist pain, decreased strength in hands, swelling, and numbness in fingers. If you have it in both hands, get an x ray of your neck, because carpal tunnel issues are rarely in both hands; usually issue is in neck. Treatment may include topical medications, injections, diet changes, nutritional supplementation, exercise recommendations, and surgery.

Diabetes/reflex sympathetic dystrophy- Symptoms of this may include a burning, "pins-and-needles" sensation in the hands. Successful treatment requires attention to the metabolic conditions causing the pain. After this is addressed, the pain in the hands usually subsides. In the meantime, relief may be found by applying (prescription) topical medications to the hands.

Q- What are some treatments for the shoulder?

A- Here are some symptoms/treatments for shoulder pain:

AC separations- This is the small joint in the shoulder that attaches the collar bone to the shoulder blade. Severe/sharp burning pain may be common. Treatments may include surgery, injections, rehabilitation, diet/metabolic modifications, and topical medications.

Dislocations- Severe pain is the hallmark symptom, even after the shoulder is relocated. During this type of injury, the tissues surrounding the shoulder are damaged. Rest, metabolic alterations, and even surgery are common treatments.

Rotator cuff tears- This is the tearing of soft tissues in the shoulder. Extreme pain is the primary symptom. It is common for lasting pain to result; even several years after the injury. Strict compliance to physical therapy and diet recommendations is a must! Injections and nerve blocks may be applied to reduce pain during treatment.

Q. What about the ELBOW?

A. The elbow is fairly easy to treat. In most cases, conditions such as tennis elbow can be treated simply by refraining from the activity that induced it (usually not tennis). Elbow pain from conditions like bursitis, or other inflammatory-response effects can be treated by injections, anti-inflammatory medications, and rest. If the chronic pain is due to a nerve condition, like a bad injury to the funny bone nerve, injections may help, as well as topical medications.

Q. What are some general recommendations for reducing chronic arm and hand pain?

Home Treatment

  • Topical medications
  • Glucosamine
  • Epsom Salt baths
  • Vitamins
  • Minerals
  • Exercise
  • Sleep?
  • Diet
  • Eliminating foods
  • MSM
  • DMSO
  • Inversion table
  • Pillows
  • Strength training
  • Workplace changes
  • Splints
  • Wall walking (listen to show for details)
  • Rubber exercise ball for hands

Professional Treatments

  • Radio frequency
  • Chiropractors
  • Injections
  • Metabolic treatments
  • Spinal Stimulator
  • Prolotherapy
  • Rx Topical medications
  • Steroids
  • Medications
  • Separation surgery
  • Braces/slings
  • Physical therapy
  • Anti-Inflammation treatments
  • Other possible surgeries

The most important thing to remember: long term pain is a direct result of the condition your body is in at the time of an injury. Injuries happen to all of us, but the better condition your body is in at the time of incidence, the better your chances for a full recovery, without long-term pain.

The next thing to consider, is EAT RIGHT + SLEEP RIGHT + EXERCISE DAILY!

  • Eat right- Avoid sugar, grains, and starchy foods. When shopping at the grocery, stay in the fresh produce section, and buy fresh meat from the butcher counter. Avoid the rest of the store, and eat NOTHING that comes in a plastic bag (all processed foods).
  • Exercise- Do this every day...even a brisk, short walk does wonders for your metabolism, joints, and circulatory/nervous system.
  • Sleep- Your body repairs and maintains itself while you sleep. If your job puts strain/stress on your body, you need rest (good sleep) to heal from these daily stresses. After a major injury, be sure to get lots of restful sleep. remember, being unconscious is not the same thing as sleeping....alcohol and sleep medications may render you unconscious, but your body's natural healing and bio-rythym cycles are disrupted, resulting in bad or no healing.