Making the Connection:
Upper Extremity Pain and Neck Injury

Over the past few years there has been an increase in technological gadgets that have broadened the communication realm. These consistent new developments have, created the option for anyone to work from anywhere at anytime. With these advancements there has also, “coincidentally”, come an increase in repetitive stress injuries sustained in the neck and upper extremities as seen in my practice.

People suffering from such injuries may show up with complaints that can include numbness, tingling, burning, aching, and pins and needle in one or more of the following areas: shoulders, deltoids, biceps, triceps, forearms, wrists, palms, thumbs, the entire hand or any of the fingers.

Often the sensations that an individual is experiencing can be related to their cervical spine / neck. It is essential when diagnosing these conditions to find out where the pain actually stems from. The problem arises when the diagnoses and treatments are aimed at the area of complaint vs. the actual area of injury.

If we look plainly at the anatomy of the body, we will find that nerves originate from the spinal cord and travel out to their respective destinations. Nerves can get “caught” or entrapped in many different structures that they pass along the way.

To better explain this I will use a patient case study. Rachel, a 30-year-old lawyer, came into the office complaining of pain that was previously diagnosed as “Carpal Tunnel Syndrome.” She explained that her pain was located in the “meaty” part of her thumb and would extend up to the pad of the finger. It felt like a tingle that would sometimes intensify to a burning sensation. She had been suffering for 10 weeks and despite her efforts, the pain had been progressing, increasing in frequency as well as duration. The pain would come and go throughout the day with no relation to any specific activity that she was aware of.

After a visit with her doctor, Rachel was initially prescribed a brace to wear at night. She was told to change her keyboard position and take an anti-inflammatory to help relieve the pain. After following this routine for two weeks without any improvement, she was prescribed physical therapy and told that she may be a candidate for surgery. After four weeks of physical therapy Rachel was still in pain.
Afraid of surgery, she found her way to my office.

A thorough medical and lifestyle history revealed a correlation between pain sensations and activities. Rachel’s pain peaked while she was on her laptop and checking emails on her hand-held phone. Both activities required her to look down for long periods at a time.

After a proper physical exam of the neck and upper extremity, ART (Active Release Technique) was used to release the muscles of the neck and shoulder. Within a few minutes after her treatment, Rachel noticed a significant change in pain levels.

The repetitive stress Rachel was putting on the neck created tightness in the muscles. After a three-week cycle of treatment, a few ergonomic changes at work, and simple daily neck exercises Rachel has been pain free ever since.

With all the hours we spend sitting at our desks, using our computers and/or hand- held devises, we put a great deal of strain on the muscles of our upper body. Over time, these stresses can create what some call “trigger points,” “knots”, or “adhesions” in the muscles, tendons, ligaments and fascia of the neck.

In Rachel’s case, the immediate cause of pain stemmed from adhesions in a muscle group of the neck called the scalenes. The scalenes are composed of three parts: the anterior (front), the medial (middle), and the posterior (back). Between these muscles travels a group of nerves called brachial plexus. The brachial plexus are thick nerve fibers that branch into the nerves of the upper extremity / arm. When these muscles get tight they can press on the nerves, which in turn can cause pain that travels or migrate to different areas of the body. These particular adhesions can create pain in the shoulder, neck, arm, forearm, and hands.

Active Release Technique, more commonly known as ART, is a patented state of the art soft tissue system/movement based technique that treats problems with muscles, tendons, ligaments, fascia and nerves. ART can be effective in releasing adhesions, tightness, and scar tissue in the body, quickly and permanently.

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