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The Common Spinal, Muscle, Tendon and Nerve Conditions Treated by Daniel Fung, DC
UPPER BACK
Today, upper back pain (pain between the shoulders) is most commonly found in people that spend hours at a time sitting in front of a computer screen, smart phone or at the steering wheel. These people usually carry their heads forward in relation to their shoulders, causing repetitive strain to the upper back musculature. Often, the trapezius and levator scapula muscles are involved as well as vertebral subluxations of the thoracic spine.
SHOULDER
Rotator Cuff Impingements - Injuries to the rotator cuff can result from repetitive strain, physical injury, muscle imbalances or even poor posture. If the rotator cuff is involved, pain can be felt in the front, top or back of the shoulder. Pain can radiate down the arm as well. Often, the cause is a build-up of scar tissue adhesions in the muscles and tendons which feed into the shoulder capsule. These tissues can become tight and inflamed with certain motions.
Bursitis- This condition involves inflammation of the bursa ( a fluid-filled sac in the shoulder joint). This is caused by abnormal stress and tension on the shoulder joint. It can be painful when the arm is moved in any direction.
LOWER BACK
Lower back pain can result from poor posture, repetitive stress, vertebral misalignments or osteo arthritis. Other causes include degenerative arthritis, osteoporosis, spondyloslisthesis and degenerative disc disease.
HIPS - Causes of hip pain include sciatica (nerve entrapment), hip rotator muscle spasm, sacroiliac joint pain, sacroiliac subluxation and piriformis syndrome.
RIBS - Rib pain and dysfunction are often associated with sharp pinpoint pain with inspiration. Common causes are subluxations of the ribs and/or strains of the surrounding muscles.
ANKLE
Ankle Sprains - The most common type of ankle injury is a sprain. These injuries are often painful with swelling and discoloration. 90% of these are on the outside of the ankle (an inversion sprain, where the foot rolls inward) and 10% are in the inside. The many ligaments surrounding the ankle joint can be damaged when the foot is forced into an abnormal position.
Initial treatment of an ankle sprain: 1. Rest - no weight bearing for the first 24 hours after the injury (Possibly longer, depending upon severity) 2. Ice - apply ice packs using a towel over a plastic bag to the area that is painful. Be careful to avoid frostbite. Ice should be intermittantly applied for the first 24 hours. 3. Compression - an ACE bandage or other soft elastic material should be applied to the ankle to help prevent the accumulaton of edema (swelling). 4. Elevation - elevating the ankle helps in removing edema. By having the foot higher than the hip (or heart), gravity is used to pull edema out of the ankle. The following should be avoided in the first 24-36 hours as they may increase swelling:
• hot packs or hot showers
• heat rubs (methylsalicylate gels or creams such as "Icy Hot" or "BioFreeze")
• alcohol consumption Note: aspirin increases the clotting time of blood which may increase bleeding into the ankle. (Tylenol or Ibuprofen may be taken to help with pain, but will not speed up the healing process.)
FOOT
Plantar Fascitis - This is often described as the presence of pain in the arch down to the heel bone (calcaneal tuberosity) of the foot. The structures involved are often the plantar fascia and/or flexor muscles of the toes. The injury is commonly caused by the overuse of the calves which cause a build up of tension at the achilles tendon. This structure can also cause sharp pain at the calcaneal tuberosity.
FOREARM / WRIST
Repetitive Stress Syndrome
A common cause of elbow or wrist pain is repetitive overuse of the forearm muscles. This can cause abnormal, excess tension on the wrist tendons. This tension can cause the tendons to become inflamed (tendinitis). Symptoms include stiffness, achiness or sharp pain in the wrist. It is often caused by racket sports, computer use, carpentry or other repetitive activities.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is one of the most commonly diagnosed (and mis-diagnosed) conditions of the wrist. It is not always painful though it is marked by weakness to the thumb, index or middle finger due to a trapped nerve in the wrist. The conditions is commonly caused by the repetitive stress of using a computer keyboard or mouse, writing, or using a hammer or screwdriver.
Peripheral Nerve Entrapments
Nerves can be trapped within soft tissues in over a dozen areas between the neck and hand. This can cause numbness, tingling and pain in the forearm, hand or fingers.
Today, upper back pain (pain between the shoulders) is most commonly found in people that spend hours at a time sitting in front of a computer screen, smart phone or at the steering wheel. These people usually carry their heads forward in relation to their shoulders, causing repetitive strain to the upper back musculature. Often, the trapezius and levator scapula muscles are involved as well as vertebral subluxations of the thoracic spine.
SHOULDER
Rotator Cuff Impingements - Injuries to the rotator cuff can result from repetitive strain, physical injury, muscle imbalances or even poor posture. If the rotator cuff is involved, pain can be felt in the front, top or back of the shoulder. Pain can radiate down the arm as well. Often, the cause is a build-up of scar tissue adhesions in the muscles and tendons which feed into the shoulder capsule. These tissues can become tight and inflamed with certain motions.
Bursitis- This condition involves inflammation of the bursa ( a fluid-filled sac in the shoulder joint). This is caused by abnormal stress and tension on the shoulder joint. It can be painful when the arm is moved in any direction.
LOWER BACK
Lower back pain can result from poor posture, repetitive stress, vertebral misalignments or osteo arthritis. Other causes include degenerative arthritis, osteoporosis, spondyloslisthesis and degenerative disc disease.
HIPS - Causes of hip pain include sciatica (nerve entrapment), hip rotator muscle spasm, sacroiliac joint pain, sacroiliac subluxation and piriformis syndrome.
RIBS - Rib pain and dysfunction are often associated with sharp pinpoint pain with inspiration. Common causes are subluxations of the ribs and/or strains of the surrounding muscles.
ANKLE
Ankle Sprains - The most common type of ankle injury is a sprain. These injuries are often painful with swelling and discoloration. 90% of these are on the outside of the ankle (an inversion sprain, where the foot rolls inward) and 10% are in the inside. The many ligaments surrounding the ankle joint can be damaged when the foot is forced into an abnormal position.
Initial treatment of an ankle sprain: 1. Rest - no weight bearing for the first 24 hours after the injury (Possibly longer, depending upon severity) 2. Ice - apply ice packs using a towel over a plastic bag to the area that is painful. Be careful to avoid frostbite. Ice should be intermittantly applied for the first 24 hours. 3. Compression - an ACE bandage or other soft elastic material should be applied to the ankle to help prevent the accumulaton of edema (swelling). 4. Elevation - elevating the ankle helps in removing edema. By having the foot higher than the hip (or heart), gravity is used to pull edema out of the ankle. The following should be avoided in the first 24-36 hours as they may increase swelling:
• hot packs or hot showers
• heat rubs (methylsalicylate gels or creams such as "Icy Hot" or "BioFreeze")
• alcohol consumption Note: aspirin increases the clotting time of blood which may increase bleeding into the ankle. (Tylenol or Ibuprofen may be taken to help with pain, but will not speed up the healing process.)
FOOT
Plantar Fascitis - This is often described as the presence of pain in the arch down to the heel bone (calcaneal tuberosity) of the foot. The structures involved are often the plantar fascia and/or flexor muscles of the toes. The injury is commonly caused by the overuse of the calves which cause a build up of tension at the achilles tendon. This structure can also cause sharp pain at the calcaneal tuberosity.
FOREARM / WRIST
Repetitive Stress Syndrome
A common cause of elbow or wrist pain is repetitive overuse of the forearm muscles. This can cause abnormal, excess tension on the wrist tendons. This tension can cause the tendons to become inflamed (tendinitis). Symptoms include stiffness, achiness or sharp pain in the wrist. It is often caused by racket sports, computer use, carpentry or other repetitive activities.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is one of the most commonly diagnosed (and mis-diagnosed) conditions of the wrist. It is not always painful though it is marked by weakness to the thumb, index or middle finger due to a trapped nerve in the wrist. The conditions is commonly caused by the repetitive stress of using a computer keyboard or mouse, writing, or using a hammer or screwdriver.
Peripheral Nerve Entrapments
Nerves can be trapped within soft tissues in over a dozen areas between the neck and hand. This can cause numbness, tingling and pain in the forearm, hand or fingers.