.

Associated medical conditions. 

Shown below are medical conditions which are sometimes included under the term RSI prior to a more accurate diagnosis being confirmed. The information below is not intended to provide instruction and you should not rely on this information to determine diagnosis, prognosis or a course of treatment. It should not be used in place of a professional consultation with a doctor.

Simplistically, most of the medical conditions below cause pain in the hand, wrist, arm or shoulder, and are caused by overuse of parts of the anatomy, or repetitive use of the same parts over a long period.

- Carpel Tunnel Syndrome
- Edema.
- Tendinitis.
- Tendinosis.
- Cubital tunnel syndrome.
- De Quervain syndrome, Tenosynovitis.
- Thoracic outlet syndrome.
- Intersection syndrome.
- Golfer's elbow (medial epicondylitis).
- Tennis elbow (lateral epicondylitis).
- Trigger finger (so-called stenosing tenosynovitis).
- Radial tunnel syndrome.
- Focal dystonia. 
- Bursitis.
- Thoracic Outlet Syndrome.
- Myofascial Pain Syndrome. 

Carpel Tunnel Syndrome

You may have heard the term before, it's one of the more common problems. It often occurs in people who work with computers or carry out repetitive manual work with poor posture or activities that require you to work in an awkward position. Significant pain occurs in the wrist. more>>

Tendinitis

This is basically inflammation of a tendon, ('..itis means inflammation) and injuries are common in the upper shoulder and lower section of the elbow (including the rotator cuff attachments), and are less common in the hips and torso. more>>

Tendinosis

Tendinosis is often misdiagnosed as tendinitis, and is damage to a tendon at a cellular level (the suffix "osis" implies a pathology of chronic degeneration without inflammation) i.e. in layman's language, the cells that make up the tendon have been physically damaged and it's not just inflammation which is causing the pain. Tennis elbow is a common symptom. more>>

Cubital tunnel syndrome

Cubital Tunnel Syndrome is a condition that involves pressure or stretching of the “funny bone” nerve, which can cause numbness or tingling in the ring and small fingers, pain in the forearm, and/or weakness in the hand. more>>

De Quervain syndrome, or Tenosynovitis

De Quervain syndrome also known as BlackBerry thumb or gamer's thumb, is damage to the sheath or tunnel that surrounds two tendons that control movement of the thumb. more>>

Thoracic outlet syndrome

Thoracic outlet syndrome is a condition whereby nerves or blood vessels, are compressed because of an inadequate passageway through an area between the base of the neck and the armpit. more>>

Intersection syndrome

Intersection syndrome is a painful condition that affects the thumb side of the forearm. The mechanism of injury is usually repetitive resisted extension, as with rowing, weight lifting, or pulling. more>>

Medial Epicondylitis. 'Golfer's elbow'

Medial epicondylitis causes pain and inflammation on the inside of the elbow where the muscles that flex the wrist attach to the bone. This can occur not only in golfers but in anyone who performs repeated motions of the wrist. more>>

Lateral epicondylitis. 'Tennis elbow'

Tennis elbow or lateral epicondylitis is a condition in which the outer part of the elbow becomes sore and tender. 
Caused by any activity, including playing tennis. Also common in carpenters and other laborers who swing a hammer or other tool with the forearm. more>>

Trigger finger (so-called stenosing tenosynovitis)

This is a painful condition caused by the inflammation of tendons in the fingers. This condition more commonly affects the middle and ring fingers and occasionally the thumb more>>

Radial tunnel syndrome

Radial tunnel syndrome causes a dull, aching pain at the top of the forearm with use. Although less common, symptoms can also occur at the back of the hand or wrist. more>>

Focal dystonia.

Focal hand dystonia causes involuntary movement, cramps or tremor in the hand or arm muscles usually when making highly practiced hand movements such as writing or playing a musical instrument. Focal hand dystonia is often called writer’s cramp or musician’s cramp.  more>>

Bursitis

Bursitis is inflammation of the bursae, the fluid-filled sacs that protect against friction between bones and other tissues. Depending on the location in the body, bursae may cushion bones from other bones, tendons, muscle, or skin. Bursitis can occur in many areas of the body. It is most common in the elbows and wrists. more>>

Thoracic outlet syndrome

Thoracic outlet syndrome (TOS) can cuase numbness in fingers, pain in shoulder, arm, and neck by compression of nerves and/or blood vessels in the upper chest. The condition is common among athletes incurring repetitive motions of the arm and shoulder, such as baseball, swimming, volleyball, and other sports. more>>

Myofascial Pain Syndrome

Myofascial pain syndrome is a chronic pain disorder (this means it gets worse with time!). In myofascial pain syndrome, pressure on sensitive points in your muscles (trigger points) causes pain in seemingly unrelated parts of your body. This is called referred pain. Myofascial pain syndrome typically occurs after a muscle has been contracted repetitively. This can be caused by repetitive motions used in jobs or hobbies or by stress-related muscle tension. more>>

 

Carpel Tunnel Syndrome

More information plus diagrams>>

Carpal Tunnel Syndrome is one example of the several conditions that are included under the umbrella term Repetitive Strain Injury. You may have heard the term before, it's one of the more common problems, but in fact it only represents a small but dangerous percentage of RSI problems.

It often occurs in people who work with computers or carry out repetitive manual work with poor posture or activities that require you to work in an awkward position.

Few people are aware that the muscles which operate your fingers, to provide the significant 'grip' which we all possess, are actually positioned in the forearm. There are small muscles in each finger, and are mainly used to 'ungrip' the fingers i.e. pull the fingers back after you have finished holding something, or move the fingers sideways, or rotate the thumb. 

The forearm is packed with large powerful muscles, and these are linked to the fingers by tendons (like strong cables) which pass through a hole or 'tunnel' in the middle of the wrist. So when the muscles in the forearm contract, the tendons are pulled through the tunnel, and as they are connected at the other end to the fingers, cause the fingers to bend inwards and create the grip. It's an extraordinarily clever system which is now being copied by engineers creating robotic hands.

The problem, however, is that there is also a nerve which passes through the same tunnel, which controls the hand, and this can become compressed due to several factors, causing the pain. One factor is the repetitive use of the hand.

What are the Symptoms?

Tightness, discomfort, stiffness, soreness or burning in the hands, wrists, fingers, forearms, or elbows.

Tingling, coldness, or numbness in the hands.

Clumsiness or loss of strength and coordination in the hands.

Pain that wakes you up at night.

Feeling a need to massage your hands, wrists, and arms.

Pain in the upper back, shoulders, or neck associated with using the computer. 

Causes

Repetitive activities which are lightweight, but which subject muscles to strain they are not used to, such as suspending the hand and arm upwards for computer keyboard or mouse use.

Carrying out an activity for a long period of time without adequate rest periods and poor posture.

Activities that require you to work in awkward or tiring positions, and/or using vibrating equipment.

It can come on quite suddenly, 'out of the blue' or gradually increase over a long period. If you continue with your activities and posture it will get worse and worse.

It may get so bad that you aren't able to do routine work or household activities. The pain may get so bad that it's there all the time, even when you're resting.

More information plus diagrams>>

 

Tendinitis

Tendinitis (sometimes misdiagnosed instead of Tendinosis - see below) is basically inflammation of a tendon. The term tendinitis should be reserved for tendon injuries that involve larger-scale acute injuries accompanied by inflammation. Generally tendinitis is referred to by the body part involved, such as Achilles tendinitis (affecting the Achilles tendon), or patellar tendinitis (jumper's knee, affecting the patellar tendon).

Tendinitis injuries are common in the upper shoulder and lower section of the elbow (including the rotator cuff attachments), and are less common in the hips and torso.

Individual variation in frequency and severity of tendinitis will vary depending on the type, frequency and severity of exercise or use; for example, rock climbers tend to develop tendinitis in their fingers or elbows, swimmers in their shoulders. 

Achilles tendinitis is a common injury, particularly in sports that involve lunging and jumping, while Patellar (kneecap) tendinitis is a common among basketball and volleyball players owing to the amount of jumping and landing.

Symptoms

Symptoms can vary from aches or pains and local joint stiffness, to a burning that surrounds the whole joint around the inflamed tendon. In some cases, swelling occurs along with heat and redness, and there may be visible knots surrounding the joint. 

With this condition, the pain is usually worse during and after activity, and the tendon and joint area can become stiff the following day as muscles tighten from the movement of the tendon. Many patients report stressful situations in their life in correlation with the beginnings of pain which may contribute to the symptoms. 

If the symptoms of tendinitis last for several months (6 months) or longer, it is probably tendinosis - see below.


 


Tendinosis

Tendinosis, sometimes called chronic tendinitis, chronic tendinopathy, or chronic tendon injury, is damage to a tendon at a cellular level (the suffix "osis" implies a pathology of chronic degeneration without inflammation) i.e. in layman's language, the cells that make up the tendon have been physically damaged and it's not just inflammation which is causing the pain. It is thought to be caused by microtears in the connective tissue in and around the tendon, leading to an increase in tendon repair cells. 

This may lead to reduced tensile strength, thus increasing the chance of tendon rupture. Tendinosis is often misdiagnosed as tendinitis due to the limited understanding of tendinopathies by the medical community. 

Classical characteristics of "tendinosis" include degenerative changes in the collagenous matrix, hypercellularity, hypervascularity, and a lack of inflammatory cells which has challenged the original misnomer "tendinitis"

Tendinosis of the common extensor tendon of the elbow (“tennis elbow”) is a common cause of elbow pain for adults.

The general opinion is that tennis elbow tendinosis is due to tendon overuse, and failed healing of the tendon. In addition, the extensor carpi radialis brevis muscle plays a key role.

 

Cubital Tunnel Syndrome

Cubital Tunnel Syndrome, (not to be confused with Carpel Tunnel Syndrome), is a condition that involves pressure or stretching of the ulnar nerve (also known as the “funny bone” nerve), which can cause numbness or tingling in the ring and small fingers, pain in the forearm, and/or weakness in the hand. The ulnar nerve runs in a groove on the inner side of the elbow. 

The nerve has little padding over it. Direct pressure (like leaning the arm on an arm rest) can press the nerve, causing the arm and hand — especially the ring and small fingers — to “fall asleep.” 

Keeping the elbow bent for a long time can stretch the nerve behind the elbow. This can happen during sleep.

Sometimes, the ulnar nerve does not stay in its place and snaps back and forth over a bony bump as the elbow is moved. Repeated snapping can irritate the nerve. Sometimes, the soft tissues over the nerve become thicker or there is an “extra” muscle over the nerve that can keep it from working correctly.

Cubital tunnel syndrome can cause pain, loss of sensation, tingling and/or weakness. “Pins and needles” usually are felt in the ring and small fingers. These symptoms are often felt when the elbow is bent for a long period of time, such as while holding a phone or while sleeping. Some people feel weak or clumsy.

 



De Quervain syndrome

De Quervain syndrome also known as BlackBerry thumb, gamer's thumb, washerwoman's sprain, radial styloid tenosynovitis, de Quervain disease, de Quervain's tenosynovitis, de Quervain's stenosing tenosynovitis, mother's wrist, or mommy thumb, is a tenosynovitis of the sheath or tunnel that surrounds two tendons that control movement of the thumb.

Symptoms are chronic pain, spasms, tenderness, occasional burning sensation in the hand, and swelling over the thumb side of the wrist, and difficulty gripping.

The cause of de Quervain's disease is not fully established. Evidence regarding a possible relation to occupational risk factors is debated. A systematic review of potential risk factors discussed in the literature did not find any evidence of a causal relationship with occupational factors. 

However, researchers in France found personal and work-related factors were associated with de Quervain's disease in the working population; wrist bending and movements associated with the twisting or driving of screws were the most significant of the work-related factors.

Proponents of the view that De Quervain syndrome is a repetitive strain injury consider postures where the thumb is held in abduction and extension to be predisposing factors.

Workers who perform rapid repetitive activities involving pinching, grasping, pulling or pushing have been considered at increased risk. Specific activities that have been postulated as potential risk factors include intensive mouse/trackball use and typing, as well as some pastimes, including bowling, golf and fly-fishing, piano-playing, and sewing and knitting.

Women are affected more often than men. The syndrome commonly occurs during and after pregnancy. Contributory factors may include hormonal changes, fluid retention and—more debatably—lifting.

See also, in the Gamers page info on gamers thumb

 

 

Thoracic outlet syndrome 

Thoracic outlet syndrome is a condition whereby symptoms are produced from compression of nerves or blood vessels, or both, because of an inadequate passageway through an area (thoracic outlet) between the base of the neck and the armpit.

It can affect one or more of the nerves that innervate the upper limb and/or blood vessels as they pass between the chest and upper extremity, specifically in the brachial plexus, the subclavian artery, and rarely, the subclavian vein.

The most common causes of thoracic outlet syndrome include physical trauma from a car accident, repetitive strain injury from a job such as frequent non-ergonomic use of a keyboard, sports-related activities, and anatomical defects such as having an extra rib.

In pregnancy, if a narrow superior thoracic outlet exists previously, the patient can have symptoms for the first time. Joints loosen during pregnancy, making it easier to develop bad posture.

Careful examinations and X-rays are required to differentially diagnose between the positional and static etiologies, first rib fixations, scalene muscle spasm, and a cervical rib or fibrous band.

TOS affects mainly the upper limbs, with signs and symptoms manifesting in the arms and hands. Pain is almost always present and can be sharp, burning, or aching. It can involve only part of the hand (as in the 4th and 5th finger only), all of the hand, or the inner aspect of the forearm and upper arm.

Pain can also be in the side of the neck, the pectoral area below the clavicle, the armpit/axillary area, and the upper back (i.e., the trapezius and rhomboid area). Decoloration of the hands, one hand colder than the other hand, weakness of the hand and arm muscles, and tingling are commonly present.

TOS is often the underlying cause of refractory upper limb conditions like frozen shoulder and carpal tunnel syndrome that frequently defy standard treatment protocols. TOS can be related to Forward head posture.

If left untreated, TOS can lead to neurological deficits as a result of the hypoperfusion and hypometabolism of certain areas of the brain and cerebellum.

Treatments include a variety of exercises that effectively stretch open the tissues of the thoracic outlet. These are done with and without weights in the hands to pull the outlet into a "relaxed" open position. 

Physical therapists are specially trained in the instruction of exercises for thoracic outlet syndrome, and their evaluation of the patient can be helpful. Shoulder-shrug exercises and others can be done at home or at work to relax the muscles around the thoracic outlet.

 




Intersection syndrome.

Intersection syndrome is a painful condition that affects the thumb side of the forearm when inflammation occurs at the intersection of the muscle bellies of the abductor pollicis longus and extensor pollicis brevis cross over the extensor carpi radialis longus and the extensor carpi radialis brevis. The 1st and 2nd dorsal muscle compartments intersect at this location, hence the name. The mechanism of injury is usually repetitive resisted extension, as with rowing, weight lifting, or pulling.

Intersection syndrome is often confused with another condition called DeQuervain's syndrome, which is an irritation of the thumb-sided set of tendons at the wrist, called the first dorsal compartment.

There is usually a history of overuse through repetitive wrist flexion and extension, or less commonly direct trauma. Weightlifters, rowers, racket sport players, horseback riders and skiers are particularly prone. Patients complain of radial wrist or forearm pain exacerbated by flexion and extension. Swelling and tenderness at the area of intersection may be present.

Conservative treatment of intersection syndrome includes immobilization, activity modification, and pharmacologic intervention. The radial wrist extensors can be immobilized with a cock-up wrist splint (20 º of extension). Because of secondary irritation by the abductor pollicis longus (APL) and extensor pollicis brevis (EPB), a thumb spica splint (allowing thumb interphalangeal [IP] motion) is frequently required.

 




Medial Epicondylitis 

Medial epicondylitis occurs with pain and inflammation on the inside of the elbow where the muscles that flex the wrist attach to the bone. This can occur not only in golfers but in anyone who performs repeated motions of the wrist.

Medial epicondylitis ME is an overuse injury affecting the flexor-pronator muscle origin at the anterior medial epicondyle of the humerus. ME is often discussed in conjunction with lateral epicondylitis LE, which occurs much more frequently. ME is the most common cause of medial elbow pain, although the clinician is likely to see at least 5 cases of LE for every case of ME. Patients who develop medial elbow pain appreciate their physician's knowledge of the subtle differences in the diagnosis and treatment of the 2 disorders.

What causes this?

Epicondylitis is caused by repetitive stress and strain to the muscles and tendons that attach the forearm muscles to the elbow. This can include any sudden change in activity level or intensity, or any incorrect grip or grip size in racquet sports. This repetitive stress causes microscopic tearing of the tendon. Blood supply to this area is poor and thus commonly the healing response is limited.

What is the treatment?

Initially, treatment consists of anti-inflammatory medications and a stretching and strengthening program. Stretching is a key component in treating epicondylitis. Each stretch should be held for at least 10 seconds, then relax the arm and repeat up to several times a day and in between activities. Minimally 3 sets of 20 repetitions should be performed.

 




Lateral Epicondylitis


Tennis elbow or lateral epicondylitis is a condition in which the outer part of the elbow becomes sore and tender. Tennis elbow is an acute or chronic inflammation of the tendons that join the forearm muscles on the outside of the elbow (lateral epicondyle). The forearm muscles and tendons become damaged from overuse — repeating the same strenuous motions again and again. This leads to inflammation, pain and tenderness on the outside of the elbow.

Any activity, including playing tennis, which involves the repetitive use of the extensor muscles of the forearm can cause acute or chronic tendonitis of the tendinous insertion of these muscles at the lateral epicondyle of the elbow. The condition is common in carpenters and other laborers who swing a hammer or other tool with the forearm.

Runge is usually credited for the first description of the condition, in 1873. The term tennis elbow first appeared in an 1883 paper by Major called Lawn-tennis elbow.

Signs and symptoms

- Pain on the outer part of the elbow (lateral epicondyle)
- Point tenderness over the lateral epicondyle, a prominent part of the bone on the outside of the elbow.
- Pain from gripping and movements of the wrist, especially wrist extension and lifting movements.
- Pain from activities that use the muscles that extend the wrist (e.g. pouring a container of liquid, lifting with the palm down, sweeping, especially where wrist movement is required)
- Morning stiffness.

Symptoms associated with tennis elbow include, but are not limited to: radiating pain from the outside of the elbow to the forearm and wrist, pain during extension of wrist, weakness of the forearm, a painful grip while shaking hands or torquing a doorknob, and not being able to hold relatively heavy items in the hand. The pain is similar to the condition known as golfer's elbow, but the latter occurs at the medial side of the elbow.
Tennis elbow is a type of repetitive strain injury, resulting from tendon overuse and failed healing of the tendon. In addition, the extensor carpi radialis brevis muscle plays a key role.

Early experiments suggested that tennis elbow was primarily caused by overexertion. However, studies show that trauma such as direct blows to the epicondyle, a sudden forceful pull, or forceful extension cause more than half of these injuries. It has also been known that incorrectly playing tennis may cause early stages of tennis elbow as shock is received when mis-hitting the ball.

 




Stenosing tenosynovitis 

Stenosing tenosynovitis (also known as trigger finger or trigger thumb) is a painful condition caused by the inflammation (tenosynovitis) and progressive restriction of the superficial and deep flexors fibrous tendon sheath adjacent to the A1 pulley at a metacarpal head. Repetitive forceful compression, tensile stress, and resistive flexion, causes inflammation, swelling, and microtrauma, that results in thickening and stenosis (commonly a nodular formation) of the tendon distal to the pulley leading to a painful digital base, limitation of finger movements, triggering, snapping, locking, and deformity progressively.

Patients report a popping sound at the proximal interphalangeal joint (PIP), morning stiffness with/without triggering, delayed and sometimes painful extension of the digit, and when more advanced, a locking position that requires manipulation to extend the affected finger. This condition more commonly affects the middle and ring fingers (occasionally the thumb), and the flexor rather than extensor tendons in the hand.

In rheumatic trigger finger (or in diabetes), more than one finger may be involved. Cases of stenosing peroneal tenosynovitis, have been reported where the patient presents with pain over the lateral malleolus, both with active and passive range of motion and no physical of radiographic evidence of instability.

Stenosing tenosynovitis is most common caused by overuse from chronic repetitive activities using the hand or the involved finger. Examples include work activities (e.g., computer use, materials handling) or recreational activities (e.g., knitting, golf, racket sports). Carpenters who use hammers suffer from this as well as those who continuously grip wood or other materials when cutting them due to having to use your hands as a clamp to hold things in place.

Primary stenosing tenosynovitis can be idiopathic, occurring in middle age women more frequently than in men, but can present also in infancy.

Secondary stenosing tenosynovitis can be caused by disease or entities that cause connective tissue disorders including the following:

Stenosing tenosynovitis often presents with a painful and swollen thumb with limited range of motion, or a ring finger or middle finger with similarly limited motion. There is often a feeling of catching when the thumb is flexed. In the ring and middle fingers, often a nodule can be felt when you press the area of the hand where the palm meets the finger.

Occupational therapy is based on relieving the symptoms and reducing the inflammation. Overall cure rate, for dutifully applied non-operative treatment, is over 95%. Several modalities of treatment exists, depending on the chronicity and severity of the condition.

Treatment

- Modification of hand activities
- Exercise & stretching
- Local heat
- Extension splinting during sleep (a custom metacarpophalangeal joint (MCP joint) blocking splint, which has reported better patient's symptomatic relief and functionality and a distal interphalangeal (DIP) joint blocking splint).
- An injection of methylprednisolone often combined with anesthetic (lidocaine) at the site of maximal inflammation or tenderness. 

 



Radial tunnel syndrome

Radial tunnel syndrome is a set of symptoms that include fatigue, or a dull aching pain at the top of the forearm with use. Although less common, symptoms can also occur at the back of the hand or wrist.

The symptoms are caused by pressure on the radial nerve, usually at the elbow. The radial nerve is one of the three main nerves in the arm. It runs from the neck to the back of the upper arm. Next, it crosses the outside of the elbow and goes down to the forearm and hand. At the elbow, the radial nerve enters a narrow tunnel formed by muscles, tendon, and bone. This is called the radial tunnel.

Symptoms

Radial tunnel syndrome causes dull aching pain at the top of the forearm, to the outside of the elbow, or the back of the hand. Patients less often describe the pain as cutting, piercing, or stabbing. It happens most often when the person straightens his or her wrist or fingers.

Radial tunnel syndrome can cause fatigue and weakness in the forearm muscles and weakness in the wrist. It affects the muscles, not the nerves, so it does not cause tingling or numbness in the arm, wrist, or fingers.

Causes

Any time the radial nerve is pinched anywhere along its length, it can cause pain. The tunnel at the elbow is one of the most common spots the nerve gets pinched or squeezed because it travels between muscle bellies and under facial bands. (Facial bands are tissue fibres that enclose, separate, or bind together muscle, organs, or other soft structures of the body.)

Overuse of the arm to push or pull and overuse of the hand by gripping, pinching, or bending the wrist can irritate the nerve and cause pain. Repeating the same movement, such as twisting the arm or wrist on the job or playing sports, squeezes the radial nerve. Over time, this can cause radial tunnel syndrome.


Who is at risk for developing radial tunnel syndrome?

Risk factors for developing radial tunnel syndrome include:

- Sports or jobs that require a constant wrist twisting motion.
- Poor physical arm and wrist strength and flexibility.
- Lack of adequate warm-up time before playing sports.
- Diabetes.
- Underactive thyroid gland.
- Tumors or ganglion cysts (mass or lump) in the arm that cause pressure on the nerve.
- Swelling or fluid in the arm that squeezes the nerve.
- Inflammation of the radial nerve.
- A hard blow to the forearm.

How is radial tunnel syndrome diagnosed?

Pain in the forearm and hand are usually the symptoms that send a person to the doctor. However, there are no tests to prove a person has radial tunnel syndrome. This makes the diagnosis difficult. 

The doctor must depend on the patient’s physical examination and the type and location of the pain. As part of the exam, the patient is asked to turn his or her palm up with a straight elbow while the doctor restricts arm and hand movement. If the patient feels pain while trying to move the arm or hands against resistance; it is a sign of radial tunnel syndrome. In another test, the patient is asked to point with his or her middle finger against resistance. Pain with this movement is another sign of radial tunnel syndrome.

Treatment

Treatment begins with resting the arm from the activity that is causing the symptoms. For most patients, rest combined with medical treatment for 3 to 6 weeks will relieve symptoms.

Treatments also include:

- over-the-counter medications to reduce swelling.
- steroid injections to relieve inflammation and pressure on the radial nerve.
- wrist and/or elbow splints to reduce irritation of the radial nerve.
- exercise, techniques to reduce the effects of repetitive motion stress, ultrasound, heat and cold.

The goal of treatment is to prevent the return of symptoms. If the job is causing the problem, the work activity may need to be changed. More breaks may be needed during the workday and heavy pulling and pushing should be avoided if possible.

For sports injuries, strength and flexibility exercises and adequate warm-up time before playing or practicing are important.

Wearing an arm splint at night can keep the arm in a position that prevents pinching the nerve.

Is there a surgical treatment for radial tunnel syndrome?

The results of surgery for radial tunnel syndrome vary. Doctors recommend surgery only when time and non-operative therapy fails.

Radial tunnel surgery is uncommon, and usually is done as an outpatient surgery (the patient does not stay in the hospital overnight). It can be done with total anesthesia (the patient is asleep) or a partial anesthesia. Partial anesthesia blocks the feeling only in the arm being operated on. The patient is awake if partial anesthesia is used.

The operation to treat radial tunnel syndrome is called radial tunnel release. In this operation, the surgeon divides all compressive sites within the radial tunnel. This makes the radial tunnel bigger so the radial nerve has more space. After the operation, new tissue grows across the split, and builds a permanently larger tunnel. 

 




Focal hand dystonia

Focal hand dystonia causes involuntary movement, cramps or tremor in the hand or arm muscles usually when making highly practiced hand movements such as writing or playing a musical instrument. Focal hand dystonia is often called writer’s cramp or musician’s cramp.

Writer’s cramp

When focal hand dystonia affects writing, this is called writer’s cramp. Writing can become painful and written work less legible. There are two types: simple and dystonic.
Simple writer’s cramp is usually caused by over-use of the hand, poor writing posture or poor penhold. The resulting muscle strain can cause the writer to press down too hard on the paper and can lead to spasms and pain.

Symptoms of simple writer’s cramp only appear during writing and include some or all of the following:

- Gripping the pen too hard
- Extension of the finger during writing making the pen difficult to hold
- Unusual postures of the wrist or elbow

These can make writing very difficult. Sometimes tremor is also a symptom although this is unusual. In many cases, symptoms are exacerbated by tension.

In a minority of cases, difficulties in writing are caused by dystonic writer’s cramp which may occur together with a more generalised dystonia that can affect other parts of the body as well. In this case, the involuntary movements and muscle cramps can also be apparent when undertaking other non-writing tasks such as using a knife and fork or applying makeup etc.

Treatment


There is no cure for writer’s cramp but many individuals benefit from techniques to help them ‘retrain’ their muscles and ‘unwind’ the problems with hand posture and pressure, one by one.

Often there is a need to relax not only hands but attitudes to handwriting too.

Some people with writer’s cramp can gain benefit from treatment with drugs either on their own or together with regular injections. There are a variety of tablets that can be helpful, although none are universally successful and side effects can occur.

Focal hand dystonia can affect any profession which requires repeated hand movement but is more common among musicians than any other professional group. Hand dystonia in musicians is often called musician’s cramp or musician's dystonia.

Symptoms can include reduced precision when playing and loss of control of the hand including fingers curling or sticking. Sometimes the effects are quite subtle - but they often prevent playing to a professional standard. 

The cause of musician’s cramp is not fully understood but it appears that the motor control systems in the brain essential for performing music fail to work properly. Occasionally, the cramp may be related to another dystonia that can affect other parts of the body as well.

There is no cure but sometimes techniques can be found to enable the musician to use different motor control systems when playing. This could be by changing the position of keys on a wind instrument or using the opposite hand for bowing on the violin. Medication can also be helpful. Regular injections are sometimes used - generally to facilitate new techniques rather than as a solution in themselves.

Coping with dystonia can be done most successfully if the person affected by dystonia (and, where appropriate, their carers) actively manages the condition. Everyone is different and so what this means in practice will vary from person to person. To manage dystonia effectively, people affected by dystonia need information about all aspects of the condition. This can enable them to take control and become the actor of their condition. 




Bursitis

Bursitis is inflammation of the bursae, the fluid-filled sacs that protect against friction between bones and other tissues. Depending on the location in the body, bursae may cushion bones from other bones, tendons, muscle, or skin. 

Bursitis can occur in many areas of the body. It is most common in the elbows and wrists. The ankles, hips, or knees may also be affected. Bursitis is caused by overuse injury or other trauma. Repetitive movements increase the risk of bursitis. Certain conditions like thyroid disease, diabetes, arthritis, and infections can inflame the bursa.

Treatment

Treatment for bursitis depends on the underlying cause. Rest, Ice, Compression, and Elevation (RICE) is one strategy to decrease the symptoms of bursitis. Pain and swelling may be managed with nonsteroidal anti-inflammatory drugs (NSAIDs). If the bursa is very swollen, the doctor may drain excess fluid. Corticosteroids are sometimes used to decrease inflammation. The doctor may recommend the use of a cane, splint, brace, or other support to reduce stress on the affected joint. 

In some cases, physical therapy may be ordered to help strengthen the area and encourage improved mobility. Surgery may be considered in severe cases when other treatments have been ineffective.

Mild bursitis resolves spontaneously with rest. More significant bursitis can require medications (either taken by mouth or locally injected) to reduce inflammation. Infectious bursitis requires drainage, possibly surgical resection, and antibiotics.

 

 





Thoracic outlet syndrome

Thoracic outlet syndrome (TOS) is a condition whereby symptoms are produced (such as numbness in fingers, pain in shoulder, arm, and neck) by compression of nerves and/or blood vessels in the upper chest. 

The passageway for these nerves and blood vessels to exit the chest and supply the upper extremities is referred to as the thoracic outlet. Muscle, bone, and other tissues border the thoracic outlet. Any condition that results in enlargement or movement of these tissues of or near the thoracic outlet can cause the thoracic outlet syndrome. 

These conditions include muscle enlargement (such as from weight lifting), injuries, an extra rib extending from the neck (cervical rib), weight gain, and rare tumors at the top of the lung. Often no specific cause is detectable.

It is felt by some scientists that the evolution of the torso of primates from a four-legged to a two-legged position may predispose humans to the development of thoracic outlet syndrome. The resulting vertical posture produced flattening of the chest cage and a shift of the shoulder joint backward, both of which narrowed the thoracic outlet. 

The following may increase the risk of developing thoracic outlet syndrome:

- Sleep disorders
- Tumors or large lymph nodes in the upper chest or underarm area
- Stress or depression
- Participating in sports that involve repetitive arm or shoulder movement, such as baseball, swimming, golfing, volleyball and others
- Repetitive injuries from carrying heavy shoulder loads
- Injury to the neck or back (whiplash injury)
- Poor posture
- Weightlifting

Symptoms

The signs and symptoms of TOS include neck, shoulder, and arm pain, numbness or impaired circulation to the affected areas.

The pain of TOS is sometimes confused with the pain of angina (chest pain due to an inadequate supply of oxygen to the heart muscle), but the two conditions can be distinguished because the pain of thoracic outlet syndrome does not occur or increase when walking, while the pain of angina usually does. Additionally, the pain of TOS typically increases when raising the affected arm, which does not occur with angina.

Signs and symptoms of TOS help determine the type of disorder a patient has. Thoracic outlet syndrome disorders differ, depending on the part(s) of the body they affect. Thoracic outlet syndrome most commonly affects the nerves, but the condition can also affect the veins and arteries (least common type). In all types of TOS, the thoracic outlet space is narrowed, and there is scar formation around the structures.

Who is affected

Thoracic outlet syndrome affects people of all ages and gender. The condition is common among athletes who participate in sports that require repetitive motions of the arm and shoulder, such as baseball, swimming, volleyball, and other sports.

Neurogenic TOS is the most common form of the disorder (95 percent of people with TOS have this form of the disorder) and generally affects middle-aged women.

Recent studies have shown that, in general, TOS is more common in women than men, particularly among those with poor muscular development, poor posture or both.

 

 



Myofascial pain syndrome

Myofascial pain syndrome is a chronic pain disorder. In myofascial pain syndrome, pressure on sensitive points in your muscles (trigger points) causes pain in seemingly unrelated parts of your body. This is called referred pain.

Myofascial pain syndrome typically occurs after a muscle has been contracted repetitively. This can be caused by repetitive motions used in jobs or hobbies or by stress-related muscle tension.

While nearly everyone has experienced muscle tension pain, the discomfort associated with myofascial pain syndrome persists or worsens. Treatment options for myofascial pain syndrome include physical therapy and trigger point injections. Pain medications and relaxation techniques also can help.

Symptoms

- Deep, aching pain in a muscle
- Pain that persists or worsens
- A tender knot in a muscle
- Difficulty sleeping due to pain

Treatment

Make an appointment with your doctor if you experience muscle pain that doesn't go away. Nearly everyone experiences muscle pain from time to time. But if your muscle pain persists despite rest, massage and similar self-care measures, make an appointment with your doctor.

Causes

The cause of myofascial pain syndrome is unknown. Nevertheless, prior injury, poor sleep patterns, stressful life situations, and depression are common underlying conditions that may play a role in inciting and exacerbating myofascial pain syndrome. It is currently felt that risk factors such as these may lead to a change in the ability of the brain to properly process pain perception (referred to as central pain processing).

Treatment

Optimal treatment of myofascial pain syndrome can be a multifaceted approach. This can include education of the patient, stress reduction, stretching and exercise programs as well as physical therapy, sleep improvement, and medications all best organized by a single physician who tailors the therapies over time by customizing them for the individual patient.

Medications used to treat myofascial pain syndrome can be directed toward various features of the individual's condition and may be used temporarily or longer term. Often trials of medications are used to find the best treatment for the particular patient. 

For example, trazodone (Serzone) or amitriptyline (Elavil) may be used at bedtime to improve sleep as well as relieve pain; cyclobenzaprine (Flexeril) or orphenadrine (Norflex) can be used at bedtime to relax muscles and to aid sleep; and antidepressants such as sertraline (Zoloft), fluoxetine (Prozac), duloxetine (Cymbalta) can be used to help control pain as can gabapentin (Neurontin) and pregabalin 


 


 

 

 

 

 

A new device to reduce the pain of rsi - check it out!

 

[home] [about this site] [ what is RSI] [medical conditions
[carpel_tunnel] [ who suffers]  [empoyees]  [employers
[gamers] [young people]  [
Useful tips from sufferers
[Hand arm vibration syndrome] [ solutions
[groups] [10 tips for computer users] [products]
[RSI device] [contact] [mobile]

 

   

info@rsipainrelief.com   -  Bath, United Kingdom

 

GDPR Compliance. The new EU data collection and processing regulations 2018.

RSI Pain Relief understands that your privacy is important to you and that you care about how your personal data is used and shared online. We respect and value the privacy of everyone who visits this website, www.rsipainrelief.com  (“Our Site”) and We do not plant cookies on your computer, and do not collect personal data about you. If you complete the enquiry form on this site, or contact us by email, this data will be forwarded to you by email and a copy will not be kept on this website.

If any cookies are found to have been added to your computer by this site, they will have come not from us, but from links connected to 3rd party sites such as Google maps, or PayPal payment systems. These companies are all GDPR compliant.

Please read this Privacy Policy carefully and ensure that you understand it. Your acceptance of Our Privacy Policy is deemed to occur upon your first use of Our Site. 
If you do not accept and agree with this Privacy Policy, you should stop using Our Site.

More details>>

 

 

website by www.spiderspider.co.uk

EH2