Dealing With Tendonitis, Wrist, Shoulder and Neck Pain

carpal tunnel and tendonitis

I’ve seen a lot of patients over the years who suffer from RSIs, or Repetitive Strain Injuries.  RSI is the blanket term for overuse injuries, usually affecting the upper extremities and often the neck and shoulder.  The common forms of RSIs are tendonitis or tendinitis; carpal tunnel syndrome, epicondylitis (golfers elbow/ tennis elbow), stenosing tenosynovitis, trigger finger, and frozen shoulder/adhesive capsulitis.    The condition affects people who use their hands frequently, or in the same manner, repetitiously.  For example:

-anyone whose job requires typing and mousing
-waitresses who have to carry heavy plates
-construction workers using vibrational tools
-sports participants whose sport requires the same movement; i.e. golf swing, tennis swing, baseball pitching, bowling

Medically speaking, the pain from RSIs is mostly from inflammation. Microscopic strands of tendon, ligament, muscle, and bursae (friction-free joint padding) snap under repetitive conditions, which initiates localized inflammation. The inflammation irritates nerve endings and increases the internal pressure in the wrist and arm, generating pain. As the tissues heal, they contract (shorten) resulting in weakness and further strain. The cycle is known to be chronic (permanent and reoccurring) in some unfortunate individuals.

The first thing to remember is that RSIs can be very painful and can take a long time to heal. So if you fall into any of the categories above and begin to experience pain in your upper extermities, take careful note and change your routine. This is where most people make mistakes– they assume the early symptoms are merely from fatigue, and keep their routine going, allowing the RSI to progress until it is firmly rooted. This is the stage where the RSI patient first contacts her/his doctor.

If you start to develop pain, numbness, tingling, fatigue, and/or weakness in your hands, wrists, and/or elbows do this:

Rest your hands and arms more frequently. If you type, take 15 second pauses every minute and stretch out your wrists and hands. If your office can accomodate job rotation, choose one that doesn’t involve typing. If you play sports, lay off for a while.

Try to determine if you are using the wrong technique, and make modifications as necessary. For example, many people who type bend their wrists upwards (should be kept in a straight line).

Strengthen your upper back and neck muscles. This will improve your posture and allow you to use your hands better.

If you are already experiencing pain, try icing the painful areas. Apply an ice pack for 10-15 minutes. Then, progress to contrast baths: fill your sink with hot water (just hot enough that it won’t scald your skin). Place your hands and arms in the hot water for a few minutes, then place them in an adjacent sink filled with ice water. Repeat 2-3 times. This forces circulation to the area and helps pump out inflammation.

Some people resort to anti-inflammatory medications like Tylenol and Motrin; these drugs usually don’t do well with RSIs for some reason.

If the pain persists, try chiropractic. Spinal adjustments to the neck and upper back can release muscle tension and improve range of motion. Adjustments to the wrist and elbows can do the same. At my clinic, we do a special type of massage called Active Release technique, which helps reduce scar tissue formation and bring the tendons to their original condition. Lastly, we employ therapeutic light to help injured cells regenerate faster.

Bottom Line: Take RSIs seriously from the start. To borrow from the sports world, the best defense is a good offense. Take active, protective measures to keep the disorder at bay.

Dan Perez, DC
San Francisco Chiropractor

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Tags: chiropractic, massage, RSI, San Francisco, tendonitis, wrist pain

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