When a patient enters the Center For Spine Care and Mobility with a chief complaint of wrist or arm pain, there needs to be a thorough examination to determine where the pain is emanating from. As discussed in our previous blog “My Arm Hurts,” there are three basic nerves that can cause such pain. Below is a case study of a patient with previously undiagnosed wrist pain.
Chiropractic Evaluation of Wrist and Arm Pain
This patient presented with a chief complaint of wrist and arm pain. The motivating factor was trouble with her forehand in tennis. For some reason, her arm had become increasingly weak with numbness and tingling into her hand. After taking a complete case history that included specific questions about her activities which could cause this type of pain, we began to examine the forearm.
Arm pain can occur in various places. When examining a patient with arm pain you have to check the nerves where they exit at the base of the neck. Palpation, range of motion, and specific orthopedic testing will help rule in or out where the pain is coming from.
With this specific patient her pain was not coming from her neck but from her forearm. More specifically the pain appeared to be emanating from the pronator teres muscle. A diagnosis of hypertonicity/spasm of the pronator teres with secondary flexor digitorum superficialis hypertonicity.
Chiropractic treatment of wrist and arm pain would consist of active release technique to the lower arm muscles, as well as physical therapy in order to strengthen the opposing musculature, and massage to the shoulder girdle and neck region. In cases like this, we usually treat two times per week and re-evaluate in four weeks.
Below is an explanation of a short video we have included to illustrate active release technique of the forearm muscles. This is part of the integrative technique we employ at CSC+M in order to heal as quickly and efficiently as possible.
Median Nerve Active Relief Technique Therapy
The Median nerve can become entrapped or stuck in a few different places. The issue is the fact that these entrapment sights can produce the same kinds of pain patterns. In order to be thorough in your treatment of this condition, you need to understand where the potential nerve entrapment is, and how to treat them effectively.
Here is a list of the following potential entrapment sites:
- Median nerve at The thenar eminence. The thumb is a spot where pain can occur from an entrapment. People who use their hands for manual labor, e.g. hammering, grip activities, and holding activities.
- Median nerve at the transverse carpal ligament. This is the spot where most surgeons release thinking this is where the nerve is primarily entrapped.
- Median nerve at the Flexor Digitorum Superficialis. These muscles are the wrist flexor muscles just above the wrist region and below the elbow. Making a fist and curling it toward your body contracts these muscles.
- Median nerve at the Pronator Teres. This is the muscle that turns the forearm inward towards the inside of the body.
- Median nerve at the Arc of Froches.
