Your wrist is made up of eight small bones (carpal bones) plus two long bones in your forearm — the radius and the ulna. Your wrist functions as the link between the hand and the forearm. In your wrist, a tendon functions to move the bone. A ligament is a fibrous connective tissue that attaches bone to bone. There are no tendon attachments that function at the wrist. Tendons cross the wrist to insert into the hand, fingers, and thumb. And there are ligaments holding and stabilizing your wrist bones in place.

Problems affecting muscles that originate off the elbow and forearm may show up as pain at your wrist. Wrist conditions are often the result of trauma, overuse, and arthritis.

In athletes, positions that strain muscles repetitively are likely to cause an insidious (gradual) onset. Ultimately, this may lead to tendonitis. Tendonitis is inflammation or irritation of a tendon. Weight lifting, gymnastics, rowing, and racquetball are examples. Overuse with typing is a common problem. You may be a professional musician or be in assembly line movement patterns at work.

Below are conditions causing Wrist Pain: 5 Tendonitises a Chiropractor Can Help With.

De Quervain’s Tenosynovitis

You will have radial (thumb side) wrist pain. It may happen after forceful gripping activities with ulnar deviation (bending the wrist to the little finger) or repetitive use of the wrist or thumb.

Cause:

A synovial tendon sheath surrounds your wrist tendon. This is a lubricated layer of tissue in which the tendon is housed and through which it moves. And stenosing tenosynovitis is inflammation of a tendon and its synovial sheath.  With de quervain’s tenosynovitis, two thumb muscles, the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons  at your wrist become stenosed.

 

Intersection Syndrome

You will have pain and crepitus (“creaky” joints) 2 inches above the wrist on the dorsoradial (back side, above thumb) aspect. This is usually after repeated wrist flexion (bending palm down) and extension (raising back of hand) movements with occupational or sports activities.

Cause:

An inflammatory response and possible bursitis occurs at the crossing of two groups of tendons: the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons crossing over the top of the wrist.  Bursae are fluid filled pads that act as cushions at the joints. Bursitis is inflammation of bursae. This occurs most often at joints that perform frequent repetitive motion. Intersection syndrome is more common in canoeists, weight lifters, and recreational tennis players.

 

Other Tendinopathies of the wrist:

 

Extensor pollicis longus (EPL)tendinitis/tendinosis

This muscle arises dorsolaterally (back or upper surface) from the middle part of the ulna (long forearm bone closest to fifth finger) and ends at the distal (tip) of the thumb. The EPL extends the thumb (moves the thumb  away from the hand and parallel to the palm). This tendonitis is seen in drummers, athletes involved in racquet sports, and patients with rheumatoid arthritis.

 

Extensor indices proprius (EIP) syndrome and extensor digiti minimi (EDM) tendinitis/tendinosis

The Extensor indices proprius (EIP) is a narrow, elongated muscle in the deep layer of the dorsal (back of ) forearm. Its tendon goes to the index finger, which it extends (bends backward).

The  extensor digiti minimi (EDM) is also a narrow muscle which originates in the lateral humerus (elbow area) and attaches to your 5th digit (5th finger). The EDM is a two joint muscle. It acts as an extensor in both joints. The EDM extends the wrist and the little finger.  This means it moves the back of the hand toward the back of the forearm and straightens the little finger from a fist.

 

Extensor carpi ulnaris tendonitis/tendonosis

This muscle originates in the lateral humerus (elbow area). And it inserts into the 5th metacarpal (5th bone in palm of hand).  The extensor carpi ulnaris serves to extend and adduct the hand (moving a hand toward the body) at the wrist.  It is a relatively common tenonitis found in occupations or sports requiring repetitive wrist movement.  Examples include racquet sports, rowing, golf, and baseball.

 

 

Chiropractic Treatment/Management of Wrist Tendonitises

 

In the acute phase, ice and rest from the causative activity are essential. Myofascial release techniques to the indicated muscles are effective. Chiropractic adjustments and mobilization to the wrist and associated areas give relief. Home-care advice includes icing, rest, wrist bracing, elevation and rehabilitation exercises. A positive outcome with a complete resolution of your wrist pain should be forthcoming.

Getting regular chiropractic care from a West Palm Beach wrist pain chiropractor can give relief naturally from an already existing injury, or even offer injury prevention. Chiropractic is a holistic and natural way to treat existing injuries and to keep your body in its best working condition.

Contact Meiri Chiropractic today at 561-253-8984 on Wrist Pain: 5 Tendonitises a Chiropractor Can Help With or/and other ailments.

 

References:

Thomas Bergman, David Peterson, Chiropractic Technique Principles and Procedures, 3rd edition, 2011

 

This post is about 4 Causes of Elbow Pain a Chiropractor Can Help With. As the link between the shoulder and the wrist/hand, your elbows are challenged with repetitive activities. These overuse mechanisms account for the majority of elbow pain. In particular for instance in throwing sports and in activities requiring the use of an arm extension device such as a bat, racquet, or club. So the pivot is at the elbow and your forearm acts as the lever arm. These devices increase the medial (toward the center) stress across the elbow by increasing the length of the lever arm.

 

Additionally, you may also have a fall.  And as with the rest of the upper extremity (arm), the elbow becomes weight bearing during the fall.  An axial (racquet) force (load is applied to the structure along the length) is applied acutely during this fall to your elbow. Furthermore, this can happen chronically with gymnastic maneuvers and even with some chiropractors due to adjusting maneuvers!

 

1. Lateral Epicondylitis (Tennis Elbow)

Lateral epicondylitis causes lateral (outer or same side as thumb) elbow pain associated with a repetitive sport or occupational activity. Repetitive movements requiring forceful wrist extension (movement of raising the back of the hand), radial deviation (bending the wrist to the thumb), and supination (rotation of the forearm) are the most common causes. Although it is associated with tennis, other sports and occupational activities are also possible causes. Butchers, plumbers, and weavers are examples of those who may be affected. With tennis, novice players with poor backhand technique account for many cases. With professional players, the forehand or serving may be the cause. Obviously, the more frequently an individual plays, the higher the risk of developing tennis elbow. Although, lateral epicondylitis is called tennis elbow, it also occurs in computer keyboardists, carpenters, and golfers.

Cause:

The currently accepted theory is that initially there is tearing of the extensor carpi radialis brevis (ECRB) muscle origin (attachment). This process may extend to the extensor digitorum communis (EDC) or the extensor carpi radialis longus (ECRL) muscles. These muscles in conjunction with the other muscles and tendons in your forearm help move your wrist and hand. The histologic (seen by microscope) description of the change in tissue is called angiofibroblastic hyperplasia. Angiofibroblastic hyperplasia or angiofibroblastic tendinosis describes the pathologic (disease cause) alterations seen in the tissue of tendonitis (inflammation of tendon).

Radiographs (xrays) may demonstrate calcification in as many as 25% of patients with lateral epicondylitis.

 

2. Medial Epicondylitis (Golfer’s Elbow)

Medial Epicondylitis causes medial (inner) elbow pain following a repetitive activity such as golfing, hammering or use of a screwdriver. In athletes, the inciting activity usually involves wrist flexion (moving wrist down so palm faces arm) and pronation (rotatory movement of elbow where palm faces down). Examples of these include in serving and overhead and forehand strokes in various sports. Obviously, golfing (“golfer’s elbow”) or throwing may also cause symptoms. You may also feel pain or weakness on gripping.

Cause:

Medial epicondylitis is a tendinopathy of the origin of the wrist flexors and pronator teres muscles in your forearm. In chronic cases, an elbow flexion contracture may occur, leading to restrictions of movement (eg. extension). An ulnar neuropathy (compression of ulnar nerve at elbow) may coexist with medial epicondylitis. Radiographs (xrays) may reveal calcifications in close proximity to the medial epicondyle in 20% to 30% of patients with epicondylitis.

 

3. Triceps Tendinitis (Posterior Tennis Elbow)

The triceps is a large muscle on the back of your upper limb. Triceps tendinitis causes pain at the tip of the elbow after a repetitive extension activity or a single event involving forceful elbow extension.

Cause:

Strain of the triceps insertion on the olecranon (bony prominence of the elbow) is usually due to common athletic endeavors performed by boxers, weight lifters, pitchers, and occasionally tennis players.

 

4. Posterior Impingement Syndrome

Posterior Impingement Syndrome usually occurs in an athlete and especially on quick extension of the elbow.  You will have a sharp posterior (back of) elbow pain. Similarly, popping or clicking may occur with extension.  Your elbow may occasionally lock.

Cause:

Firstly, repetitive extension leads to compression between the olecranon trochlea and olecranon fossa (1 of 3 joints of elbow). Secondly, this may simply cause a reactive synovitis. So the synovium is connective tissue that lines the inside of the joint capsule. Thirdly, synovitis  (synovial inflammation) is when the synovium of a joint becomes inflamed (swollen). Lastly, it may progress to degeneration and the production of osteophytes (bone spurs) or loose bodies.

Elbow Pain Treatment at Meiri Chiropractic in North Palm Beach

 

In the acute phase, ice and rest from the causative activity are essential. Myofascial release techniques are effective. Furthermore, Chiropractic adjustments, manipulation, and mobilization to the elbow and associated areas give relief.

 

A recently published study compared manipulation of the wrist with a second protocol of ultrasound, friction massage, and muscle stretching and strengthening for the management of lateral epicondylitis. Success was better for chiropractic manipulation of the wrist compared to the traditional physical therapy of ultrasound, massage, and muscle stretching/strengthening approach.

 

Getting regular chiropractic care from a West Palm Beach elbow pain chiropractor can help relieve pain naturally from an already existing injury, or even offer injury prevention. Chiropractic is a holistic and natural way to not only treat existing injuries, but to keep your body in its best working condition.

 

Contact Meiri Chiropractic today on the 4 causes of elbow pain a chiropractor can help with or/and other ailments.

 

References:

Thomas Bergman, David Peterson, Chiropractic Technique Principles and Procedures, 3rd edition, 2011

 

 

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Meiri Chiropractic

561-253-8984