Acromioclavicular Syndrome

Caused by a disruption or impingement of the coracoid process (upper arm bone end) within the shoulder joint capsule.

Characterised by pain at the shoulder tip upon movement.

Arthritis

Inflammation of joints caused by friction of bone and cartilage or bone and bone structures leading to extra release of synovial fluid.

Symptoms include aching pain, swelling, stiffness and ‘rednesss’.

Bursitis

This condition is the inflammation of the sac like cavities acting like cushions near joints.

General swelling and discomfort are the usual symptoms.

http://www.nlm.nih.gov/medlineplus/ency/article/000419.htm

Carpel Tunnel Syndrome (CTS)

A specific, severe and debilitating form of RSI, which describes a squeezing of the median nerve as it runs into the hand. Swollen tendons surrounding the median nerve squeeze it as they cross through a bony passage (carpel tunnel) at the inside of the wrist. Experts consider that CTS is also associated with nerve compression symptoms in the chest and shoulders.

Pain, tingling, numbing sensations and loss of strength in wrists, hands and/or fingers.

More Information.

Carpal tunnel syndrome is a specific pattern of sensory problems and muscle weakness that affects the hand. It happens because tendons and nerves to the hand have become irritated as they thread through the carpal tunnel (a passage between bones and ligaments in the wrist). This irritation usually happens because arthritis or some other inflammatory disorder has narrowed the carpal tunnel, pinching the median nerve and the tendons to hand muscles. However, it may also be caused by overuse, especially if a person performs repetitive hand movements (such as typing or keyboarding), which strain the wrist, or if the person participates in sports such as racquetball, handball or weightlifting. In some cases, carpal tunnel syndrome may also be caused by sudden weight gain, especially in pregnant women, or by edema (an abnormal accumulation of body fluid).

Carpal tunnel syndrome affects more women than men, and it can occur in one or both hands. Persons who may be at increased risk of carpal tunnel syndrome include pregnant women, women who use birth control pills or who suffer from premenstrual syndrome, persons with rheumatoid arthritis, or patients with myxedema (thickening of body tissues caused by low levels of thyroid hormone) or acromegaly (abnormal body growth caused by excess growth hormone).

Symptoms

Symptoms of carpal tunnel syndrome may include burning, tingling or numbness of the fingers; difficulty gripping tools or other implements; and problems making a fist. Symptoms may appear first at night and are most noticeable in the thumb, index and middle fingers. There may be pain in the wrist that radiates into the hand or into the forearm. If the condition is not treated, the muscles of the thumb may eventually waste away so that the normal "hill" of muscles at the base of the thumb eventually flattens.

What Your Doctor Looks For

Your doctor will look for decreased sensation in your fingers and for muscle weakness in the affected hand. Your doctor will also check your thumb muscles for signs of wasting and your wrists for signs of arthritis. If your doctor suspects edema, he or she will look for abnormal accumulation of fluid in several different parts of your body, including your hands, feet and legs.

Diagnosis

Doctors usually diagnose carpal tunnel syndrome based on your history of hand symptoms and your physical examination. An X-ray of your wrist may be also be needed. Your doctor can confirm the diagnosis of carpal tunnel syndrome by ordering nerve tests of the median nerve in your affected hand. These tests measure the nerve function and the extent of the damage.

Expected Duration

The exact duration of carpal tunnel syndrome varies depending on the cause. Sometimes the syndrome comes and goes and does not require treatment. For example, a person whose carpal tunnel syndrome is caused by sports-related overuse may recover quickly with treatment, rest and modified activity. In someone whose carpal tunnel syndrome is caused by chronic arthritis, symptoms may be more stubborn and require longer therapy.

Prevention

If you type or use a computer keyboard, you can decrease your risk of carpal tunnel syndrome by making sure that you work in a "wrist neutral" position (wrist joint straight, not bent up or down). To help you do this, several types of office aids are available, including a cushioned wrist rest; a keyboard tray that adjusts to a position below the work surface; and the Tony keyboard, which is hinged in the middle. Newer types of keyboards are also being developed, including ones that split the keys into left-hand and right-hand groups, and others that bend the keyboard into a tent shape. Because scientists suspect that persons who consistently use computer mice and trackballs may also have an increased risk of carpal tunnel syndrome, modifications in these computer accessories may also be needed to protect the wrists. Professional assessment of your workstation may be advisable if you continue to have symptoms.

To prevent sports-related carpal tunnel syndrome, ask your trainer or a sports medicine physician about effective ways to support your wrist during high-risk activities.

Treatment

In most cases of carpal tunnel syndrome, treatment begins with a wrist splint to be worn mainly at night. Anti-inflammatory medication may also be given to decrease pain and numbness, with or without injections of cortisone to reduce swelling. In patients whose carpal tunnel syndrome is linked to edema, diuretics (medicine to remove excess body fluid) are also helpful. In the small number of patients who do not improve with non-surgical treatments, surgery may be done to relieve pressure on the median nerve by cutting a ligament at the bottom of the wrist.

When To Call Your Doctor

Call your doctor if you feel pain, tingling or numbness in your fingers that does not go away. If you have trouble grasping objects or making a fist or have weakness in your hand or arm, then you should see your doctor.

Prognosis

Almost all patients with carpal tunnel syndrome recover completely with treatment. A small percentage (1 percent) may sustain permanent nerve injury.

Compressed Disc

Swelling of the inter-vertebral disc due to mechanical stress. Disc swelling may cause spinal cord nerve compression causing a migration of symptoms to other body parts.

Symptoms may start with a mild tingling and/or pinching sensation and progress to a ‘stabbing painn’.

A common example is Sciatica.

Epicondylitis

Inflammation of tendons (muscle to bone attachments) at the elbow joint including:

Lateral Epicondylitis (outside of elbow - ‘Tennis Elboww’)

Medial Epicondylitis (inside of elbow – ‘Golfers Elboww’)

Symptoms include pain, inflammation and swelling of affected areas, particularly with any movement.

Ganglion (plural Ganglia)

An enlargement of the tendon sheath which swells with fluid.

Symptoms include the formation of an irritating bulging protrusion.

Hyper-kyphosis

Caused by a ‘hunchedd’ posture and subsequent postural decompensation involving a shortening of the pectoral, sternocleidomastoid and sub-occipital muscles. Also may be congenital appearing usually during an adolescent growth spurt where the cervical spinal segments develop a wedge shape. The condition can develop in later years as a result of poor posture caused by calcification of external vertebrae and compression of the internal inter-vertebral discs. In advanced cases the anterior portions vertebrae start to deteriorate and become arthritic.

The appearance of a ‘hunch backk’ is the visual symptom. Other symptoms include stiffness, pain, swelling, pinching and lateral immobility of the neck.

Hyper-lordosis

Caused by an imbalance of the cervical (neck), thoracic (upper back) and lumbar (lower back) musculature resulting in an accentuated ‘SS’ spinal curvature. Excessive calcification of vertebrae and ‘bulging of discss’ may cause a permanent disability.

Symptoms may include; referred and localised pain, nausea, headaches, insomnia, Sciatica, stabbing pain and muscular spasms.

Myositis

Caused by an inflammation of the muscles.

General swelling and discomfort are the usual symptoms.

Neuritis

Nerve inflammation.

Symptoms include burning pain, itching and red spots.

Paraesthesia

Nerve compression.

Associated with symptoms of Thoracic Outlet Syndrome or Carpel Tunnel Syndrome. Characterised by unusual sensations without any external cause. Examples include numbness, tingling, ‘pins and needless’ and irritation of the skin (crawling sensation).

Postural Decompensation

This is a term used to describe an effect of gradual postural collapse whereby the muscular skeletal system breaks down due to imbalances created from overuse and under use of muscles and the re-calcification/ deformation of bones.

Forward tilt and ‘stoopp’ of head, hunched back, forward shoulder girdle displacement, excessive lumbar lordosis are the visual signs. General aching, discomfort and painful muscular spasms coupled with occasional sharp pains, headaches and symptoms associated with nerve damage can occur with varying severity.

Pronator Teres Syndrome

Caused by static exertion and concurrent repeated digital muscle movements.

Symptoms are the inflammation and/or pain of the forearm muscles.

Reflex Sympathetic Dystrophy

Damage to the automatic unconscious nervous system of the limbs.

Symptoms include; pain, swelling, skin changes (dark red, glossy or mottled colour, cold and moist). This condition has the potential to become permanent.

Repetitive Strain Injury

Repetitive Strain Injury (RSI) is a description of a manual injury or injuries to the muscles, tendons, ligaments, peripheral nerves, structures, bones or associated vascular systems of the body. These are associated with repetitive activity, poor posture, soft tissue and nerve compression, vibration, low temperatures, poor physical condition, static exertion of muscles, heavy loads and restricted circulation of blood and synovial fluids.

Alternative terms equivalent to RSI include:

• Occupational RSIInfo Syndrome (OOS)
• Cumulative Trauma Disorder (CTD)
• Work Related Upper Limb Disorders (WRULD)
• Work-related muscular-skeletal disorders (WMSDD’s)

The affects to an organisation may include decreased productivity, absenteeism, Increase of workers compensation costs/premiums, decreased morale and employee replacement costs.

News

• The RSI Generation

RSI Background Information and Resources

• Repetitive-Strain-Injury.com
• Mass. Institute of Technology RSI Info page
• RSI Questions and Answers

Prevention and Treatment

• UCLA Ergonomics: Injury Prevention Webpage
• How Can Your Prevent RSI?

Common Repetitive Strain Injuries

• Common Repetitive Strain Injuries (UCLA Ergonomics)

Bursitis

• Overview of bursitis (MEDLINEplus, NIH) - Includes: Illustrations, Definition, Causes and risks, Prevention, Symptoms, Signs and tests, Treatment, Prognosis, Complications.
• Links to bursitis information (MEDLINEplus, NIH)

Carpal Tunnel Syndrome

• Overview of carpal tunnel syndrome (MEDLINEplus, NIH) - Includes: Illustrations, Definition, Causes and risks, Prevention, Symptoms, Signs and tests, Treatment, Prognosis, Complications.
• Carpal Tunnel Syndrome (American Medical Association) - Includes: Diagram, Symptoms, Risks, Treatment information
• Carpal Tunnel Syndrome: Questions and Answers
• Links to carpal tunnel syndrome information (MEDLINEplus, NIH)

Epicondyliti

• Overview of epicondylitis (MEDLINEplus, NIH) - Includes: Illustrations, Definition, Causes and risks, Prevention, Symptoms, Signs and tests, Treatment, Prognosis, Complications.

Tendonitis

• Overview of tendonitis (MEDLINEplus, NIH) - Includes: Illustrations, Definition, Causes and risks, Prevention, Symptoms, Signs and tests, Treatment, Prognosis, Complications.

Trigger Finger

• Trigger Finger (American Society for Surgery of the Hand) - Includes: Causes, Signs and Symptoms, Treatment

Rheumatism

The painful inflammation of joints and their nearby structures.

Symptoms include aching pain, swelling, stiffness and ‘rednesss’.

Scapular Protraction

Caused by the shortening of the upper and lower chest and anterior deltoid muscles, coupled with under-active and weak opposing rhomboid (lower/middle of shoulder blades) muscles and lower trapezius muscles (beneath the shoulder blades). Forward shoulder blade displacement (rounded shoulders) results.

Symptoms include general aching, soreness and pain between the shoulder blades, neck and shoulder region and the top of the shoulder blades.

Sciatica

Caused by the compression of the sciatic nerve that starts between the L4 L5 vertebrae that runs down the lateral side of the hip, upper leg and calf. This usually results from a hyper-lordosis, whereby the nerve is compressed between the vertebrae/spondylose.

Symptoms start as a pinching sensation of the lower back and progress to a sharp stabbing pain that may radiate down either leg.

Scoliosis

Caused by an imbalance in the musculature leading to a lateral curvature of the spine.

This condition usually results from poor posture. If left uncorrected, calcification of spinal segments may cause the development of a permanent condition.

Symptoms may include localised referred pain and discomfort, muscular spasms that are caused by the impingement of nerves and compression of discs.

Static Muscle strain

Caused by holding or suspending limbs or torso in a still position for extended periods of time, especially shoulders, neck and forearms.

Symptoms include tenderness, stiffness and soreness in muscles, which eventually become shortened. This can cause compression of joints leading to compression of nerves, tightening of the muscles and further aggravation of the condition.

Supraspinous (Supraspinatus) Tendinitis

The inflammation of a muscle tendon that is responsible for lifting the arm at the shoulder.

Symptoms include an aching dull pain and general soreness of the affected area.

Supraspinous (Supraspinatus)

Tendonitis

Tendonitis describes the inflammation of a tendon.

A tendon attaches a muscle to a bone and may become inflamed due to constant overuse.

Tenosynovitis

Inflammation of fibrous and synovial sheaths that secrete lubricating fluid around the tendons.

Begins as mildly aggravating pain and discomfort in the wrists and/or fingers and may quickly progress to be severely debilitating.

Tension Headaches

What are they?

Tension headaches are common, nonspecific headaches that are not caused by underlying disease. Because they affect 40 percent of the population at some time, they are often considered to be "normal" headaches.

Tension headaches fall into two general categories: episodic (occurring less than 15 times per month); and chronic (15 or more headaches per month).

Symptoms

Tension headaches often start in the afternoon or early evening, typically building in intensity over time. The chief symptom is usually a sense of tightness around the head — the "tight hatband" or "vice" sensation. Neck and shoulder muscles are often tense and sore to the touch. Other symptoms may include trouble concentrating, difficulty sleeping, and an increase in headache pain when there is noise or bright light.

What Your Doctor Looks For

If severe or unusual headache pain brings you to your doctor's office, he or she will want to determine exactly what type of headache you are experiencing. Your doctor will ask you about:

• The frequency of your headaches (how often they occur)
• The timing of your headaches ( what time of day they start)
• The headache triggers (what makes the headache begin)
• The duration of your headaches (how long they last)
• The headache location (what part of your head is involved)
• The quality of the pain (whether the pain feels steady or throbbing)
• What make the pain feel better or worse
• The presence of other, associated symptoms (nausea, vomiting, sore muscles, insomnia, difficulty concentrating)

Diagnosis

There is no specific test to confirm the diagnosis of a tension headache. The diagnosis is determined by your symptoms, your medical history and a physical examination by your doctor. In some patients, a computed tomography (CT) scan of the head may be needed to investigate headache pain that is either constant or associated with atypical (unexpected or unusual) symptoms.

Expected Duration

An episodic tension headache may last only a few hours or it may linger for a day or more. A chronic tension headache typically persists through a 24-hour cycle, although there may be fluctuations in pain intensity during that time.

Prevention

To help prevent tension headaches you can:

• Maintain good posture to prevent the muscle cramps which can lead to tension headaches.
• Follow a program of frequent, regular exercise, especially one involving aerobic exercises such as running or cycling. Exercise can prevent tension headaches from forming.
• Practice relaxation techniques.

Treatment

For episodic tension headaches that occur less than three times weekly, over-the-counter pain relievers such as aspirin, acetaminophen or ibuprofen are convenient and effective. Combination products whose formulas combine pain medication with caffeine may be most beneficial. An ice compress or a heating pad can also be extremely helpful, or a massage to any tight areas in the neck and shoulders. Relaxation techniques, such as deep breathing exercises or biofeedback and acupuncture may help decrease the frequency of headaches.

Chronic tension headaches that occur daily may require treatment with a prescription medication such as the tricyclic antidepressant amitriptyline. Even for people without depression, this class of drug has been found to offer significant relief from tension headache pain.

When To Call Your Doctor

Most headaches are benign (harmless) and only rarely signal the presence of a serious problem such as a brain tumour or meningitis (an infection of membranes covering the brain). However, if headaches become persistent or increase in severity, consult a doctor for prompt diagnosis. Any headache that occurs after a head injury or one that is accompanied by fever, vomiting or blurred vision, should be evaluated by your doctor immediately.

Also, consult your doctor if you frequently need to take non-prescription medication for episodic tension headaches. Non-prescription pain medications should not be used more than two or three times a week for headache relief without your doctor's guidance. Prognosis

Given time, most tension headaches will resolve on their own. Recovery is fastest when the patient takes pain medication and withdraws from any tension-producing situations.

Tension Neck Syndrome

This is the same condition as Occupational Cervicobrachial Syndrome. This is caused by static muscle strain of the sternocleidomastoid, scalene (front neck muscles), sub-occipital (base of skull), levator scapulae and upper trapezius muscles (upper shoulder).

Symptoms include stiffness, tenderness, swelling, muscle hardening, weakness, and possible headaches. Minor symptoms include, vertigo, tremor, ‘voice boxx’ compression and insomnia.

Thoracic Outlet syndrome

Caused by the compression of the cervical-brachial nerves near the upper chest and anterior deltoid (front shoulder muscle) beneath the clavicle (collar bone). This may further restrict the transmission of sensory impulses through to the median nerve increasing the chance of carpal tunnel syndrome.

Symptoms include numbness, aching pain and tingling in the arms

Trigger Finger

This condition is caused by irritation or scarring of a tendon within the tendon sheath in a finger joint.

This has the effect of ‘stickingg’ and subsequent locking of the finger joint causing pain and discomfort.