Arm and hand pain causes: Old injuries or surgeries

Arm pain, Hand pain, Understanding pain / Thursday, December 17th, 2009

This is a series about the causes of arm and hand pain. If you missed the beginning, go back to the checklist or just scroll back to read previous entries.

Often the cause of arm and hand pain emerges after delving into a person’s past medical history and finding a forgotten injury or surgery. You wouldn’t think that something that happened when you were a young person so many years ago would cause a problem now!

Injuries that cause trauma to the soft tissue sometimes don’t heal normally, leaving scar tissue adhesions that distort the surrounding structures and prevent normal movement. Sometime those injuries cause joint misalignment as well, translating into nerve irritation that affects the muscles.

Kids who play hard get hurt. Sometimes those hurts cause the body to compensate and move in ways that overwork the muscles and distort the joints. Scar tissue adhesions can pull the whole network of connective tissue (fascia) out of line like a snag in a sweater. Sometimes the damaged tissue isn’t rehabilitated and eventually causes problems in movement or has to be used carefully to avoid pain from use that for a healthy muscle would not be too much. (I still have problems with my right leg from a double fracture 15 years ago and I had months of Physical Therapy.)

The same scenario applies to surgeries. During the healing process the tissue around the incision site changes and distorts any soft tissue connected to it. You can see the results on the skin with an indented scar and skin that doesn’t look like the skin around it. That happens beneath the skin too where muscles and fascia and blood vessels have been cut.

I still treat a woman who fell off a curb in an another country and fractured her elbow. It was set with a new titanium head on one bone, but Physical Therapists were never able to give her full range of motion. She had pain that went down into her arm and even to her hand at times. Over months of Neuromuscular Therapy, we finally were able to achieve full extension and get rid of the pain in her arm. She still requires maintenance, however, to prevent recurring pain from this old injury and surgery.

In my Neuromuscular Therapy center near Boston, the initial evaluation includes a medical history and exploration of any injuries or surgeries, even from years ago. They are often an underlying cause of low back pain.