Dr Maggie Ju Acupuncture Harley street and Kensington

Shoulder pain

Shoulder joint is the most mobile one in the body.  Shoulder consists of  bones, joint, cartilage, muscles, tendons and ligaments.  If something goes wrong with the shoulder, it will cause pain and limit the movement. With aging the soft tissues surrounding the shoulder tend to degenerate, and older people are likely to get shoulder problem. Soft tissues injury around the shoulder is very common and this will cause shoulder pain. The pain can come on gradually or abruptly, and it may range from mild to severe often accompanied with limited motion. The common causes of shoulder pain include

No1: Fronzen shoulder. It is caused by a thickening and stiffening of the tissues around the shoulder joint. This is is a painful condition in the shoulder.  Typical symptoms are shoulder pain and restricted shoulder movement. It presents a painful persistent stiffness of the shoulder joint that it is difficult to carry out everyday tasks such as dressing, driving and sleeping comfortably. Some people are unable to move their shoulder at all. This is caused when the capsule surrounds the shoulder joint becomes inflamed. The capsule that surrounds the shoulder joint becomes swollen, thickened and tightened This leaves less space for the upper arm bone in the shoulder joint, and makes the movement stiff and painful. The symptoms of frozen shoulder can vary greatly, but tend to get worse slowly over the time. They are usually felt in three stages spread over a number of months or years. This is a common condition affecting about 2% of adults. 

No2: rotator cuff injuries and irritations: due to tears and inflammation of rotator cuff, the symptoms include pain or stiffness in the shoulder when you lift your arm above your head to brush your hair or when you reach behind your back.

No3: Osteoarthritis can affect shoulder as well thigh less common than knee and hip.

Treatment for shoulder pain is aimed at relieving pain and preserving range of motion of the shoulder.

Muscles around the shoulder related to shoulder pain 

Trapezius muscle is a broad triangular muscle at neck and upper back, one of the largest superficial muscles at the back. It attaches to the base of the skull and extends down to the neck, the upper back until mid-back; laterally it inserts to the shoulder blades. Pain caused from this muscle may be on the top of the shoulder, neck, mid back and/or upper shoulder pain; pain at the back of the shoulder blade which could go down the inside of the arm to the ring and little fingers.

Latissimus dorsi is the largest flat muscle at the back. Tight latissimus dorsi and the trigger points on the muscles could be one of the causes of chronic mid back pain, shoulder pain, forearm pain, pain between shoulder blades, shoulder blades and pain in front of shoulder. The characteristic of pain is at lower shoulder blade and mid back and also the pain can go down the backside of the arm or the inner side of the arm and reach the hand and 4th and 5th fingers. Pain can be present at the front of the shoulder and to the side of the body just above the hip.

Rotator cuff comprises four muscles. They connect scapula to the head to humerus, stabilize shoulder joint and contribute to shoulder joint movement including abduction, internal rotation, and external rotation of the shoulder. Rotator cuff disorder is one of the problems that cause shoulder pain. The main symptoms are pain around the shoulder and reduced shoulder joint movement. Acupuncture can help reduce the pain.

Teres major muscle

Teres major muscle is the muscle that connects shoulder blades to the upper arms. The pain caused in the teres major trigger is the back of the shoulder and also this pain can radiate to the front and side of the shoulder and down the backside of the arm. The trigger points for this muscle can be found at the lower angle of shoulder blades. 

Muscles connect the humerus (upper arm) to the scapula (shoulder blade)

There are seven muscles that connect the upper arm to the shoulder blades and help the movement of the shoulder.  Overuse or injury to these muscles can cause shoulder and arm pain. 

Deltoid muscles

The deltoid muscle is the big muscle on the shoulder which forms the rounded contour of the shoulder. Deltoid muscle strain is less common than rotator cuff muscles strain.

Pectoralis major and minor muscles are located at the chest. Underneath the pectoralis major is the pectoralis minor muscle. The trigger point of the muscle contributes to the pain in front of the shoulder, that could radiate to the chest and all the way down the inner arm.

 

Biceps is two headed lies on the upper arm between the shoulder and the elbow. It can contribute to the pain on the front of the arm, the elbow and the shoulder. 

Triceps is three headed muscle of the arm is the large muscle on the back of the upper limb. If the triceps contain trigger points, you can experience pain on the shoulder, arm, elbow or the pain can radiate to the forearm.

Elbow pain

Golfer's elbow, also known as medial epicondylitis. It is a condition caused by damage to the muscles and tendons that control the wrist and fingers. These tendons of the forearm muscles attach to the bony bump on the inside of the elbow. It is the opposite side to tennis elbow which occurs on the outside of the elbow. The main symptom is pain at the inner side of the elbow and the pain sometimes extends along the inner side of the forearm. Pain typically worsens with certain movements. The inner site of elbow is tender to touch. The elbow may feel stiff and making a fist might hurt. There may be weakness in the hands and wrists. There could be also umbness or tingling present. These sensations might radiate into the ring and little fingers. This condition is caused by overusing the muscles in the forearm that allow you to grip, rotate the arm, and flex the wrist. Repetitive flexing, gripping, or swinging can cause pulls or tiny tears in the tendons causing inflammation.

Tennis elbow a condition that causes pain around the outside of the elbow, also known as lateral epicondylitis. It often occurs after strenuous overuse of the muscles and tendons of the forearm on the outside of the elbow joint. If the muscles and tendons are strained, tiny tears and inflammation can develop near the bony lump (the lateral epicondyle) the elbow. The main symptom is notice pain: on the outside of the upper forearm, just below the bend of the elbow, when lifting or bending the arm, when gripping small objects, such as a pen, when twisting the forearm, such as turning a door handle or opening a jar.

Acupuncture is effective for golfer’s elbow and tennis elbow reducing pain, and inflammation.

Wrist pain

Wrist pain is often caused by sprains or fractures from sudden injuries. Wrist pain can be caused by disease or injury affecting any aspect of the wrist joint, including the bones, ligaments, and connective tissue surrounding the area. Wrist pain can often result from long-term problems, such as repetitive stress, arthritis and carpal tunnel syndrome.

The symptoms of wrist sprains are sudden pain with redness, swelling and bruising, difficult to move wrist or grip anything.

Repetitive stress from any activity that involves repetitive wrist motion such as playing tennis, driving etc can cause wrist pain. It is caused by inflaming the tissues around joints. The symptoms include pain, swelling, redness and stiffness at the wrist.

Carpal tunnel syndrome (CTS) is a common condition that causes pain, numbness and a tingling sensation in wrist, the hand and fingers. This is caused by compression of median nerve that passes carpal tunnel and controls sensation and movement of the hand. If the nerve is entrapped in the tunnel, an unpleasant tingling, pain or numbness will occur in the distal distribution area which is in the hand and fingers. About 10% of people in the UK develop this condition. The symptoms include slowed median nerve conduction velocity, local pain and abnormal sensations such as tingling, burning, numbness etc.  The symptoms develop gradually and are worse during the night. The affected fingers include thumb, index finger, middle finger and half of the ring finger. The risk of developing carpal tunnel syndrome include a family history of CTS, pregnancy, injuries to the wrist, other health conditions such as diabetes and rheumatoid arthritis and strenuous, repetitive work with the hand.

Research has shown that acupuncture could be an effective treatment for CTS and has greatly improved the symptoms in patients with CTS.

Thumb pain

Skier’s thumb, acupuncture can help.

Skier’s thumb also called gamekeeper’s thumb is an injury of the index finger side of the ligament of the thumb that connects the bones of the thumb together. Skier’s thumb is the second common skiing injury after knee injury. In severe cases, the ligament is completely broken and the injury must be repaired by surgery. The symptoms may occur after the fall that causes the injury. The symptoms include: pain at the base of the thumb in the web space between the thumb and index finger which is worsens with thumb movement; swelling of the thumb; inability to grasp or weakness of the grasp between the thumb and index finger; tenderness along the index finger side of the thumb; change colour of the skin over the thumb; pain in the wrist which is referred pain from the thumb. Acupuncture can help relieve the pain and improve local blood flow to help recovery.