Shoulder Pain

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23 03, 2012

Sports Injuries

Sports injuries are injuries that occur in athletic activities. Some sports injuries result from accidents; others are due to poor training practices, improper equipment, lack of conditioning, or insufficient warm up and stretching. Many sports injuries can be due to overuse of a part of the body when participating in an activity. Other types of injuries can be caused by hard contact with something. Sports injuries typically involve the musculoskeletal system, which includes the muscles, bones, and associated tissues like cartilage.

Common sports injuries include:

  • Sprains are a stretch or tear of a ligament, causing tenderness, pain, bruising, swelling and inflammation.
  • Strains are a twist, pull, or tear of a muscle or tendon, causing pain, muscle spasms, and weakness. 
  • Knee injuries are very common and can range from mild to severe, from pain or tenderness at the front or side of the knee close to the knee cap, tendinitis, and pain in the iliotibial band (the outer side of the knee), to bone bruises or damage to the knee cartilage or ligaments. 
  • Shin splints are another common sports injury involving pain along the tibia or shin bone, typically seen in runners. 
  • Achilles tendon injuries can occur when there is tendinitis already present in the tendon or when a stretch, tear or irritation happens to the tendon. 
  • More severe can be stress fractures, which occur from repeated stress to a bone over time, most often occurring in the legs or feet, and acute fractures, that can occur from a quick, one-time injury to the bone. 
  • Dislocations occur when the two bones that come together to form a joint become separated. Dislocations a usually caused by contact sports or high-impact sports.

The great news is that acupuncture can be of benefit to all types of sports injuries. It is of course always best to treat an injury in the acute stage or as soon after an injury occurs as possible, in order to assist the body in healing quickly and fully. Early treatment also helps to prevent the possibility of long-term or chronic problems with the injury down the road due to improper healing. However, acupuncture is also very beneficial in any stage of healing and can also be of great help to old, lingering injuries or injuries that did not properly heal. Acupuncture taps into the body’s own resources to encourage the healing process and the body’s optimal functioning. With sports injuries this can mean reduced inflammation, increased circulation, reduced muscle tension, and of course, pain relief. Treating sports injuries, whether old or new, can help the body to regain former functioning and health levels and prevent more long-term consequences such as reduced mobility, stiffness, weakness, or arthritis.

Our bodies have amazing abilities to self-regulate and repair themselves. In any injury the body attempts to minimize, repair and overcome the damage to its normal functions and in many cases, given adequate rest and support, our bodies are able to recover successfully. However, in cases where the body isn’t able to correct a problem on its own, or in cases where long-term damage can occur if left untreated, acupuncture is a promising treatment that helps bolster the body’s healing abilities so that we can return to our normal, healthy selves.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, downtown Kelowna. He can be reached at www.okanaganacupuncture.com. 

 

6 03, 2012

Thoracic Outlet Syndrome

Thoracic outlet syndrome occurs when the blood vessels or nerves in the thoracic outlet (the space just under the collarbone) become compressed. This can cause pain in the shoulders and neck and numbness in the fingers. The symptoms vary depending on whether it is the nerves or the blood vessels that are affected. When the nerves are compressed, symptoms usually include numbness or tingling in the fingers, pain in the shoulder and neck, ache in the arm or hand, and weakened grip. When a vein or artery is compressed, symptoms can include bluish discoloration or lack of colour in the hand, a blood clot under the collarbone, arm pain and swelling (possibly due to blood clots), a throbbing lump near the collarbone, weak or no pulse in the affected arm, and tiny, black spots (infarcts) on the fingers.

Thoracic outlet syndrome may develop from a variety of causes. Physical trauma from a motor vehicle accident, repetitive stress injury from work or sports, anatomical defects such as having an extra rib, poor posture, and pressure on the joints due to body weight or because of carrying an oversized backpack or purse can all lead to thoracic outlet syndrome. Even a long-ago injury can lead to thoracic outlet syndrome in the present, as can pregnancy, because of the joints loosening. In some cases, the cause of thoracic outlet syndrome cannot be determined.

Treatment for thoracic outlet syndrome usually involves a combination of exercises, relaxation, and medications. Physiotherapy is used to open the thoracic outlet, improve range of motion and posture, and strengthen the shoulder muscles. Relaxation techniques may help to reduce tension in the shoulders and maintain posture. Medications such as muscle relaxants, anti-inflammatories, and pain medications may be prescribed for pain relief. In severe cases where the syndrome does not improve, surgery may be recommended.

Acupuncture is also an option worth considering for thoracic outlet syndrome. Acupuncture is a well-known therapy for pain relief and for musculo-skeletal conditions. Chinese medicine (TCM) does not use the term “thoracic outlet syndrome”, diagnosis instead depends on the specific symptoms that an individual is presenting. Typically thoracic outlet syndrome will be categorised as an injury to the tendon, a bi-syndrome (pain caused by a blockage in one of the body’s meridians and a lack of circulation of qi-energy and blood to the area), or a wei-syndrome (weakening and evening atrophying of a muscle due to a lack of proper nutrients or blood and qi-energy circulation). Depending on the type, the specific symptoms will vary but may include pain, numbness and heaviness of the muscles, tendons or joints, tendon or joint swelling, limitation of movement, and weakness in the limbs.

Acupuncture can help with thoracic outlet syndrome in a number of ways. Acupuncture of course offers very effective pain relief, and it can also reduce inflammation and relax tight muscles or tendons to relieve pressure to the nerve or tendon. Treatment also helps to remove blockages and increase blood circulation and energy, so that the area can receive adequate nourishment to function properly and to heal. Acupuncture can also resolve any imbalances in the meridians that may be causing a weakness in the body, leaving an area prone to injury or strain, as is often the case when a condition develops.

In my practice, I have seen thoracic outlet syndrome respond very positively to acupuncture. A series of treatments can offer relief of symptoms and can help to resolve the condition, depending on the cause. Stretching and postural exercises are also important and can help support recovery from this syndrome.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, downtown Kelowna. He can be reached at  www.okanaganacupuncture.com.

24 01, 2012

Post Operative Recovery

Surgery is a powerful tool in the modern medical tool kit and is used today in a wide range of applications. Surgery for musculoskeletal conditions is called orthopedic surgery, and is used to treat musculoskeletal trauma, degenerative diseases, sports injuries, infections, tumours, and congenital disorders (disorders we are born with). This includes surgeries such as hip or knee replacement, spinal surgery or fusion, carpal tunnel release, or repair of tendons, ligaments, or cartilage. However, there are many, many other surgeries that are performed for a variety of reasons, such as to help relieve or prevent pain, to reduce a symptom, to improve some body function, or to diagnose conditions.

With surgery comes certain post-operative side effects and risks. Some of the major concerns with surgery is dealing with post-surgery pain and the side effects of pain medications, as well as making a complete recovery from surgery and regaining our former mobility and functions.

Doctors rely on powerful medications to relieve pain during and immediately after surgery, including opioids and anesthesia. Opioid pain medications are known to cause side effects such as nausea, vomiting, dizziness, pruritis (itch or a sensation that makes a person want to scratch), constipation, and sleepiness, symptoms which can cause difficulty in the recovery and interfere with our day-to-day life. Use of opioids and their side effects may also delay post-operative recovery.

Acupuncture is an excellent option for post-operative recovery and has been shown to be very effective in the treatment of both post-operative pain and the side effects of opioid medications. Acupuncture is probably best known for the treatment of pain and it is indeed very effective for relieving pain and reducing the need for pain medications. Pain limits your ability to breathe deeply, cough, walk and perform the activities necessary for a speedy recovery, and acupuncture can help to manage the pain so that recovery can happen more quickly.

Acupuncture can also treat the side effects of pain medications including dizziness, upset stomach or nausea, loss of appetite, pruritis (itching sensation), urinary incontinence, and digestive problems, making it an effective option for post-operative recovery.

Acupuncture can also help with the body’s recovery following surgery. While surgical techniques have come a long way, surgery still remains a type of trauma that the body must recover and heal from afterwards. Acupuncture helps to boost the immune system and to restore proper functioning to the body, and in post-operative care can help the body to recover and regain health more quickly.  Acupuncture can also help with inflammation, decrease swelling and improve mobility and range of motion after surgery. This is important to recovery in order for a person to regain their full abilities and have full use of the body in the months down the road from surgery. Acupuncture may also help reduce adhesion formation and reduce scarring and scar tissue as the body heals from surgery.

Research shows that acupuncture can indeed be very effective for post-operative recovery when surgery is followed by a series of acupuncture treatments, and it can also be beneficial to perform acupuncture a day or two before surgery. This ensures that the body is in a healthy state going into surgery in order to ensure a complete and healthy recovery!

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, downtown Kelowna, BC. He can be reached at www.okanaganacupuncture.com.

25 02, 2011

Rotator Cuff

The rotator cuff is made up of the various muscles and tendons in the shoulder that connect the upper arm bone to the shoulder blade. They also help hold the ball of the upper arm bone firmly in the shoulder socket. The shoulder has the greatest range of motion of any joint in our body.

A rotator cuff injury is fairly common and can involve any type of irritation or damage to the rotator cuff muscles or tendons. The most common problems are tendinitis, when one of the rotator cuff tendons becomes inflamed due to overuse or overload (especially common in athletes), bursitis, when the fluid-filled sac (bursa) between the shoulder joint and rotator cuff tendons become irritated and inflamed, and muscle or tendon strain or tear, which can happen with tendonitis that is left untreated, or with stress from overuse.

Injuries are most commonly caused by normal wear and tear of daily life, poor posture or slouching, a sudden fall (and using our arms to break the fall), lifting a too-heavy object or lifting improperly, pulling something heavy, or repetitive arm activities, especially those done overhead, that cause stress to the shoulder.

Symptoms may include shoulder pain, tenderness and weakness, loss of shoulder range of motion, and a tendency to keep the shoulder inactive. Pain is the most common symptom of rotator cuff injuries, and may be experienced when reaching overhead, behind the back, lifting, pulling, or sleeping on the affected shoulder. A severe injury, such as a large tear may cause continuous pain and muscle weakness.

Treatment for rotator cuff injuries typically involves rest, over-the-counter pain relievers, and gentle stretching. Physiotherapy may be recommended to help heal the injury, improve flexibility of the rotator cuff, and develop shoulder muscle strength. Depending on the severity of the injury, full recovery may take from several weeks to several months. In more severe or chronic cases, treatment may involve corticosteroid injections or surgery. About half of the time, a rotator cuff injury can heal with self-care measures or exercise therapy.

Acupuncture can be very helpful in dealing with rotator cuff injuries, and this is good news. Treatments can help to relieve the inflammation, pain and muscle weakness and stiffness caused by the injury, which can speed recovery and bolster the body’s self-healing mechanisms. This makes acupuncture an excellent option in treatment of rotator cuff injuries, as it can complement other treatment therapies and can reduce the length of recovery time. Acupuncture can also be of particular benefit to lagging injuries that seem to just not want to get better. In addition, acupuncture helps the body to function better, and so can help to strengthen the shoulder and promote its proper functioning.

In Chinese medicine, rotator cuff injuries are often due to an obstruction of the flow of qi-energy and blood to the shoulder, causing pain and weakness. Acupuncture can remove these blockages to allow full circulation of qi-energy and blood to the shoulder, allowing it to receive the nourishment it needs for proper functioning. In addition, a person may also have internal balances or weaknesses that make him or her particularly prone to a shoulder injury of some sort. By determining the cause of the pain and looking at each person's individual health, we can not only resolve the pain and weakness that is being experienced, but we can also strengthen the body so that it is functioning in better health and less prone to a repeat injury or pain problem in the future.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, downtown Kelowna.

3 01, 2011

Tendinitis

Tendinitis is the inflammation or irritation of a tendon- the thick, fibrous cords that attach muscles to bones. Tendinitis causes pain and tenderness just outside a joint. While tendinitis can occur in any of the body's tendons, it's most common in the shoulders, elbows, wrists and heels.  Tendinitis symptoms typically include pain (usually a dull ache), tenderness, and mild swelling at the point where the tendon attaches to the bone.

Common names for tendinitis are tennis elbow, golfer's elbow, pitcher's shoulder, swimmer's shoulder, and jumper's knee. From this list it’s easy to see that tendinitis typically develops from the stress of a repetitive movement over time. Most people develop tendinitis because of jobs, sports or hobbies that involve repetitive motions, which aggravate the tendons needed to perform the tasks, although tendinitis can also be caused by a sudden injury. Age can also play a factor in tendinitis because as we get older, our tendons become less flexible, making them more prone to injury.

Most cases of tendinitis can be successfully treated with rest and self-care. If symptoms persist for more than a few days and interfere with day-to-day activities, your doctor may recommend medications to reduce the pain and inflammation. Injections of cortisone medication around a tendon may also be recommended to reduce inflammation and help ease pain but repeated injections may weaken a tendon, increasing the risk of tendon rupture. Tendon rupture is a much more serious problem that may require surgical repair. Without proper treatment, tendinitis can develop into a chronic problem and increase the risk of developing into tendon rupture.

Acupuncture can be a great option for resolving tendinitis problems and promoting proper healing. In Chinese medicine, most musculo-skeletal disorders have some relevant underlying imbalance or contributing lifestyle factor. Understanding a person’s general health gives an acupuncturist insight into the internal imbalances that can contribute to injury. Lifestyle can play a role, whether it be our occupation, the exercise or sports we choose, or our nutrition and diet. Chinese medicine also considers the role of emotion and thought in health, as they can be either the cause or the symptom of an internal balance.

With tendinitis, and all types of musculo-skeletal injuries, pain is caused by stagnation of qi-energy and blood. Acupuncture treatment focuses on removing the blockage and helping the energy and blood to flow again in order to remove pain and resolve the symptoms of the injury. This also helps to promote proper and complete healing.

In addition, we look at what underlying factors have influenced health and weakened the joint or made it vulnerable to injury. These causes can be external (such as exposure to the elements or an external trauma or blow to the area) or internal (caused by an imbalance in the body’s normal functioning due to our genetics or our lifestyle). By also treating these underlying factors, we are can strengthen the injured area and improve health, with the goal of preventing future reoccurrence.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, Kelowna, BC.

3 01, 2011

Osteoarthritis

Osteoarthritis, sometimes called degenerative joint disease, is the most common form of arthritis. Osteoarthritis occurs when cartilage in the joints wears down over time. The smooth surface of the cartilage becomes rough, causing irritation. Eventually, if the cartilage wears down completely, there may be no cushion left between the bones and the joint may be left with bone rubbing on bone, causing damage to the ends of the bones and the joints to become painful. The disorder can affect any joint in your body, but most commonly affects joints in your hands, hips, knees, neck, and lower back.

Osteoarthritis symptoms often develop slowly and worsen over time. Symptoms of osteoarthritis include joint pain (during or after movement), joint tenderness when palpated, joint stiffness (especially upon awakening or after a period of inactivity), loss of flexibility in the joint, a grating sensation in the joint, and bone spurs (extra bone that may form around the affected joint and feel like hard lumps).

It isn't clear what causes osteoarthritis in most cases. Researchers suspect that a combination of factors may play a role in the condition, including the aging process, joint injury or stress, heredity, muscle weakness, and obesity.

There is no known cure for osteoarthritis, and those suffering from osteoarthritis must look for treatments to relieve pain and manage symptoms. Western medical treatment for osteoarthritis includes pain relievers, non-steroidal anti-inflammatories (NSAIDs), cortisone shots, and in more severe cases surgery to replace the joint, to fuse the bones in the affected joint, or to realign the affected bones. Physiotherapy, occupational therapists, and braces or shoe inserts may also be recommended, to reduce stress on the joint.

Acupuncture is a useful option to help manage osteoarthritis and help prevent further progression of this condition. Acupuncture sees osteoarthritis as a “bi syndrome”, meaning that it is caused by a blockage that prevents circulation of blood and qi-energy to the joint, leading to pain and stiffness. Over time, the syndrome progresses and the joint deteriorates because of the lack of proper nourishment. Acupuncture focuses on removing the obstruction to the joint and increasing circulation so that the can joint receive proper nourishment. In this way, the symptoms of pain, inflammation, and stiffness can be relieved, and the joint can become stronger and healthier.

This is one of the strengths of acupuncture, especially in the treatment of chronic conditions such as osteoarthritis- acupuncture focuses not only on relieving the symptoms but also on strengthening the body and supporting healing, to address the cause of the problem. In this way, acupuncture can help a person with osteoarthritis not only live symptom-free, but also help them to manage the condition in a healthy way and prevent or slow the progression of the condition.

With osteoarthritis, we should remember that this is a problem that will not go away and a proactive approach is necessary. Having osteoarthritis does not necessarily mean that a person must be resigned to pain and suffering- steps can be taken to minimize or prevent symptoms. The key to living with a condition such as this is to take steps towards healthy management through exercise, lifestyle changes, and therapies which relieve symptoms and help manage the condition. Acupuncture is certainly worth considering as part of this routine.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, Kelowna, BC.

3 01, 2011

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic inflammatory disorder that affects the lining of the joints, causing a painful swelling that can eventually lead to bone erosion and joint deformity. This condition is an autoimmune disorder where the immune system mistakenly attacks the body's own tissues.

Rheumatoid arthritis can cause symptoms of joint pain, swelling and tenderness, as well as red and puffy hands, firm bumps of tissue under the skin on the arms (rheumatoid nodules), and morning stiffness that may last throughout the day. It can also affect the whole body with fevers, fatigue, and weight loss.

Rheumatoid arthritis tends to affect the smaller joints first, such as the wrists, hands, ankles and feet, but as the disease progresses, the shoulders, elbows, knees, hips, jaw and neck can also become involved. Symptoms may vary in severity and may come and go. Flare-ups of disease activity alternate with periods of relative remission, during which the swelling, pain, difficulty sleeping and weakness lessen or disappear.

Doctors don’t know what causes rheumatoid arthritis, though it may have a genetic factor that is triggered by environmental factors such as a bacterial or viral infection. There is no cure for rheumatoid arthritis, and treatment involves managing symptoms to prevent flare-ups and further progression of the disease. Western medical treatment may involve medications to reduce joint inflammation, relieve pain and prevent or slow joint damage; physiotherapy to teach better movements to protect the joints; and in severe cases, surgery.

In Chinese medicine, rheumatoid arthritis is considered a “bi syndrome”. “Bi” means obstruction or blockage, and bi syndromes are characterized by an obstruction of qi-energy and blood by wind, cold, dampness, or heat. This causes symptoms of aching, pain, heaviness, numbness, stiffness, redness, and swelling. Bi syndromes usually arise because of an underlying weakness or imbalance in the body that makes us vulnerable to injury or disease.

Bi syndromes that lead to rheumatoid arthritis typically arises from an imbalance of the kidneys, because of their role in the functioning of the bones and marrow, and the spleen, because problems with the spleen can lead to internal dampness in the body, as with joint swelling during a flare-up. The liver is also often involved with rheumatoid arthritis, because liver dysfunction can lead to blockages of qi-energy and shortage of blood, and the liver is also closely tied into the health of the tendons and ligaments.

However, rheumatic arthritis may have different causes depending on the person, and determining the organs involved is done by looking at the specific symptoms for each person. In this way, treatment is tailored to the individual’s symptoms and constitution, to better target the causes and relieve the symptoms.

Acupuncture has a lot to offer those suffering from rheumatoid arthritis. It offers a healthy way to manage the symptoms of the condition, helping to reduce pain and inflammation and prevent flare-ups from occurring. Acupuncture improves the body’s healthy functioning, including the immune system. It is also very effective for the relief of pain and inflammation- in the case of rheumatoid arthritis, relieving joint pain and stiffness and helping the joints to function more healthily.

For those who suffer from rheumatoid arthritis, acupuncture offers a safe and healthy option to help manage the condition, prevent further progression, and enjoy life symptom-free.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, Kelowna, BC.

7 10, 2010

Frozen Shoulder

Frozen shoulder, also known as adhesive capsulitis, is a condition where there is stiffness and pain in the shoulder joint leading to a limited range of motion in the joint. Frozen shoulder usually only affects one shoulder, but some people may eventually develop it in the other shoulder as well. This condition usually develops slowly, over a period of months. The shoulder starts out in the painful stage, where pain occurs with movement and the range of motion begins to become limited. Gradually there is a decrease in pain along with a drastic decrease in the range of motion of the shoulder.

Frozen shoulder can occur after an injury to the shoulder, a surgery or an arm fracture, or it may occur in people with other health conditions such as diabetes, heart disease, lung disease, thyroid problems, and Parkinson’s disease. Frozen shoulder is also more common over the age of 40. With frozen shoulder, the shoulder capsule (the connective tissue in our shoulder joint) becomes inflamed and stiff, which in turn can cause adhesions to develop between the joint’s surfaces and a decrease in the natural lubricating fluids in the joint, all of which contribute to the pain and reduced mobility. At night the shoulder might hurt when sleeping on the painful side and there can be a numbness or tingling in the arm and hand. With the limited use and mobility, strength is lost in the surrounding muscles.

The treatment in Western medicine consists of pain management by using painkillers, muscle relaxants and anti-inflammatory drugs. To regain mobility, physiotherapy or acupuncture may be recommended. A frozen shoulder that isn’t treated well can become a lengthy condition.

What can acupuncture do in these cases? There are several meridians (energy pathways) running over the shoulder or close to the shoulder. When the qi-energy and blood flow in these meridians is obstructed, problems begin to arise. This obstruction can be the result of an underlying problem in one or more of the related organs- in other words, if we have a constitutional weakness in our body due either to genetics or to the accumulated effects of our lifestyle, it can create the conditions for a problem to occur. Because there are many meridians that run over or near the shoulder, internal weaknesses or imbalances can create a weakness in the shoulder, leaving it prone to injury.

An acupuncturist investigates where exactly there is improper functioning within the patient and then will treat the underlying organ problems to get the blood and energy flowing again in the meridians. By increasing circulation and blood flow to the shoulder and reducing inflammation, we can relieve the symptoms of pain and increase mobility in the shoulder, setting the stage for further healing.

The significant difference between Western medicine and Traditional Chinese Medicine (TCM) is that Western medicine will treat the shoulder mainly locally, while in TCM we will treat the organ-related problems together with the meridians, addressing internal factors that contribute to the health and healing of the shoulder area. In fact we will treat the whole person and their imbalances, stimulating the body to return to its own natural equilibrium. By going to the core of the problem, relief through acupuncture can be long lasting if treated properly.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, downtown Kelowna, BC.

11 05, 2010

Neck and Shoulder Pain

I had been suffering with a painful neck and shoulder for almost four years following a car accident. Also I was experiencing pain with my hand for a few weeks. Then I went for a few acupuncture treatments and I am happy to report that they have helped me greatly to have me free of pain.

During each treatment I was able to take a short "cat-nap", altogether an enjoyable experience. I must add here that the staff are very caring, and the treatment rooms very comfortable.   -Beatrice, Kelowna, BC