Pain

Pain

What Causes Arm Pain?

Arm pain and injuries are extremely common. Arm pain can occur as a result of either sudden, traumatic or repetitive overuse. The causes can be related to sports injuries, work injuries or simply everyday arm use.

Arm pain can be a local injury, musculoskeletal injury or could even be referred from nerves in your neck (cervical radiculopathy). This can result in neck-arm pain.

What Arm Pain is Associated with a Heart Attack?

Left-arm pain can be an early sign of a life-threatening cardiac issue. Based on this, a professional medical assessment that involves an accurate history, symptom analysis, physical examination and diagnostic tests to exclude a potential heart attack is important to exclude this potentially life-threatening source of arm pain.

For more information, please consult with your health practitioner, call an ambulance on 000, or visit a hospital emergency department to put your mind at ease.

Good News. Most Arm Pain is NOT Life-Threatening.

Luckily, life-threatening arm pain is far less likely than a local musculoskeletal injury. Arm pain caused by a localised arm muscle, tendon or joint injury should be assessed and confirmed by your health practitioner before commencing treatment.

Referred Arm Pain

As mentioned earlier, arm pain can be referred from another source. Cervical radiculopathy is a common source of referred arm pain. Cervical radiculopathy will not respond to treatment where you feel the arm pain. However, it will respond positively to treatment at the source of the injury (e.g. your neck joints).

Professional assessment from a health practitioner skilled in the diagnosis of both spinal-origin and local-origin (muscle and joint) injuries (e.g. your physiotherapist) is recommended to ensure an accurate diagnosis and prompt treatment directed at the arm pain source.

Common Causes of Arm Pain

The most common sources of arm pain include shoulder painwrist pain and elbow pain.

Arm Pain has Diverse Causes

The causes of your arm pain can be very wide and varied. Due to this diversity, your arm pain should be assessed by a suitably qualified health practitioner to attain an accurate diagnosis, treatment plan and implementation specific to your arm pain.

Arm Pain Prognosis

The good news is that arm pain and injury will normally respond very favourably to medical or physiotherapy intervention when early professional assessment and treatment is sought. Please do not delay in consulting your healthcare practitioner if you experience arm pain.

Causes of Arm Pain by Region

Causes of Arm Pain by Structure

Neck-related Arm Pain

Shoulder-related Arm Pain

Elbow-related Arm Pain

Wrist-related Arm Pain

Hand-related Arm Pain

Muscle-related Arm Pain

Other Sources of Arm Pain

Common Arm Pain Treatments

With accurate assessment and early treatment, most arm injuries respond extremely quickly to physiotherapy or medical care allowing you to quickly resume pain-free and normal activities of daily living.

Please ask your physiotherapist for their professional treatment advice.

Article by P.Xu

As we slowly start getting into the cooler seasons, many people will begin to notice sore joints waking up in the morning, or that movement has become stiff, or even headaches increasing in frequency or severity. Why is this? It turns out that cold weather can have a significant impact on your body’s tissues. Notably, the connective tissue gives our muscles and joints the ability to move as they do, called elastin. As the name suggests, elastin is one of the critical components that provide our joints and muscles with the ability to bend, stretch, and move as they need to get you through the day.
Now, imagine putting a rubber band in the freezer for a few hours. You take it out and then stretch it as hard as you can without warming it up. It’s either not going to stretch as well as it should or break in two. Elastin shares these properties. Under cold temperatures, the tissue cannot stretch or bend as well as it is supposed to, causing stiffness or soreness. Coupled with a few other common changes in the cold, vasoconstriction causes a decrease in your blood circulation. Plus, the tendency to stay home and not move our body makes many of us unaccustomed to cooler temperatures feel the full brunt of these effects moving forward. The good news is, it’s a relatively easy fix. Stay warm. If you’re planning on exercising, make sure to perform a dynamic warm-up to decrease the risk of injury, rather than pushing a cold muscle past its limit (remember the rubber band). If a joint feels stiff in the morning, remedy this with a heat pack or a hot shower. If you suspect your headache cause is the cold, slap on a beanie. This head-warming has the added benefit of hiding a bad hair day. Another excellent fix is getting a massage. Soft tissue therapy such as massage excels at combating several things caused by the cold. The physical act of heating a muscle or joint with friction provides warmth to deep tissues that a heat pack may not reach, allowing the elastin to function as it should. Trigger point work into deep muscle fibres may also bring longer-lasting relief than superficial heat therapy or static stretching. If you’re prone to feeling the cold effects, massage therapy may be the fix that you have been looking for if you want to achieve long-lasting relief from stiff or sore joints and muscles this winter.

What is Physiotherapy Treatment?

Physiotherapists help people affected by illness, injury or disability through exercise, manual joint therapy, soft tissue techniques education and advice.  Physiotherapists maintain physical health, allow patients to manage pain and prevent disease for people of all ages. Physiotherapists help encourage pain-relief, injury recovery, enabling people to stay playing a sport, working or performing daily living activities while assisting them to remain functionally independent.

There is a multitude of different physiotherapy treatment approaches.

Acute & Sub-Acute Injury Management

Hands-On Physiotherapy Techniques

physiotherapy treatment

Your physiotherapist's training includes hands-on physiotherapy techniques such as:

Your physiotherapist has skilled training. Physiotherapy techniques have expanded over the past few decades. They have researched, upskilled and educated themselves in a spectrum of allied health skills. These skills include techniques shared with other healthcare practitioners. Professions include exercise physiologists, remedial massage therapists, osteopaths, acupuncturists, kinesiologists, chiropractors and occupational therapists, to name a few.

Physiotherapy Taping

Your physiotherapist is a highly skilled professional who utilises strapping and taping techniques to prevent and assist injuries or pain relief and function.

Alternatively, your physiotherapist may recommend a supportive brace.

Acupuncture and Dry Needling

Many physiotherapists have acquired additional training in acupuncture and dry needling to assist pain relief and muscle function.

Physiotherapy Exercises

Physiotherapists have been trained in the use of exercise therapy to strengthen your muscles and improve your function. Physiotherapy exercises use evidence-based protocols where possible as an effective way that you can solve or prevent pain and injury. Your physiotherapist is highly-skilled in the prescription of the "best exercises" for you and the most appropriate "exercise dose" for you, depending on your rehabilitation status. Your physiotherapist will incorporate essential components of pilates, yoga and exercise physiology to provide you with the best result. They may even use Real-Time Ultrasound Physiotherapy so that you can watch your muscles contract on a screen as you correctly retrain them.

Biomechanical Analysis

Biomechanical assessment, observation and diagnostic skills are paramount to the best treatment. Your physiotherapist is a highly skilled health professional. They possess superb diagnostic skills to detect and ultimately avoid musculoskeletal and sports injuries. Poor technique or posture is one of the most common sources of a repeat injury.

Hydrotherapy

Aquatic water exercises are an effective method to provide low bodyweight exercises.

Sports Physiotherapy

Sports physio requires an extra level of knowledge and physiotherapy to assist injury recovery, prevent injury and improve performance. For the best advice, consult a Sports Physiotherapist.

Vestibular Physiotherapy

Women's Health

Women's Health Physiotherapy is a particular interest group of therapies.

Workplace Physiotherapy

Not only can your physiotherapist assist you in sport, but they can also help you at work. Ergonomics looks at the best postures and workstation set up for your body at work or home. Whether it be lifting technique improvement, education programs or workstation setups, your physiotherapist can help you.

Electrotherapy

Plus Much More

Your physiotherapist is a highly skilled body mechanic. A physiotherapist has particular interests in certain injuries or specific conditions. For advice regarding your problem, please contact your PhysioWorks team.

Pain

Pain is the built-in alarm that informs you something is wrong! Pain is your body's way of sending a warning to your brain. Your spinal cord and nerves provide the pathway for messages to travel to and from your brain and the other parts of your body. Pain travels along these nerve pathways as electrical signals to your brain for interpretation. Receptor nerve cells in and beneath your skin sense heat, cold, light, touch, pressure, and pain. You have thousands of these receptor cells. Most cells sense pain. When there is an injury to your body, these tiny cells send messages along nerves into your spinal cord and then up to your brain. In general, pain receptors are classified according to their location. Receptors that respond to injury or noxious stimuli are termed nociceptors and are sensitive to thermal (heat), electrical, mechanical, chemical and painful stimuli. Each nociceptor is connected to a nerve that transmits an electrical impulse along its length towards the spinal cord and then, ultimately, your brain. It is your brain that informs you whether or not you are experiencing pain. Plus, your pain can plays tricks - especially when you suffer chronic pain.

Pain messages travel slower than other nerve stimulation.

Nerves can also be categorised according to their diameter (width) and whether a myelin sheath is present. Three types of nerves are concerned with the transmission of pain: A-beta fibres, which have a large diameter and are myelinated A delta fibres, which have a small diameter and also have myelinated sheaths. C fibres have small diameters and are non-myelinated (slowing their conduction rate) and are generally involved with the transmission of dull, aching sensations. Nerves with large diameter conduct impulses faster than those with a small diameter. The presence of a myelin sheath also speeds up the nerve conduction rate. One method of easing your pain is to provide your nervous system with high speed "good feelings" such as rubbing your injured area. This is the same principle that a tens machine (pain-relieving machines) utilises to provide pain relief.

Nerve Pain

Nerve pain is pain that is caused by damage or disease that affects the nervous system of the body. It is also known as neuropathic pain or neuralgia. Nerve pain is a pain that comes from problems with signals from the nerves. It is different to the common type of pain that is due to an injury. This is known as nociceptive pain.

What Causes Nerve Pain?

nerve pain Neuropathic pain is caused by a problem with your nerves themselves, which sends pain messages to the brain.

What is Nerve Pain Symptoms?

Nerve pain is often described as burning, stabbing, shooting, aching, or like an electric shock.

What Causes Nerve Pain?

Various conditions can affect your nerves and cause nerve pain. Common sources of nerve pain include:
  • Shingles (post-herpetic neuralgia).
  • Trigeminal neuralgia.
  • Diabetic neuropathy.
  • Phantom limb pain following an amputation.
  • Cancer.
  • Multiple sclerosis.
  • Chemotherapy.
  • HIV infection.
  • Alcoholism.
  • Other nerve disorders.

Nerve Pain & Nociceptive Pain

You can suffer both nerve pain and nociceptive pain simultaneously. Both pain types can be caused by the same condition.

Nerve Pain Treatment

Nerve pain is less likely than nociceptive pain to be helped by traditional painkillers such as paracetamol, anti-inflammatories and codeine.  However, other types of medicines often work well to ease the pain. Nerve pain is often eased by anti-depressant or anti-epileptic medicines. Please ask your doctor for more advice.

Pain Links

Pain & Injury

Tens Machine

What is a TENS Machine?

Chronic Pain

Recent research has helped to shed more light on the changes that occur in your body with chronic pain.

What is Normal ‘Protective’ Pain?

Normally pain is good. It informs you about potential or actual damage to your body’s tissues. Nociceptor nerve cells in the tissues of your body, react to strong stimuli such as pressure, heat, cold or chemicals. These nociceptors send a message to the spinal cord, which then forward another message up to the brain. Your brain then processes these messages and produces a coordinated response to escape whatever is causing the tissue damage.

What is ‘Pathological’ Pain?

Research has shown that changes occur in your body at all levels of pain processing. These changes include:

Changes at the Injury Site

At the site of the injury, your peripheral nerve becomes much more easily excitable.  This means that it takes far less of a stimulus to cause it fire off. In some cases, even a gentle brush against the skin is enough to fire off the pain pathway. Unfortunately it is not just the damaged nerves that become more excitable, but also the neighbouring nerves, which means even further amplification of the nerve messages. Some nerves can also start firing off spontaneously, which means that they do not need a stimulus to fire off.

Changes in your Spinal Cord

In the dorsal horn of the spinal cord, changes occur in some of the cells that receive the nociceptor messages. These changes lead to greater sensitivity to the spontaneous nociceptor messages mentioned previously. Changes can also occur in some cells that leads to a ‘memory’ developing between two cells, which leads to an amplified response in the neighbouring cell.

Changes in your Brain

Usually, your brain can decrease the level of pain you experience through releasing natural opioid hormones. When you suffer chronic pain, changes occur in the midbrain which actually increase the nociceptive messages. This means you’ll perceive even more pain. Chronic pain messages stimulate parts of the brain involved in emotion, fear and feelings. This may help explain why conditions such as depression, sleep disorders and pain catastrophising are linked in with chronic pain. We also know that chronic pain leads to atrophy or ‘shrinking’ of parts of the cortex and midbrain. Brain-stimulating activities may help to limit this ageing.

Do You Need More Information about Chronic Pain?

If you need more information about your pain or how to best manage your chronic pain, please consult the advice of your physiotherapist. Your physiotherapist is an highly trained at helping you to understand and reverse the changes that occur with chronic pain.

Pins and Needles - Paraesthesia

What Causes Pins & Needles?

A moderately pinched nerve is the most common cause of "pins and needles". Pins and needles are referred to as "paraesthesia" in the medical community. Did you know that feeling "pins and needles" can be a worse sign than having pain in your arm or leg? The reason is that you can't even feel pain anymore when you significantly squash the nerve.

Even worse than "pins and needles" is "numbness" or "anaesthesia", which is a total lack of sensation. You will experience anaesthesia when there is severe nerve compression. Anaesthesia or numbness that persists for more than a few hours can be a sign of permanent nerve compression. Please seek prompt medical attention to prevent the nerve from permanent damage and the muscles it innervates to weaken drastically.

The majority of pinched nerves and nerve compressions are only transient and quickly reversed with early treatment. However, neglect can lead to permanent nerve compression injuries, which may never recover.

Common Causes of Pinched Nerves

The most common forms of nerve compression are in the spinal joints where either a disc bulge or a bony arthritic spur can irritate and compress the nerve. Compressions can also occur as the nerve passes through or around muscles. Your physiotherapist will know where to look.

How Can You Fix "Pins and Needles"?

If you know of someone who is experiencing chronic or permanent "pins and needles", "numbness" or "muscle weakness", please encourage them to seek urgent professional advice. The secret to quick success is the correct diagnosis. A highly trained health practitioner such as your physiotherapist or doctor is your best port of call.

More info

What is a TENS Machine?

TENS is an abbreviation of Transcutaneous Electrical Nerve Stimulation.

Transcutaneous means "across the skin". In simple terms, a tens machine stimulates your nerves via an electrical current through your skin. A TENS machine is an electronic medical device. A TENS machine may assist you in modest short-term pain relief.

The use of a TENS machine should be as one part of a pain management program under the guidance of your doctor or healthcare practitioner. Please consult your healthcare practitioner before using a TENS machine.

How Does a TENS Machine Provide Short-Term Pain Relief?

what-is-a-tens-machine

Researchers believe that TENS controls pain in one of two ways:

Sensory Level Stimulation - The Gate Control theory of pain means that the electrical input of the TENS machine interferes with the transmission of pain signals, by blocking the neural "gate" through which the pain travels.

Motor Level Stimulation - The goal of motor level stimulation is to cause the release of the body's opiate-like substances to achieve pain relief.

Further Reading

Johnson M. 2014, Walsh DM et al. 2009, Nnoaham KE, Kumbang J. 2008, Watson 2008, Andrews JR et al. 2004

IMPORTANT

Use your TENS machine only as directed. A TENS machine and EMS machine are electronic medical devices.  Always read the label and instruction manual. A TENS machine may assist you in modest short-term pain relief. Consult your doctor/healthcare professional before use and if symptoms persist.

TENS Machine FAQs

What is a TENS Machine?

TENS is an abbreviation of Transcutaneous Electrical Nerve Stimulation. Transcutaneous means "across the skin". In simple terms, a tens machine stimulates your nerves via an electrical current through your skin. A TENS machine is an electronic medical device. A TENS machine may assist you in modest short-term pain relief. The use of a TENS machine should be as one part of a pain management program under the guidance of your doctor/healthcare practitioner.

How does a TENS Machine provide Short-term Pain Relief?

Pain is thought to be controlled by TENS in one of two ways: Sensory Level Stimulation - The Gate Control theory of pain means that the electrical input of the TENS machine interferes with the transmission of pain signals, by blocking the neural “gate” through which the pain travels. Motor Level Stimulation - The goal of motor level stimulation is to cause the release of the body’s own opiate-like substances to achieve pain relief.

TENS Machine FAQs

IMPORTANT
Use only as directed. A TENS machine and EMS machine are electronic medical devices.  Always read the label and instruction manual. A TENS machine may assist you in modest short-term pain relief. Consult your doctor/healthcare professional prior to use and if symptoms persist.

What is the PhysioWorks Difference?

You'll be impressed with the experienced physiotherapists, massage therapists and reception staff who represent PhysioWorks.  To ensure that we remain highly qualified, we are committed to participating in continuing education to provide optimal care. If you've been searching for health practitioners with a serious interest in your rehabilitation or injury prevention program, our staff have either participated or are still participating in competitive sports at a representative level. We also currently provide physiotherapy and massage services for numerous sports clubs. Our experience helps us understand what you need to do to safely and quickly return to youryouryour sporting field, home duties, or employment.

How You'll Benefit from the PhysioWorks Difference?

At PhysioWorks physiotherapy and massage clinics, we strive to offer our clients quickeffective and long-lasting results by providing high-quality treatment. We aim to get you better quicker in a friendly and caring environment conducive to successful healing. With many years of clinical experience, our friendly service and quality treatment is a benchmark not only in Brisbane but Australia-wide.

What are Some of the BIG Differences?

Our therapists pride themselves on keeping up to date with the latest research and treatment skills to ensure that they provide you with the most advantageous treatment methods. They are continually updating their knowledge via seminars, conferences, workshops, scientific journals etc. Not only will you receive a detailed consultation, but we offer long-term solutions, not just quick fixes that in reality, only last for a short time. We attempt to treat the cause, not just the symptoms. PhysioWorks clinics are modern thinking. Not only in their appearance but in the equipment we use and in our therapists' knowledge. Our staff care about you!  We are always willing to go that 'extra mile' to guarantee that we cater to our clients' unique needs. All in all, we feel that your chances of the correct diagnosis, the most effective treatment and the best outcomes are all the better at PhysioWorks.
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