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Repetitive Stress Injuries Part II

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By: Dr. Stephen O’Neil

Repetitive stress injuries, as with any injury or condition, require specific focused history and exams in order to arrive at an accurate diagnosis. This first step is crucial in setting up an accurate and specific plan of treatment. As I said last week, there are always treatment options. Every condition has several treatment choices and some may be more appropriate or effective for different people.

It is important to explore these options before committing to a treatment plan. For example, some of the most common repetitive stress syndromes that workers deal with are medial and lateral epicondylitis, more commonly known as golfer's elbow and tennis elbow, respectively. These syndromes present with acute pain and tenderness over the inside or outside of the elbow joint. This pain is caused by an inflammation of the capsule around the elbow joint or small tears in the muscular attachments at these joints. These syndromes are most commonly caused by repetitive wrist motion requiring contraction of the forearm muscles, such as computer or typewriter work, production work, meat cutting or specific sports. The syndromes are usually accompanied by wrist weakness and painful contraction of the hand and forearm.

Treatment options include ice, rest, deep tissue therapy, electric stimulation, ultrasound or acupuncture. Medical treatment includes the use of anti-inflammatory drugs, pain killers, cortisone shots in the elbow joint and in rare cases, surgery. Common sense would dictate that the most conservative treatments should be explored before making injections or surgery an option. My personal treatment of choice is myofascial release therapy, which is deep tissue manual therapy in conjunction with ice and ultrasound. Specific exercises and stretches are a necessary augment to these therapies. Most of these cases respond well to this conservative therapy. The key to treatment is patient compliance and catching the syndrome in time. The sooner treatment begins, the less damage there is to repair and the better the prognosis.

The last part to successfully treating repetitive stress injuries is knowing the cause or mechanism of these stressors and eliminating or modifying them. A person who successfully completes treatment for their injury and immediately returns to doing the same actions which caused it in the first place, will almost certainly have a re-occurrence of symptoms. The best thing to do is to get rid of this stress, however quitting our jobs or not playing sports for most of us, is just not an option. With that in mind, the next best thing is: 1. Strengthening the area of injury to stronger than pre- injury status, 2. maintain stretching and strengthening exercises after return to activity and 3. wear supportive bracing. The prognosis will again get progressively better if these post treatment steps are followed. The best treatment is to make the body better able to deal with the stresses that cannot be eliminated, thereby preventing a re-occurrence.

If you suffer from repetitive stress type injuries, see your chiropractor for an accurate diagnosis, treatment regimen and preventative schedule. The sooner treatment starts, the sooner you can get back to beating yourself up, whether at work or at play.