The bulk of the population of Essex County is employed at some type of industry or production job that requires a great deal of repetitive movements. Some assembly work can require a person to perform the same intricate task 600 or 700 times a night. As a Chiropractor in this area, I am bombarded with repetitive stress type injuries. These injuries can affect any part of the body, but are most common in the upper body, especially shoulders, elbows, and wrists.
It is not uncommon for a patient to present to my office with a certain ailment and mention their extreme elbow or wrist pain merely as a nuisance they must live with. Often these people have been given a nonspecific diagnosis such as tendonitis or carpel tunnel syndrome. Anti-inflammatory drugs or painkillers are prescribed and the patient is sent on his way with little or no explanation as to what exactly is happening or what their treatment options are. Worse yet, many are steered towards surgery, which have varying degrees of success and are often only a temporary fix. These people end up going back to the same job doing the same repetitive work, exposing themselves to the same repetitive stresses that caused the problem in the first place. This results in the same syndrome returning.
The fact is that repetitive stress affects many people because of a lack of education as to how these injuries occur as well as how they should be treated and ultimately how they can be prevented. With this knowledge many people would be able to decrease their use of medications, decrease their pain levels, and return to a normal level of functional ability.
The first step in the process is finding out what is actually wrong with your injured area. Obtain an accurate diagnosis. A diagnosis of simply ‘tendonitis’ should not be accepted. A specific diagnosis from a focused exam of the area is the only way a proper treatment plan can be designed and implemented. For example, many patients are inaccurately diagnosed as having ‘shoulder tendonitis’ when they may actually have a tear in a rotator cuff muscle or bursitis. I have also had patients come into my office with the diagnosis of carpel tunnel syndrome only because they had some wrist pain and finger numbness. There are many conditions that may have the same symptoms and may be a much easier fix.
Once a ‘specific’ and ‘accurate’ diagnosis has been achieved, all available treatments for that condition must be discussed to come up with an appropriate treatment plan. Treatment options should be presented to every patient. There is no one simple treatment that is best for a certain condition for every patient, every time. Drugs and surgery are not always the answer, although they may be the best for some people. Some patients may respond great to acupuncture while others may not and some may have moral or religious objections to the use of needles. As I said, there are always options when it comes to treatment of these repetitive stress injuries. It is my opinion that the least invasive treatment options should always be explored first. Electric stimulation, ultrasound, acupuncture, and manual therapy should be explored prior to undergoing more invasive procedures such as surgery or the injection of cortisone. When it comes to treatment, the possible benefits should always outweigh the possible risks.
A proper and acceptable treatment plan should be designed with input from both the patient and the physician. The patient should then decide on where to go for therapy. The patient should choose a well-qualified physician with whom they feel comfortable. Next week’s article will be a continuation of repetitive stress injuries: cause and treatment, with a focus on wrist and elbow injuries.