How To Manage A Painful Joint
Joint pain can be caused by many different processes which include degeneration of the articular cartilage, infection, inflammation, trauma and deposition of crystals. Distinguishing one type of joint diagnosis from another is mostly made by taking a history and examining the joint, as this process is able to narrow down the options well. Once a provisional diagnosis is made then investigations are typically used to confirm the diagnosis and are less useful in trying to look for a cause without a narrow range of options. Clinicians try first to establish the source of the joint symptoms and then the potential underlying pathological process.
The Shoulder Girdle ” Part Two
Typically when the shoulder becomes painful and dysfunctional the movement tends to fall into a particular pattern of use by lifting the shoulder area, winging the scapula out from the thorax and leaning the neck towards the lifting shoulder. This movement pattern exposes the shoulder to abnormal forces and can provoke shoulder conditions such as impingement and tears of the rotator cuff muscles. The body makes preparations before an activity by pressing the scapula against the thoracic chest wall and engaging the core stability system.
The Shoulder
The shoulder is a very special joint. It allows a very great degree of movement to occur at the important junction between the torso and the arm. Notionally a ball and socket joint, the shoulder has been modified so this structure is much less clear than in the hip. The top of the arm bone or humerus is expanded into a large rounded knuckle which is like a ball but the socket is different. Unlike the deep hip socket which holds the head of the femur, the shoulder socket is very small in comparison to the head and very shallow.
Injuries to the Brachial Plexus
As the individual nerve roots emerge from the neck they join together and separate in a complex fashion in an area called the brachial plexus, running down from the neck to the axilla where the individual arm nerves emerge. Nerves are very vulnerable structures and can be injured in gunshots, direct blows, knife attacks and traction injuries, which involve a sudden stretch. The results can be very disabling, with a chronically painful arm the patient is not able to move or use very well. Recovery is very variable and many patients have to cope with a less than useful arm.
The Development of Chronic Back Pain
For people of forty-five or younger low back pain syndromes are the major cause of activity limitation in the industrialised societies of the west. Defining what a chronic syndrome has been agreed that any condition lasting longer than the expected time of healing of the soft tissues could be classed as chronic, a period of approximately three months. The soft tissues of the body should heal in this time and pain has a useful survival function for us in these cases, making us remove the injuring forces and look after the damaged part as it heals. There appears to be no useful biological function for the chronic pain syndromes.
