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Examination and treatment of the spine for upper extremity pain: a case series
Stephen C Hegarty1, Mark H Shepherd2
1Froedtert Health Rehabilitation Department, Marquette University Department of Physical Therapy, Milwaukee, WI, USA.
Background:
Patients with upper extremity pain often have concurrent spine dysfunction, which may be a primary source of their symptoms. This case series describes three patients receiving physical therapy treatment for upper extremity pain.
Case Descriptions:
Patient A presented with primary complaints of elbow and shoulder pain. Patient B was presented with posterior shoulder pain. Patient C was presented with bilateral wrist pain. All patients were treated with spine mobilization or manipulation techniques. At discharge, they all had clinically significant improvements in self-reported disability and were able to complete necessary daily activities without pain.
Conclusion:
Each patient's symptoms presented in locations that do not correspond with typical pain referral patterns from the spine. Clinical examination of upper extremity conditions should include screening of spinal structures to account for central nervous system changes, which may facilitate pain in remote regions from the site of pathology.
