Diagnosis and Treatment of Arm Musculoskeletal System Problems

Shoulder Problems Shoulder disorders are the leading cause of arm pain. The diseases that cause shoulder pain are listed as follows:

Rotator Cuff Disease – What is Shoulder Impingement Syndrome?

It is the compression of the supraspinatus muscle during overhead activities of the arm.

What are the Symptoms of Rotator Cuff Disease – Shoulder Impingement Syndrome?

Pain is felt on the front of the shoulder, which increases with overhead activity, and there is restriction in shoulder movement. Swelling, thickening, and tears develop in the tendon of the muscle. It is one of the most common causes of shoulder pain in individuals over 40. The patient struggles to raise their arm and experiences limited shoulder movement. Daily activities such as dressing and bathing become very difficult for the patient. MRI is used for diagnosis.

How is Rotator Cuff Disease – Shoulder Impingement Syndrome Treated?

Overhead activities are restricted, and a physiotherapy program is implemented to strengthen the muscles that stabilize the shoulder, relieve the restriction, and reduce pain. Injections may be applied to the shoulder. If the physiotherapy program does not provide relief, surgical treatment is considered.

Rotator Cuff Disease – Shoulder Impingement Syndrome Rehabilitation Program

Acute Phase

Rest: Overhead activities, heavy lifting, and other activities that cause pain should be restricted. During this phase, it is important to use the arm below shoulder level in daily activities.

Physical Therapy: In this phase, treatments such as ice, electrical stimulation, edema therapy, non-corticosteroid pain relievers, and shoulder injections are included.

Exercise Therapy: Pendulum exercises, wall walking finger exercises, and isometric strengthening exercises (strengthening the muscle without causing movement) are used in exercise therapy.

2. Subacute Phase (Starting Movement Phase)

Physical Therapy: Pre-treatment heat, post-treatment cold application, electrical stimulation, edema therapy, non-corticosteroid pain relievers, and shoulder injections are methods used in physical therapy during the starting movement phase.

Exercise Therapy: During the subacute phase, joint range of motion exercises, shoulder capsule stretching exercises, and strengthening exercises for the muscles around the shoulder and scapula are used. Towards the end of this phase, strengthening exercises with theraband (exercise bands) and light-weight dumbbells are incorporated.

3. Advanced Strengthening and Return to Activity Phase

In the advanced strengthening phase, exercises to strengthen the muscles around the shoulder are increased, and specific sports activities are introduced.

2. Frozen Shoulder Problems

Frozen shoulder is a painful condition characterized by restricted shoulder movements that develop slowly, where shoulder movements are limited in all directions. The most significant factor causing its development is the prolonged immobility of the shoulder. Other factors, such as diabetes, thyroid disorders, lung, and heart diseases, can also lead to frozen shoulder. Treatment includes a physical therapy program that intensely stretches the shoulder in all directions and injection therapy into the shoulder. In cases where there is no response to physical therapy, surgical treatment is applied.

3. Elbow Problems

Tennis Elbow Disease (Lateral Epicondylitis): What is it?
Tennis elbow is the damage to the muscles that move the wrist and fingers, caused by excessive use of the wrist and repetitive hand activities, where the muscles attach to the bony prominence on the outer side of the elbow.

What are the symptoms of tennis elbow disease (lateral epicondylitis)?
There is tenderness and pain on the outer bony prominence of the elbow when touched. The pain increases with wrist movements and lifting heavy objects. One of the most typical signs is the worsening pain when the back of the hand is pulled toward the face while the elbow is straight. Improper techniques in tennis and non-tennis sports can also lead to this problem.

How is tennis elbow disease (lateral epicondylitis) treated?
A wrist brace and elbow bandage are used to limit repetitive wrist movements. Cortisone injection into the painful spot can be helpful. A physical therapy program aimed at relieving pain and stretching and strengthening the muscles around the wrist is applied. If there is no response to physical therapy, surgical treatment is used.

What is nerve compression at the elbow (cubital tunnel syndrome)?
It is the compression of the ulnar nerve at the elbow due to repetitive elbow movements and direct pressure on the elbow while at rest. Holding the elbow in a bent position for a long time and working with the elbow resting on a surface can lead to this problem.

What are the symptoms of nerve compression at the elbow (cubital tunnel syndrome)?
Numbness, burning, loss of sensation, and loss of grip strength may be felt on the inner surface of the 4th and 5th fingers. Symptoms worsen when the elbow is bent.

How is nerve compression at the elbow (cubital tunnel syndrome) treated?
It is important to avoid keeping the elbow bent for long periods and working with the elbow resting on a surface. A resting splint for the elbow is recommended, and physical therapy is applied. If there is advanced nerve compression and neurological findings, and there is no response to physical therapy, surgery is applied.

4. Wrist and Finger Problems

What is tenosynovitis (De Quervain) in the thumb?
This condition develops due to chronic overuse of the wrist and thumb.

What are the symptoms of tenosynovitis (De Quervain) in the thumb?
Pain that increases with movement and tenderness upon palpation are seen on the outer surface of the wrist and at the base of the thumb.

How is tenosynovitis (De Quervain) in the thumb treated?
A splint is used to restrict thumb movements, local cortisone injections are given, and a physical therapy program is applied. The aim of the physical therapy program is to relieve pain and swelling, and strengthen the muscles.

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

What is a ganglion cyst in the wrist?

A ganglion cyst is a soft tissue lesion commonly found in the wrist, defined as a cystic enlargement of a joint or tendon sheath. It occurs in the wrist and hand due to acute trauma or repetitive microtrauma.

How is a ganglion cyst in the wrist treated?
Treatment involves the use of a wrist splint for rest, non-steroidal pain relievers, and local injections. Surgery is recommended for patients who do not respond to these treatments.

What is a trigger finger?

Trigger finger is the most common repetitive strain injury of the hand. It is a stenosing tenosynovitis of the thumb or other fingers, often associated with repetitive gripping. It is 2-6 times more common in women.

What are the symptoms of a trigger finger?
There is noticeable pain on the inner surface of the finger in the morning, and a sensation of the finger getting stuck when trying to open it.

How is a trigger finger treated?
Treatment includes using a finger splint, avoiding repetitive gripping motions, local injections, and a physical therapy program. Surgical intervention is recommended for patients who do not respond to these treatments.