When is Hand Pain Not True Hand Pain

By Emily Attard, LMT & Desirée Gagné, MA, OTR/L

Do you, or someone you know, deal with carpal tunnel pain, or burning/tingling in the hand and wrist?  Do you, or the person you know, also deal with neck pain? Degenerative disc disease, bulging/herniated discs, or surgery of the neck? These two areas, the neck and the hand, are connected by the brachial nerve. This major nerve exits your spinal column at the base of your neck (C5-T1 vertebrae) and travels through a small group of muscles in the anterior (front) neck called the scalenes. This major nerve then starts to branch into smaller nerves called the brachial plexus. This bundle travels under the collarbone where it continues to branch into even smaller nerves through the shoulder, down the arm, wrist, and ends in the hand and fingers. Many times, this nerve can become irritated or impinged at various points in the neck or shoulder, but the pain manifests in the wrist and hand. It is possible for hand or wrist pain to originate in the neck where the nerve exits between the cervical vertebrae, or in the shoulder or elbow joint. Just because there is nerve pain (burning, tingling, numbness) felt in one area does not mean that’s where the pain is originating from. This is where a thorough assessment is very beneficial. A massage therapist can assess, but only an orthopedic surgeon or physician can determine the cause and confirm a diagnosis.

Did You Know…

Different tissues have different healing times based on their vascularity (blood supply) and structural composition. Your body is composed of muscles, tendons, ligaments, bones, cartilage, and nerves. Muscle tissue has a rich blood supply and heals in about 2-4 weeks. Tendons, which attach muscle to bone, generally have a more limited blood supply than muscle and can take 4-6 weeks, or longer, to heal. Bones take 6-8 weeks to heal and usually are immobilized with a cast. Ligaments attach bone to bone and help stabilize joints. The joint capsule that surrounds a joint is made up of strong ligament tissue. Sprains and tears are common injuries to ligaments and are categorized into 3 grades depending on the severity of the injury. Ligaments have even less blood supply than muscles or tendons and can take 10-12 weeks to heal. Cartilage is unique in that it is avascular and aneural, meaning it has no blood or nerve supply. This makeup causes cartilage to have a very slow healing time and pain is not felt until it is worn very thin (think bone on bone in a knee). Nerve healing proceeds at a very slow rate (3-4mm per day) and stimulating nerve repair is a process that requires patience and persistence. For people who have had joint replacements, the hardest part of the healing process is having patience. So, even though the scar from surgery may be healed, there is a lot of healing still going on under the surface!

“Ligaments and nerves have the longest healing time after injury or surgery. Joint capsules are made of ligamentous tissue and suffer damage when they are cut in the process of joint replacement surgery.”

HOW DOES MASSAGE THERAPY HELP REDUCE PAIN?

Massage therapy produces an invitation to relax, which can assist with pain relief. Your body’s response includes a lower breathing rate and lower stress hormones allowing your muscles to relax. When muscles are in a relaxed state, this can also help to reduce nerve compression, which may relate to pain. Massage therapy can involve different pressures, depending on the type of massage you are receiving. It’s important to communicate with your massage therapist if you prefer a light touch, medium, or deep pressure. A person suffering from fibromyalgia or chronic pain for instance may not be able to tolerate heavy pressure.

A study published in Complementary Therapies in Clinical Practice showed a reduction in hand pain and an improvement in grip strength among people who had four weekly hand massage sessions and did self-massage at home. They also slept better and had less anxiety and depression than people in the control group who did not receive hand massages.

A study published in Annals of Family Medicine in 2014 found that 60-minute therapeutic massage sessions two or three times a week for four weeks relieved chronic neck pain better than no massage or fewer or shorter massage sessions.
(Source Harvard Health Publishing July 2016)

HOW DOES PHYSICAL THERAPY HELP REDUCE PAIN?

The US Pain Foundation reports that 50 million people experience pain every day! Physical Therapists can help to determine positions that are causing pain and recommend treatment and exercises to help you move more efficiently. Physical Therapists will determine why certain muscles, or groups of muscles, are stiff or weak. A plan of care will be initiated to address these areas, with the goal of alleviating pain and improving your ability to function.

If you have been dealing with pain that is interfering with your daily tasks, Rehability can help! An interdisciplinary approach to treat pain can be very beneficial. Both massage and physical therapy are great alternatives to opioids and pain medication use.

Rehability offers massage therapy and physical therapy in one convenient location. To learn more about our services, contact us today.

DISCLAIMER:

This article is intended to provide general health information and is not intended to provide individual-specific medical advice, diagnosis, or treatment.