Lateral Epicondylitis (Tennis Elbow)

Lateral Epicondylitis (Tennis Elbow)

 

Lateral epicondylitis (Tennis Elbow) 

What is it

Lateral epicondylitis also known as tennis elbow is a repetitive overuse injury in the forearm and elbow that is caused by inflammation on the proximal attachment of the tendon of the extensor carpi radialis brevis muscle, which is a muscle on the dorsal aspect of your forearm.

Why does it occur

This inflammation is caused by an excessive amount of load which can be done through gripping and wrist extension movements which puts too much load on the tendon therefore causing inflammation and pain. Another reason why tennis elbow or lateral epicondylitis may occur is due to poor mechanics of the hand and wrist, elbow or even the shoulder which can cause compensatory patterns therefore causing more stress and load on the extensor carpi radialis brevis tendon.

 

Signs and symptoms

The signs and symptoms of lateral epicondylitis/ tennis elbow are:

–           Pain in the elbow with gripping, lifting objects,

–           Any wrist extension that causes pain

–          Pain with a gradual onset

–           Pain at night

–           Weak grip strength / with pain

–           Swelling around the elbow

–           Tenderness and stiffness in the elbow

 

Management / Treatment options

Ice/ cold therapy: Implementation of cold therapy and ice therapy has been proven to decrease pain in inflammation to the effected tendon. This can be an easy way to reduce pain and swelling in the area.

Exercise prescription:  Strengthening exercises have been shown to increase muscle and tendon strength while also reducing pain levels. The Eccentric load of the muscle and tendon has proven to be beneficial in providing symptom relief.  Some of the results that eccentric strength training has provided include increased functions like grip strength, range of motion before the point of pain, and load capacity in everyday activities. This suggests that strength training focussing on the eccentric part of the movement provided the most effective results for lateral epicondylitis. (Chen & Baker, 2021)

Anti-Inflammatory medication: Can be used to decrease inflammation but is recommended only for a short period of time for up to 5 days. This is not a long-term management strategy. These can be useful for speeding up the healing process.

Bracing / Strapping: Taping and bracing has been shown to increase grip strength and reduce pain intensity and pain with pressure. This can provide support and relief to the tendon reducing load and increase the tendons’ ability to begin to heal. (Rodruigues & Syrivastava, 2021)

Needling: Dry needling has been proven to decrease pain intensity, increase grip strength, and increase functional capabilities.

Corticosteroid injection: Corticosteroid injection is an option for lateral epicondylitis/ tennis elbow as studies have shown that in some cases it can provide pain relief and decreased inflammation therefore allowing patients to complete daily tasks easier. (Saccomani, 2010)

 

When to consider or go for surgery?

As osteopaths, we advocate for a conservative approach to injury management and treatment before considering surgical intervention. We prioritise non-invasive techniques to promote healing and restore function. However, if pain persists, worsens, or significantly impairs daily activities over an extended period without improvement, surgical options may be considered as a last resort.

How can osteopathy help?

At our clinic, we provide comprehensive care utilising a range of techniques and management strategies to alleviate pain and enhance function. Our treatment approach considers various factors, including workplace and home ergonomics, joint alignment, and activity modifications to reduce strain on the affected area. We aim to facilitate pain relief and promote recovery, we incorporate specialised techniques such as dry needling, taping, soft tissue massage, and targeted interventions for muscles and ligaments in the hand, wrist, elbow, and shoulder. Our goal is to optimise rehabilitation and support long-term musculoskeletal health.

 

Reference list

Chen, Z., Baker, N, A. (2021). Effectiveness of eccentric strengthening in the treatment of lateral elbow tendinopathy: A systematic review with meta-analysis, Science Direct, 34, 1, 18-28. https://doi.org/10.1016/j.jht.2020.02.002

​ Ma, K., & Wang, H. (2020). Management of lateral epicondylitis: A narrative literature review. Pain Research and Management, 2020, Article 6965381. https://doi.org/10.1155/2020/6965381

Özünlü Pekyavaş, N., & Cerezci Duygu, S. (2022). Which cold application is more effective for tennis elbow? Cooling gel vs cold pack. International Journal of Disabilities Sports and Health Sciences, 5(1), 16–21. https://doi.org/10.33438/ijdshs.1039813

Saccomanni, B. (2010). Corticosteroid injection for tennis elbow or lateral epicondylitis: A review of the literature. Current Reviews in Musculoskeletal Medicine, 3(1–4), 38–40. https://doi.org/10.1007/s12178-010-9066-3

Xia, M. B., Yaqin, Q. B., Jinyang, W. M., Anke, X., & Jiteny, R. (2024). Therapeutic effects of dry needling on lateral epicondylitis: An updated systematic review and meta-analysis. Science Direct, 105(11). https://doi.org/10.1016/j.apmr.2024.02.713

Yoon, S. Y., Kim, Y. W., Shin, I. S., Kang, S., Moon, H. I., & Lee, S. C. (2021). The beneficial effects of eccentric exercise in the management of lateral elbow tendinopathy: A systematic review and meta-analysis. Journal of Clinical Medicine, 10(17), 3968. https://doi.org/10.3390/jcm10173968

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Frozen Shoulder

 

What is Frozen Shoulder?

Adhesive capsulitis, commonly known as frozen shoulder, is a condition that causes stiffness, pain, and a significant reduction in shoulder mobility. It is an inflammatory disorder that can severely impact daily activities, making even simple movements like reaching for an object or getting dressed difficult. The exact cause of frozen shoulder remains unknown however there are factors that contribute to the condition or make people more susceptible.

 

There are 3 stages of Adhesive Capsulitis (frozen shoulder)

  1. Freezing stage: during this initial phase, any movements of the shoulder cause significant pain, and the range of motion gradually decreases. As the inflammation becomes worse in the shoulder, the ability to do simple movements and activities gradually decreases. The freezing stage can last from 2-9 months.
  2. Frozen stage: While pain may decrease in this stage, shoulder stiffness with further increase and become worse which will further limit mobility of the shoulder. This stage can persist for 4-12 months.
  3. Thawing stage: This is the final stage, this is when the shoulder begins to gradually regain mobility and range of motion as the stiffness decreases. Over the time the shoulder will return to normal function. This process can take up to 5-24 months.

 

The prevalence and Risk factors for frozen Shoulder

This Condition primarily affects women around the age of 55, however men are also affected. Adhesive capsulitis or also known as frozen shoulder affects up to 8.2% of males and 10.1% on females therefore making females slightly more susceptible to the condition.

Some of the risk factors that studies have shown that increase the chance of developing the condition are gender (female), diabetes, trauma, and long periods of shoulder immobilization.

 

Signs and Symptoms /Diagnosis

The main signs and symptoms of frozen shoulder include: insidious shoulder pain, gradual loss of range of motion/ movement both actively and even passively, stiffness in the shoulder. Frozen shoulder can only be diagnosed through clinical evaluation like X-rays or MRIs which rule out other potential conditions.

 

Treatment / How Osteopathy Can Help

Here at the clinic, we cannot fix the condition however we can assist with pain management, and exercise to help sustain range of motion as much as possible. Studies show that patients who receive manual therapy have improved function and pain levels. Our aim with this condition is to maintain range of motion throughout the three stages then in the thawing stage, we can work with the patient to regain and increase their strength, Range of motion, and function overall.  Some of the techniques we use to do this may include needing, joint mobilisation, muscle release, and exercise prescription.

 

Summary

Effective management of frozen shoulder requires planning and management throughout the different stages of the conditions.  A well-coordinated care plan can significantly improve patient outcomes, reduce discomfort, and restore shoulder function over time.

By understanding more about what frozen shoulder is and the symptoms, risk factors, and treatment options for adhesive capsulitis, we can help you take proactive steps to seek early intervention and improve your quality of life. If you or someone you know is struggling with persistent shoulder pain, consulting a healthcare provider is the first step toward recovery.

 

References

Abudula, X., Maimaiti, P., Yasheng, A., Shu, J., Tuerxun, A., Abudujilili, H., & Yang, R. (2024). Factors associated with frozen shoulder in adults: A retrospective study. BMC Musculoskeletal Disorders, 25, Article 493. https://doi.org/10.1186/s12891-024-07614-8

 

Page, M. J., Green, S., Kramer, S., Johnston, R. V., McBain, B., Chau, M., & Buchbinder, R. (2014). Manual therapy and exercise for adhesive capsulitis (frozen shoulder). Cochrane Database of Systematic Reviews, (8), Article CD011275. https://doi.org/10.1002/14651858.CD011275

 St Angelo, J. M., Taqi, M., & Fabiano, S. E. (2023). Adhesive capsulitis. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532955/

 Kim, J., & Lee, J. H. (2023). Effects of dynamic stretching combined with manual therapy on pain, range of motion, function, and quality of life of adhesive capsulitis. Healthcare, 12(1), 45. https://doi.org/10.3390/healthcare12010045

 

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Understanding Neck Pain & Stiffness: An Osteopath’s Perspective Dr Andrew Welsh, PhD

Understanding-Neck-Pain
Understanding Neck Pain & Stiffness

Neck pain is a common issue that affects many people, often disrupting daily activities like working, driving, or even sleeping comfortably. In our modern, fast-paced lives, with prolonged screen time and increased stress, neck discomfort has become more common at our clinic. At Eclipse Health & Osteopathy, we take a whole-body approach to neck pain, focusing not just on the neck itself but also on related areas that might be contributing to the issue, as well as factors that may a play a role in limited movement, like the aging process, postures and repetitive strains.

What is Neck Pain & Stiffness?

Neck pain can range from mild stiffness to severe discomfort, affecting your ability to move your head freely. You might notice symptoms like muscle tightness, headaches, shoulder pain, or even tingling in the arms. While poor posture is a common cause, neck pain can also result from injuries, stress, or underlying medical conditions.

Neck pain can be classified as either acute (short-term) or chronic (long-lasting). Acute neck pain often results from muscle strain or sudden movements, while chronic pain may be related to ongoing posture issues, degenerative changes, or stress-related muscle tension.

In today’s busy and often stressful world, with limited opportunities for rest and recovery, stress can also play a significant role in neck pain. Clenching your jaw, tensing your shoulders, or sitting hunched over for extended periods can contribute to muscle tightness and discomfort.

The Value of the Osteopathic Approach

We focus on treating the whole person, not just the area of pain. Our goal is to help reduce discomfort and improve how your neck and body work together. We use gentle, hands-on techniques to ease tension, restore movement, and support your body’s natural balance.

Our approach may include:

  • Gentle stretches and exercises with the goal often being to improve neck mobility and strengthen supporting muscles (Gross et al., 2016).
  • Hands-on therapy commonly aiming to release muscle tension and promote better joint function (Bronfort et al., 2012).
  • Posture advice to help reduce strain on the neck and shoulders. A combination of manual therapy and stabilising exercises has been shown to improve forward head posture and rounded shoulders, reducing strain on the neck over time (Fathollahnejad et al., 2019).
  • Relaxation techniques to support overall wellbeing and help manage stress-related tension. Adding relaxation training to stabilisation exercises has been shown to lead to significant improvements in pain intensity, pressure pain threshold, cervical range of motion, and movement-related fear in individuals with chronic neck pain (Özer Kaya & Toprak Çelenay, 2019). Post-isometric relaxation techniques (often referred to as gently “push-and-relax”) have also been found to effectively reduce pain and disability in those with non-specific neck pain (Khan et al., 2022).
  • Measurement of movement using goniometry to assist in examination, treatment, and reassessment of progress (Norkin & White, 2016).

Measuring neck ROM

Understanding-Neck-Pain

(© 2025 Dr Andrew Welsh, PhD)

The Importance of Measuring Movement

To better understand how your neck is functioning, we use goniometry, a method of measuring joint movement. This allows us to assess range of motion (ROM) at the beginning of treatment and track improvements over time.

According to Norkin & White (2016, p. 452-454), certain ranges of motion are necessary for daily activities. For example:

  • 40–50 degrees of cervical flexion (bringing the chin to the chest) is required for activities like looking down to tie shoelaces.
  • 60–70 degrees of cervical rotation (turning the head) is essential for driving and checking blind spots.
  • 40–50 degrees of cervical extension (tilting the head back) is needed for looking up at the ceiling.

Considering these approximate functional ROM requirements helps us to consider how to help each person to restore the movement they require to complete their daily tasks. In this way, we are not simply “rubbing sore spots” but trying to improve our capacity to perform activities and quality of life.

It is also common for people to believe that stiffness and reduced mobility are simply a normal part of aging. Multiple studies have researched this question, and while many agree that some neck movements tend to stiffen over the later decades of life, it is a little more complicated than that, with two studies finding that rotation (looking over your left and right shoulder) increases near the top of the neck as we reach older ages, perhaps to compensate for the common stiffening in the lower levels of our neck (Norkin & White, 2016). Importantly, research suggests that between the ages of 15 and 45, the neck range of motion does not significantly decline (Tommasi et al., 2009). In fact, flexion and extension movements (looking down and up)  were found to be very similar between younger and middle-aged adults, with only minor, non-significant differences (Norkin & White, 2016). So, for people in this age-bracket, on average, these findings challenge the belief that one must accept increasing stiffness or discomfort due to age alone. Instead, these findings highlight the importance of identifying other contributing factors, such as posture, muscular imbalances, and lifestyle habits, which may be more relevant to neck mobility and discomfort. This is what we aim to help people explore at Eclipse Health & Osteopathy.

How Hands-On Therapy May Help

Research has shown that hands-on therapy can benefit people experiencing neck pain. Techniques like gentle spinal mobilisation, soft tissue massage, and muscle relaxation can help ease pain and improve range of motion (Bronfort et al., 2012).

Several studies have compared the effectiveness of different manual therapy techniques—such as manipulation, mobilisation, muscle energy techniques (MET), and proprioceptive neuromuscular facilitation (PNF)—in alleviating neck pain and improving range of motion (ROM) (Sbardella et al., 2021).

  • Manipulation vs. Mobilisation: A Cochrane review evaluated the effects of manipulation and mobilisation for neck pain. Both treatment interventions produced similar pain relief and functional improvement outcomes, but further research is required (Gross et al., 2010).
  • Muscle Energy Technique (MET): A systematic review by Sbardella et al. (2021) assessed the efficacy of MET in reducing neck pain and improving cervical ROM. The analysis indicated that MET could effectively decrease pain and enhance ROM in individuals with both acute and chronic neck pain.
  • Proprioceptive Neuromuscular Facilitation (PNF): A recent study compared the effectiveness of PNF therapy to manual therapy in patients with chronic mechanical neck pain. The findings suggested that PNF was more effective in reducing pain and improving ROM and functional disability than manual therapy (Khan et al., 2022).
  • MET vs. PNF: A randomised controlled trial compared the efficacy of MET and PNF in individuals with chronic mechanical neck pain. Both techniques were effective in reducing pain and improving ROM; however, the study did not find a significant difference between the two methods, suggesting that either could be beneficial depending on individual patient needs (Khan et al., 2022).

 

Considering Osteopathy for Neck Pain?

If you are experiencing neck pain and looking for a holistic approach, osteopathy may be a beneficial option. At Eclipse Health & Osteopathy, we focus on helping you regain comfort and function by addressing the root causes of your discomfort. Our hands-on approach aims to improve mobility, ease tension, and support overall well-being.

Get in touch with us today to discuss how we can support your journey to better health.

 

References

  1. Bronfort, G., Evans, R., Anderson, A. V., Svendsen, K. H., Bracha, Y., & Grimm, R. H. (2012). Spinal manipulation, medication, or home exercise with advice for acute and subacute neck pain: a randomised trial. Annals of Internal Medicine, 156(1 Pt 1), 1–10. https://doi.org/10.7326/0003-4819-156-1-201201030-00002
  2. Fathollahnejad, K., Letafatkar, A., & Hadadnezhad, M. (2019). The effect of manual therapy and stabilising exercises on forward head and rounded shoulder postures: a six-week intervention with a one-month follow-up study. BMC Musculoskeletal Disorders, 20, 86. https://doi.org/10.1186/s12891-019-2438-y
  3. Gross, A., Miller, J., D’Sylva, J., Burnie, S. J., Goldsmith, C. H., Graham, N., Haines, T., Brønfort, G., Hoving, J. L., & COG (2010). Manipulation or mobilisation for neck pain: a Cochrane Review. Manual therapy, 15(4), 315–333. https://doi.org/10.1016/j.math.2010.04.002
  4. Gross, A. R., Paquin, J. P., Dupont, G., Blanchette, S., Lalonde, P., Christie, T., Graham, N., Kay, T. M., Burnie, S. J., Gelley, G., Goldsmith, C. H., Forget, M., Santaguida, P. L., Yee, A. J., Radisic, G. G., Hoving, J. L., Bronfort, G., & Cervical Overview Group (2016). Exercises for mechanical neck disorders: A Cochrane review update. Manual Therapy, 24, 25–45. https://doi.org/10.1016/j.math.2016.04.005
  5. Khan, Z. K., Ahmed, S. I., Baig, A. A. M., et al. (2022). Effect of post-isometric relaxation versus myofascial release therapy on pain, functional disability, ROM, and QoL in the management of non-specific neck pain: A randomised controlled trial. BMC Musculoskeletal Disorders, 23, 567. https://doi.org/10.1186/s12891-022-05516-1
  6. Norkin, C. C., & White, D. J. (2016). Measurement of Joint Motion: A Guide to Goniometry (5th ed.). FA Davis.
  7. Özer Kaya, D., & Toprak Çelenay, Ş. (2019). Effectiveness of relaxation training in addition to stabilisation exercises in chronic neck pain: A randomised clinical trial. Turkish Journal of Physiotherapy and Rehabilitation, 30(3), 145-153. https://doi.org/10.21653/tjpr.665131
  8. Sbardella, S., La Russa, C., Bernetti, A., Mangone, M., Guarnera, A., Pezzi, L., Paoloni, M., Agostini, F., Santilli, V., Saggini, R., & Paolucci, T. (2021). Muscle Energy Technique in the Rehabilitative Treatment for Acute and Chronic Non-Specific Neck Pain: A Systematic Review. Healthcare (Basel, Switzerland), 9(6), 746. https://doi.org/10.3390/healthcare9060746
  9. Tommasi, D. G., Foppiani, A. C., Galante, D., Lovecchio, N., & Sforza, C. (2009). Active head and cervical range of motion: effect of age in healthy females. Spine, 34(20), 2098-2103. https://doi.org/10.1097/BRS.0b013e3181afe826
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Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a common condition, affecting approximately 3% to 6% of adults in the general population it is also known as median nerve entrapment. Carpal tunnel syndrome occurs when the median nerve is compressed by a ligament that runs directly across the wrist, with nerves running under it. This leads to the entrapment of the median nerve. While the median nerve extends down the entire arm, the affected area is specifically at the wrist, just before it reaches the palm. (Sevy et al, 2023)

 

Why Does it Occur

The reason why carpal tunnel or median nerve entrapment occurs can be due to a range of potential factors that decrease the space between the ligament (flexor retinaculum)  and the structures underneath (muscles, tendons, and nerves) then the ligament begins to press on other structures like the median nerve which leads to pain felt at the fingers, wrist, and forearm. These risk factors include: inflammation of structures that pass under the flexor retinaculum (carpal tunnel ligament) which can be caused by:   repetitive hand movements, history of wrist injuries, obesity, arthritis (Rheumatoid arthritis), Hormonal changes like menopause, pregnancy or diabetes and age.  (Sevy et al, 2023)

 

Signs and Symptoms

Some signs and symptoms include numbness and tingling in the thumb index and middle finger on the palmar aspect of the hand, weakness and pain gripping objects, pain worse at night in the wrist and hand that can prevent sleep and swelling in the fingers.

 

Treatment options

Some of the different treatment options for carpal tunnel/Median nerve entrapment include:

Ice therapy can be used to reduce the inflammation that is pressing on the median nerve. The ice helps constrict the (flexor retinaculum ligament) to give the median nerve more space and less compression therefore decreasing pain. (Laymon et al, 2015)

Surgery: In the surgery, they will cut the flexor retinaculum which forms the roof of the carpal tunnel which prevents the nerve from being compressed or entrapped. (National Library of Medicine, 2024)

Wrist splints: Wrist splinting and immobilising the hand and wrist can provide support and allow the body to time to recover. Night splinting is a useful strategy to decrease pain.  This can help decrease the irritation/ inflammation of the structures that pass through the carpal tunnel.

(Karjalainen et al, 2023)

Exercise therapy: Forms of exercises that can be implemented in the rehab of carpal tunnel to decrease pain and improve function. Exercise can also be used as a tool to measure progress. Some of the exercises are stretching in the forearm flexors and nerve glides.

Ergonomic changes:  Ergonomic changes in everyday tasks or at work can improve symptoms and limit reaggravation which will help the condition improve and recover at a faster rate. Some ergonomic changes include: using tools to pick things up limiting gripping motions, using an open-handed grip to pick things up, using both hands rather than one hand, Lifting lighter loads, altering bottle feeding positions, and many more. By implementing these strategies this can improve quality of life and speed up the recovery process. (Conor et al, 2012)

Steroid injections: Corticosteroid injections are used to provide temporary relief however they have not shown promising long-term effects. The steroid injection is a more effective way to be administered than oral steroid tablets. (National Library of Medicine, 2024)

 

When to go for surgery

As osteopaths, we recommend initially adopting a conservative treatment approach. However, if the condition persists and the pain becomes severe or significantly impacts daily activities, surgical intervention may be necessary for optimal patient outcomes.

 

How can osteopathy help?

As an osteopath we can help with a conservative approach to the management of the condition through the use of a range of techniques and approaches these include:  soft tissue massage, ergonomic changes within your daily activities to help take the pressure and reduce inflammation on that area, Dry needling, joint mobilization, nerve glides, and joint manipulation. These techniques aim to decrease your pain, increase function, and get you back to normal function as fast as possible. 

 

References:

Institute for Quality and Efficiency in Health Care (IQWiG). (2024). Carpal tunnel syndrome: Learn more – How effective are steroids? In InformedHealth.org. https://www.ncbi.nlm.nih.gov/books/NBK279598/

Karjalainen, T. V., Lusa, V., Page, M. J., O’Connor, D., Massy-Westropp, N., & Peters, S. E. (2023). Splinting for carpal tunnel syndrome. Cochrane Database of Systematic Reviews, 2023(2), Article CD010003. https://doi.org/10.1002/14651858.CD010003.pub2

Laymon, M., Petrofsky, J., McKivigan, J., Lee, H., & Yim, J. (2015). Effect of heat, cold, and pressure on the transverse carpal ligament and median nerve: A pilot study. Medical Science Monitor, 21, 446–451. https://doi.org/10.12659/MSM.892462

O’Connor, D., Page, M. J., Marshall, S. C., & Massy-Westropp, N. (2012). Ergonomic positioning or equipment for treating carpal tunnel syndrome. Cochrane Database of Systematic Reviews, 2012(1), Article CD009600. https://doi.org/10.1002/14651858.CD009600

Sevy, J. O., Sina, R. E., & Varacallo, M. A. (2023). Carpal tunnel syndrome. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK448179/

 

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Shoulder Pain

 

Shoulder Pain: Causes, Symptoms, and Treatment Options

Shoulder pain is a common complaint that can be caused by a variety of factors. Whether you have injured your shoulder during physical activity or are experiencing chronic pain, it is important to understand the underlying causes and treatment options available to you. Today, we will discuss the causes, symptoms, and treatment options for shoulder pain.

Causes of Shoulder Pain

Shoulder pain can be caused by a wide range of factors, including:

  • Rotator cuff injuries: The rotator cuff is a group of muscles and tendons that surround the shoulder joint. Injuries to the rotator cuff can occur due to overuse, trauma, or degeneration over time.
  • Shoulder dislocation: Dislocating your shoulder can lead to pain, swelling, and instability in the joint.
  • Frozen shoulder: Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness and pain in the shoulder joint.
  • Tendonitis: Tendonitis is inflammation of the tendons in the shoulder, often due to overuse or repetitive motions.
  • Arthritis: Arthritis can cause pain, swelling, and stiffness in the shoulder joint.

Symptoms of Shoulder Pain

The symptoms of shoulder pain can vary depending on the underlying cause. Common symptoms include:

  • Pain: Pain in the shoulder joint that may be sharp or dull.
  • Stiffness: Difficulty moving the shoulder joint, especially when raising your arm.
  • Weakness: Weakness in the shoulder muscles, making it hard to perform daily activities.
  • Swelling: Swelling and inflammation in the shoulder joint.
  • Popping or clicking: Audible sounds or sensations when moving the shoulder joint.

Treatment Options for Shoulder Pain

There are several treatment options available for shoulder pain, depending on the underlying cause and severity of the symptoms. Some common treatment options include:

  • Rest: Taking a break from activities that aggravate your shoulder pain can help reduce inflammation and promote healing.
  • Ice and heat therapy: Applying ice or heat to the affected area can help reduce pain and inflammation.
  • Physical therapy: A physical therapist can teach you exercises to strengthen the muscles in your shoulder and improve range of motion.
  • Medication: Over-the-counter pain relievers or prescription medications may be recommended to manage pain and inflammation.
  • Injections: Corticosteroid injections can help reduce inflammation and pain in the shoulder joint.
  • Surgery: In severe cases, surgery may be necessary to repair damaged tissues or improve joint function.
  • Osteopathy: an Osteopath can help you to release the area and the surrounding tissues, and provide advice and support to aid in the management of Shoulder issues

Preventing Shoulder Pain

While some causes of shoulder pain cannot be prevented, there are steps you can take to reduce your risk of developing shoulder problems. Some tips for preventing shoulder pain include:

  • Warm up before exercising: Stretching and warming up before physical activity can help prevent injuries.
  • Practice good posture: Maintaining proper posture can reduce strain on your shoulder muscles and joints.
  • Avoid repetitive motions: If possible, avoid repetitive movements that can strain your shoulder joint.
  • Use proper lifting techniques: Lift heavy objects with your legs, not your shoulders, to reduce the risk of injury.
  • Stay active: Regular exercise can help strengthen your shoulder muscles and improve joint flexibility.

Shoulder pain can be a frustrating and debilitating condition, but with the right treatment and preventative measures, you can manage your symptoms and improve your quality of life. If you are experiencing shoulder pain, it is important to consult with a healthcare professional to determine the underlying cause and develop a treatment plan that works for you. The Osteopaths here at Eclipse Health and Osteopathy can help you to understand the cause of your pain and assist in relieving or managing the condition. We aim to keep you doing what you love.

By understanding the causes, symptoms, and treatment options for shoulder pain, you can take the necessary steps to address your symptoms and prevent future injuries. Remember to listen to your body and seek medical attention if you experience persistent or severe shoulder pain.

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What is Bursitis?

What are bursa?

Bursa are synovial fluid filled sacs that are approximately 4cm in diameter and 2mm thick.

Busa are located in many joints of the body such as the subacromial/subdeltoid bursa in the shoulders, olecranon bursa in the elbows, trochanteric bursa in the hip, prepatellar and infrapatellar bursa of the knee and the retrocalcaneal bursa in the ankle.

They aim to help the bones, tendons, ligaments and muscles in the joints to glide and move smoothly and decrease friction.

What is bursitis

Bursitis is inflammation and irritation of the bursa.

Symptoms include pain, tenderness, decreased joint range of motion. This can be particularly prominent on any compression of the bursa such as when laying on that side to sleep, overhead movements and more.

Bursitis can commonly occur with tendonitis of other muscles that attach to the site such the rotator cuff or gluteal muscles.

Bursitis can be diagnosed using ultrasound or MRI.

An acute bursitis can take anywhere from 4-6 weeks to heal if there is no re-injury or aggravation

Why does bursitis occur

Bursitis can occur as a result of a traumatic injury to an area or as a repetitive movement in activities such as carpentry, painting, gardening, shovelling and sports such as tennis, golf and baseball.

You are more likely to develop bursitis if you have conditions such as arthritis, gout, immune deficiencies such as HIV and diabetes, autoimmune conditions such as rheumatoid arthritis, scleroderma and lupus. Trauma and infection also predispose you to greater risk of bursitis.

How can you prevent bursitis?

As an athlete make sure you are warming up properly for 5 to 10 minutes prior to exercise and warming down properly after exercise and maintaining proper recovery strategies.

Use good equipment such as braces, shoes and pads to protect your joints.

Maintain a healthy lifestyle through exercise and diet by eating foods rich in vitamins, antioxidants, fibre, omega-3 and other anti-inflammatory foods. Avoid foods containing excess sugar and saturated fats.

What are the medical treatments for Bursitis

Medication that can be used for treatment includes nonsteroidal anti-inflammatory drugs (NSAIDS) to decrease acute pain, corticosteroid injections into the affected area and if the bursa is infected antibiotics.

Surgical treatment such as an arthroscopy in which the bursa will be drained and scar tissue removed.

What are some conservative treatments for Bursitis

Activity modification to avoid aggravating movements may be suggested. This can include overhead motions with the arms, running or laying on the side of bursitis of a hip, kneeling, bending and squatting for bursitis of the knee.

Exercise to strengthen the surrounding musculature as well as mobility to ensure that the joint and other compensatory mechanisms are working to the best of their ability may also be prescribed.

Some practitioners may choose to use ultrasound therapy or TENS machine for treatment however results are varied.

Seeing an Osteopath can also help with the symptoms of bursitis.

What will happen when you come to an osteopathic appointment?

When you come to an osteopathic appointment there are three stages of consultation. We will ask you about your injury, the mechanism of how you did it, what movements hurt, what makes it better. From there we will assess the area and test for impingement that may be caused by bursitis as well as other tests for the muscles and joints.

Through treatment we aim to decrease pain, increase range of motion and achieve specific patient set goals. Treatment can involve muscle energy techniques that focus on the muscle, joint mobilisation, fascial release, ligament release and more. After treatment we may prescribe exercises and refer you back to your doctor for scans if we think further investigation is required.

References:

What You Need to Know About Knee Bursitis – Well Heeled Podiatry. (n.d.). Retrieved June 27, 2024, from https://www.wellheeledpodiatry.com.au/what-you-need-to-know-about-knee-bursitis#:~:text=Activities%20like%20frequent%20kneeling%2C%20squatting%2C%20or%20bending%20the

Bennett, S., Macfarlane, C., & Vaughan, B. (2017). The Use of Osteopathic Manual Therapy and Rehabilitation for Subacromial Impingement Syndrome: A Case Report. EXPLORE, 13(5), 339–343. https://doi.org/10.1016/j.explore.2017.01.002

Bursa. (n.d.). Kenhub. https://www.kenhub.com/en/library/anatomy/bursa

‌bursa | Description, Types, & Function. (n.d.). Encyclopedia Britannica. https://www.britannica.com/science/bursa-anatomy

Chmielewski, R., Pena, N., Capalbo, G. (2013). Osteopathic manipulative treatment of pes anserine bursitis using the triple technique: a case report. AAOJ 23. Pp 34-38. https://www.researchgate.net/profile/Nicole-Pena-6/publication/287632071_Osteopathic_manipulative_treatment_of_pes_anserine_bursitis_using_the_triple_technique_A_case_report/links/5ff26ee5a6fdccdcb82a73d4/Osteopathic-manipulative-treatment-of-pes-anserine-bursitis-using-the-triple-technique-A-case-report.pdf?_sg%5B0%5D=started_experiment_milestone&origin=journalDetail&_rtd=e30%3D

Cleveland Clinic. (2020, May 29). Bursitis; Causes, Treatment & Prevention. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/10918-bursitis

McCormack, J. (2023, October 10). Hip Bursitis Exercises To AVOID by a Physical Therapist. Flawless. https://flawlessphysio.co.uk/hip-bursitis-exercises-to-avoid/#:~:text=Walking%2C%20running%2C%20cycling%2C%20and%20many%20cardio%20exercise%20machines%2C

MSN. (n.d.). Www.msn.com. Retrieved June 27, 2024, from https://www.msn.com/en-us/health/condition/Bursitis/hp-Bursitis?source=conditioncdx

Sears, B. (2022, March 3). Bursae Are Small Structures That Protect Your Joints. Verywell Health. https://www.verywellhealth.com/bursae-anatomy-function-and-treatment-4686312

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Radiculopathy

Radiculopathy

What is radiculopathy?

Radiculopathy is described as irritation of a single nerve root that can be caused by a variety of musculoskeletal and immune factors. This is different from Myelopathy which is narrowing of the vertebra causing compression of the spinal cord.

Radiculopathy can be caused at any level of the spine however it is most common in the cervical spine (neck) and lumbar spine (low back). Radiculopathy of the neck is most common over 40 years of age however radiculopathy into your legs is generally more common irrespective of age. It can result in muscular atrophy and weakness.

What is it caused by?

Radiculopathy can be caused at the level of the spine or along the nerve pathway.

Compression of the nerve root can be caused by disc herniation (disc bulge), trauma resulting in narrowing or displacement of the spine, bone or tumour growth, diabetes, and immune disease.

A peripheral cause may be Deep Gluteal Pain Syndrome. It presents with pain on sitting, burning/cramping in the buttock and posterior thigh, radiculopathy in the lower limb and can be caused by a history of trauma.

What are the conservative treatments:

Conservative treatment includes manual therapy, such as Osteopathy, pharmaceutical pain therapy and the use of corticosteroid injections. This treatment aims to decrease inflammation around the nerve and as a result reduce pain. Results vary and some patients may have a decrease in pain and increase in function however it is only a short-term solution (Chou et. al., 2015).

What is involved in surgery:

Surgery in the case of a disc bulge includes a discectomy – that is the removal of excess disc tissue that is compressing the nerve and causing radicular symptoms. This procedure is performed as a minimally invasive surgery and typically the patient will be discharged the same or next day. Risks include recurrent disc herniation – a bulging disc at a different level of the spine, infection and bleeding. The success rate for this surgery is between 70% – 90% (Cluett, 2023)

What can we do as osteopaths?

Osteopathic treatment commonly consists of de-loading and decompressing the area. This can be done using traction, mobilisation, soft tissue and nerve flossing (Kuligowski et. al., 2021). Mobilisation was found to be effective at improving functional ability and range of motion when applied in both a rhythmic or static position (Hassan et. al., 2020).

Practitioners may decide to use manipulation in the thoracic in the treatment of cervical radiculopathy. A study by young et. al. (2019) revealed that thoracic manipulation improved pain, disability, cervical rom and deep neck flexor endurance.

A study by Langevin et. al. revealed that when combined with exercise manual therapy is effective in reducing neck radiculopathy pain and increasing functionality. This included mobilisation and facet gliding as well as strengthening of the deep stabilising muscles, muscles of the spine and muscles that would help increase range of motion that were specific to the patient (Langevin et. al., 2015).  Strengthening exercise can include press ups, flexion rotation stretches, lumbar glides and pelvic tilts (Sears, 2023)

Addition of neurodynamic exercises such as sciatic nerve flossing can result in reduced nerve symptoms and mechanical sensitivity however do not appear to assist in decreasing pain (Plaza-Manzano et. al., 2020).

 

Sciatic Nerve Flossing Instructions:

  • Begin in a seated position and straighten your knee on the effected leg.
  • Pull your toes towards your head.
  • Look to the floor.
  • Reverse those steps until you are again in a normal seated position.
  • Repeat ten times.

 

References:

Chou, R., Hashimoto, R., Friedly, J., Fu, R., Bougatsos, C., Dana, T., Sullivan, S.D., Jarvik, J. (2015). Epidural Corticosteroid Injections for Radiculopathy and Spinal Stenosis. Annals of Interna; Medicine 162, 373-381. https://doi.org/10.7326/M15-0934

Cluett, J. (20 September, 2023). Lumbar Discectomy for a Herniated Disc. Very Well Health. Lumbar Discectomy – Spine Surgery to a Herniated Disc (verywellhealth.com)

Healthline. (23 April, 2018). Nerve Flossing Exercises to Try. Nerve Flossing: How it Works for Sciatica and Other Conditions (healthline.com)

Kuligowski, T., Skrzek, A., Cieslik, B. (2021). Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature. International Journal of Environmental Research and Public Health 18. https://doi.org/10.3390/ijerph18116176

Langevin, P., Desmeules, F., Lamothe, M., Robitaille, S., Roy, J.S. (2015). Comparison of 2 Manual Therapy and Exercise Protocols for Cervical Radiculopathy: A Randomised Clinical Trial Evaluating Short-Term Effects. Journal of Orthopaedic and Sports Physical Therapy 45, 1-17. https://doi.org/10.2519/jospt.2015.5211

Plaza-Manzano, G., Cancela-Cilleruelo, I., Fernández-de-Las-Peñas, C., Cleland, J.A., Arias-Buria, J.L., Thoomes-de-Graaf, M., Ortega-Santiago, R. (2020). Effects of Adding a Neurodynamic Mobilization to Motor Control Training in Patients With Lumbar Radiculopathy Due to Disc Herniation: A Randomized Clinical Trial. American Journal of Physical Medicine and Rehabilitation 99 (2), 124-132. https://doi.org/10.1097/PHM.0000000000001295.

Sears, B. (27 May, 2023). Epidural Corticosteroid Injections for Sciatica: Epidural for nerve pain in the lower back, buttocks, and thigh. Very Well Health. Epidural Corticosteroid Injections for Sciatica (verywellhealth.com)

Young, I.A., Pozzi, F., Dunning, J., Linkonis, R., Michener, L.A. (2019). Immediate and Short-term Effects of Thoracic Spine Manipulation in Patients With Cervical Radiculopathy: A Randomized Controlled Trial. Journal of Orthopaedic and Sports Physical Therapy 49 (5), 299-309. https://www.jospt.org/doi/10.2519/jospt.2019.8150

 

 

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Shin Splints

What are Shin Splints?

Shin Splints are the common name for a condition in which the muscles on top of the shin bones – the tibia and the fibula, become tight and as a result cause pain.

It mostly occurs after an increase in activity – either frequency, length or intensity, and can last for an undetermined amount of time depending on various factors such as exercise, rest and strength.

Medial Tibial Stress Syndrome:

Medically, shin splints are referred to as Medial Tibial Stress Syndrome (MTSS). It is caused by overuse and is commonly seen in athletes and military personnel. The cause of MTSS is not known however many factors can cause it including overtraining, poor unsupportive footwear, ankle muscle imbalance, tight triceps surae muscles (calf/soleus) and your back being out of balance.

Typically MTSS presents with a diffuse (wide spread) palpable pain worse after exercise – it is more common in females than males. The pain is usually described as a dull ache that gets better with rest. One reason MTSS is so painful is due to periostitis – the inflammation of the periosteum (covering of the bone) where the muscle attaches.

Specific movements that may cause pain is knee extension – that is the straightening of the leg, as this activated the muscles affected. Inflammation of the Achilles tendon (Achilles tendonitis), the bursa on the back of the heel (retrocalcaneal bursitis), plantar fasciitis (irritation of the plantar fascia), medial arch discomfort, calf pain and cramping, iliotibial band syndrome and Osgood Schlatter’s can also occur at the same time as MTSS.

One of the risks of having MTSS repeatedly or long term is a stress fracture. Signs this has occurred is when pain occurs after activity has finished into cooldown and daily activities. Another sign is when the pain becomes less wide spread and more specific to the inside of the tibia (shin bone) and the from halfway up the shin down after exercise. Imaging such as x-ray and magnetic resonance imaging (MRI) can be used to detect other sources of pain as well as stress fractures.

Treatment:

Treatment of MTSS varies depending on therapist and sport. In the acute, short-term treatment use of compression stockings, anti-inflammatories, rest and either ice or heat depending on the varied evidence. Kinesiology taping uses tape that aims to relieve pain, facilitate proprioception, change muscle activation and correct abnormal movement patterns.

Long term orthotics (inserts) and supportive shoes can be used to try and correct the posture of the foot. Increasing the supination (weight on the outside of the foot), strength of the inverter/evertor muscles and releasing the muscles on the bottom of the foot can also be helpful. Supplements such as vitamin D, calcium for bone health/density and magnesium for muscle fatigue should be taken long term as preventatives.

Manual therapy, such as osteopathy can be beneficial in both the short and long term phases of shin splints/MTSS. Through various techniques such as soft tissue, myofascial release, mobilisation and manipulation treatment is aimed at decreasing muscle tension, improving joint mobility and releasing the fascia of the foot and lower leg.

References

Bhusari, N. and Deshmukh, M. Shin splint: a review. Cereus, 15 (1), e33905. https://doi.org/10.7759/cureus.33905

Guo, S., Lui, P. (2022). Efficacy of Kinesiology taping on the management of shin splints: a systematic review. The physician and sports medicine 50 (5), 369-377. https://doi.org/10.1080/00913847.2021.1949253

Schulze, C. Finze, S., Bader, R., Lison, A. (2014). Treatment of medial tibial stress syndrome according to the fascial distortion model: a prospective case control study. The Scientific World Journal, 790626. https://doi.org/10.1155/2014/790626


Yüksel, O., Ozgürbüz, C., Ergün, M., Işlegen, C., Taskiran, E., Denerel, N., Ertat, A. (2011). Inversion/eversion strength dysbalance in patients with medial tibial stress syndrome. Journal of sports science & medicine 10 (4), 737-742. Inversion/Eversion strength dysbalance in patients with medial tibial stress syndrome – PubMed (nih.gov)

Ozgürbüz, C., Yüksel, O., Ergün, M., Işlegen, C., Taskiran, E., Denerel, N., Karamizrak, O. (2011). Tibial bone density in athletes with medial tibial stress syndrome: a controlled study. Journal of sports science & medicine 10 (4), 743-747. Tibial bone density in athletes with medial tibial stress syndrome: a controlled study – PubMed (nih.gov)

 

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Baker’s Cyst

What are Baker’s Cysts:

Also called popliteal cysts, baker’s cysts occur behind the knee in the popliteal fossa and are fluid filled sacs. They are predominantly asymptomatic and usually discovered during imaging for another unrelated condition.

Symptoms associated with these cysts include knee pain, tightness, and discomfort. Pain worsens with increased activity and decreases range of motion. Inflammation is most visible when the knee is at full extension and least visible at 45 degree flexion.

Lower limb swelling can occur due to the cyst’s impingement of blood vessels and in some cases may present the same as deep vein thrombosis. If the cyst bursts it can cause inflammation/swelling, sharp knee/calf pain and a sensation of water running down the calf. When the cyst busts it can cause nerve entrapment, blood vessel blockage and compartment syndrome.

It is typically diagnosed through physical examination and imaging such as plain radiography, ultrasound and MRI.

Causes:

The knee is a synovial joint where a capsule of synovial fluid cushions between the two bones. Bakers’ cysts can occur when this synovial fluid accumulates and moves between muscle attachments to the knee. This is due to the pressure gradient between the knee joint capsule and fossa moving fluid flow into the fossa.

While more common in adults they can also occur in children. However rather than being caused by a co-morbidity they typically occur when the knee joint capsule herniates.

Commonly occurring in patients aged 35 to 70 years of age or in children 4 to 7 years of age.

Inflammation of the semimembranosus (hamstring) bursa can also cause fluid build up in addition to arthritis, meniscus damage and other degenerative conditions.

Risk factors:

Patients that have a history of trauma to the knee cartilage and meniscus are at greater risk of developing a baker’s cyst. In addition, they commonly occur when patients have degenerative conditions such as arthritis.

 

Treatment:

If the cyst is asymptomatic and is discovered by accident during imaging or another condition no treatment is typically performed.

Conservative treatment involves behaviour modification such as decreasing aggravating activity and taking anti-inflammatories/pain relief.

In children conservative treatment of the cyst is preferred if the site is not painful and the size of the cyst is less than 3 cm. If the cyst is larger than this and presents with pain surgical excision is considered.

Aspiration (drainage) of the cyst can be performed in which a needle is placed through the posterior leg at the popliteal fossa and into the baker’s cyst. From there a syringe is used – this procedure is performed under ultrasound guidance. Corticosteroid injections into the baker’s cyst aiming to decrease the size of the cyst and relieve pain can also be performed. Risks with these interventions include pain, bleeding, infection, tissue damage and cyst recurrence.

Surgical intervention includes arthroscopy where the degenerative tissue is removed. Complete excision of the cyst can also be performed however this is not recommended in patients that have developed the cyst secondary to degenerative conditions.

Our Osteopaths have found that patients report increased range of motion and improved function after treatment.

 

 

References:

Al Khateeb, A. (2024). Bakers Cyst. Baker cyst | Radiology Case | Radiopaedia.org

Fredericksen, K., & Kiel, J. (2021). Bedside ultrasound-guided aspiration and corticosteroid injection of a baker’s cyst in a patient with osteoarthritis and recurrent knee pain. Journal of the American College of Emergency Physicians Open, 2(2), e12424. https://doi.org/10.1002/emp2.12424

Leib, A. D., Roshan, A., Foris, L. A., & Varacallo, M. (2020). Baker’s Cyst. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430774/

Mansour, M. A., Shehata, M. A., Shalaby, M. M., Arafa, M. A., & Almetaher, H. A. (2021). Baker’s cyst in children: conservative management versus surgical excision according to clinical and imaging criteria. Annals of Pediatric Surgery, 17(1). https://doi.org/10.1186/s43159-021-00071-1

‌Nanduri, A., Stead, T. S., Kupsaw, G. E., DeLeon, J., & Ganti, L. (2021). Baker’s Cyst. Cureus, 13(12). https://doi.org/10.7759/cureus.20403

Patel, C. (29 August 2012). Baker’s Cyst. Baker’s cyst – wikidoc

Van Nest, D. S., Tjoumakaris, F. P., Smith, B. J., Beatty, T. M., & Freedman, K. B. (2020). Popliteal Cysts: A Systematic Review of Nonoperative and Operative Treatment. JBJS Reviews, 8(3), e0139. https://doi.org/10.2106/JBJS.RVW.19.00139

 

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Nerve Impingement

Lymphatic system

What is Nerve Impingement?

Nerve impingement or entrapment occurs when nearby bone – whether it be vertebrae or otherwise, impinge on the pathway of the nerve or the nerve itself resulting in neurological symptoms.

Nerve impingement typically only occurs on a single side unless it presents in the spine when caused by a disc or narrowing of the spinal foramen (gaps where the nerves exit the spinal cord). In the extremities it can occur at the elbow, knee, fibular, hips, wrists and shoulders.

It is more common if the patient has experiences trauma in the past. There can be feelings of the joint “Giving out”, decreased sensation of hot/cold, fine touch, sharp and dull as well as tingling, numbness or weakness. 

In the legs the most common nerve impingement is of the peroneal/fibular nerve which runs on the outside of your shin. When this nerve is impinged it can cause a foot drop where the food cannot lift the ball of their feet or toes. They may have pain in the knee or below, weakness in the movement of pulling the toes to the ceiling and a burning/tingling pain on the top of the foot.

The most common form of nerve impingement in the upper limb is of the median nerve. This is commonly known as carpal tunnel and affects 3% of the adult population, mostly female and between the age of 40 and 60 years old. Like nerve entrapment of the lower limb patients will experience neurological symptoms and weakness. Repetitive movements found in occupations such as admin (office work) and trades can increase the risk of carpal tunnel syndrome.

 

Assessment:

Firstly, your osteopath will look at the area of symptoms and the associated chain. For example, if it is the foot they will look at the foot, knee, hip and low back. They will assess range of motion, the nerve pathway and possibly perform a Tinel tap (taping the nerve to reproduce neural symptoms). They may refer you to a radiographer for imaging such as an x-ray if this was after an acute trauma, ultrasound to identify soft tissue lesions or scar tissue build up. In addition, general practitioners (GP’s) can perform motor conduction studies where they test musculature innervated by nerves in the same chain to identify what nerve may be impinged.

Lower limb neurological assessments will also be performed that identify reflexes, strength of muscles/nerves, light touch sensation of nerves, sharp and cold sensation of nerves. These tests will be performed on both sides to make sure it is an issue with the peripheral nervous system and not the central nervous system (spinal cord). 

 

Treatment:

Osteopathically your practitioner will work on decreasing tissue tension in the area – this includes muscles and ligaments. They will work on the joint itself as well to increase space and range of motion.

As the nerves begin in the spinal cord you may find your practitioner works on the entire chain (Neck, shoulder, elbow wrist or low back, pelvis/hip, knee and ankle). This can be done using a variety of techniques such as soft tissue, mobilisation, manipulation (if deemed appropriate) as well as more indirect techniques such as balance ligamentous tension, osteopathy in the cranial field and functional techniques. In addition, we may prescribe stretching, strengthening and nerve gliding exercises.

As we are a holistic therapy, we will also ask about your lifestyle factors such as sleeping position, work, exercise and more. We may suggest changes to the positions or activities you are doing to see if it makes an improvement of the symptoms.

Surgically, nerve blocks using a lidocaine solution may be used or a local corticosteroid injection. If there is a build-up of scar tissue in the area the practitioner may work on that or refer you to a specialist for a procedure called neurolysis for nerve decompression – this has been seen to be effective in patients with nerve injured less than or equal to 8 cm in length. There is a healing time of 3-4 months however healing can take up to 12 months depending on a range of factors.

 

References

Carpal tunnel syndrome: MedlinePlus Genetics. (n.d.). Medlineplus.gov. https://medlineplus.gov/genetics/condition/carpal-tunnel-syndrome/

Fortier, L.M., Markel, M., Thomas, B.G., Sherman, W.F., Thomas, B.H., Kaye, A.D. (2021). An update on

peroneal nerve entrapment and neuropathy. Orthopaedic reviews, 13(2). Pp 24937. https://doi.org/10.52965/001c.24937

Klifto, K.M., Azoury, S.C., Gurno, C.F., Card, E.B., Levin, L.S., Kovach, S.J. (2022). Treatment approach

to isolated common peroneal nerve palsy by mechanism of injury: systemic review and meta-analysis of individual participatnts’ data. Journal of plastic, reconstructive and aesthetic surgery, 75(2). Pp 683-702. https://doi.org/10.1016/j.bjps.2021.09.040

LaPrade, R. (2022). Peroneal Nerve Entrapment.

Peroneal Nerve Entrapment (drrobertlaprademd.com)

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