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Medical Scans & Assessments

My Medical Scans & Assessments

The following are findings from scans, x-rays and reports:

January 2004

Nerve conduction studies, mainly assessing the likelihood of Carpal Tunnel Syndrome, came back all in the clear.

July 2004

CT scan of cervical and thoracic spine detected no nerve root compression. Slight scoliosis at T4/T5 detected.

August 2004

MRI of cervical spine and brachial plexus identified no nerve root compression or any other structural complications.

X-Ray of whole spine revealed unhealthy spine alignment from top to bottom, and a badly uneven and twisted pelvis, right side 14mm higher than left.

Medical Assessments

Here are extracts from two third-party reports from practitioners in Sydney who helped me enormously. Both were written in the September/October period.

The first, written in September 2003, is from a certified chiropractor:

There are possibly two mechanisms responsible for Mr Bennett’s symptoms.  Firstly, the zygapophyseal joints of the spine, like any synovial joints, need stimulation through movement to provide proprioceptive feed back to the brain.  The zygapophyseal joints can become restricted with adhesions over a period of time, building up the capsule and thus reducing the proprioceptive input to the brain.  It has been noted that a decrease in the firing rate of mechano receptors in the joint leads to an increased firing rate of the nociceptors, associated with pain and inflammation.

Due to the direct neural input of the zygapophyseal joints in the cervical spine to the trigeminal nucleus of the brain, it has been suggested that these aberrant signals and noxious chemicals can affect the spinal reflex through the efferent nerves.  This manifestation in the spinal reflex can produce such symptoms in the hand.  All literature and studies can be supplied on the above discussion (if you would like further information).

Secondly, and less likely is the dysfunction of the zygapophyseal joints and the lack of mechanical input may possibly increase the inflammatory properties in the local area, thus directly affecting the nerve supply to the hand.

In conclusion, the moderate to severe spinal restrictions, especially in the cervical spine, are consistent with the typical symptoms that can occur in the hand.  Burning sensation is also a sign of centralised neural degeneration also consistent with a noxious stimuli.

The second extract, from a report written October 2004, is from a certified physiotherapist and chiropractor:

Initial assessment revealed adhesions / entrapments of the brachial plexus between the scalene muscles and under the medial pectoral tunnel, as well entrapment of the medial cord of the brachial plexus near the subscapularis muscle on both side. Scar tissue adhesion was also found around the median nerve near the transverse carpal ligament, flexor digitorum superficialis muscle, pronator teres, and ligament of Struthers on both sides. Entrapment the median nerve and the brachial plexus can give rise to neurological symptoms in both hands. Repetitive overuse is suspected to contribute to the formation of scar tissues. All the nerve adhesion sites detected above reproduced Mr. Bennett’s hand symptoms, thus further confirm the diagnosis of peripheral nerve entrapment.

Initial treatments were directed to minimize scar tissue at these adhesion sites to promote proper sliding of the nerve and surrounding soft tissues. The main techniques use is the Active Release Technique or A.R.T. Further information on A.R.T. is attached. Corrective stretches have also been prescribed to maintain muscle flexibility and neural mobility.

Further assessment revealed postural dysfunction including a forward head carriage and rounded shoulders, which are frequently observed in sedentary population and office workers with poor ergonomics. In Mr. Bennett’s case, we suspect that chronic postural dysfunction in turns lead to disuse and weakness of postural muscles such as thoracic extensors, deep neck stabilizers, and scapular stabilizers and perpetuates overuse of other muscles for dynamic stability. Chronic overuse will eventually lead to muscle fatigue and injury; this is followed by scar tissue formation as the repair progress sets in. A corrective exercise plan has been implemented to strengthen these postural muscles and restore proper function.

Summary of findings

The medical scans did not detect any structural problems thus confirming that is was a soft-tissue injury and enabling me to safely being a guided exercise program.

The chiropractic reports mainly refers to restrictions in the neck affecting nerves that lead to the hand while the physiotherapists report refers to muscle imbalances causing injury and the formation of scar tissue (or adhesions, as mentioned in the chiropractic report) that lead to peripheral nerve entrapment and pain.

© 2012 How I Beat RSI

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