Recently a hand surgeon came into my office needing treatment for his “elbow problem”. After my evaluation, I determined that this might very well be a neck problem instead of or in addition to the elbow problem and verbalized my findings to this professional. To his credit, he said that he would agree to go along with my plan because I was the professional in this situation. He also indicated that he thought he just needed some stretching and strengthening exercises.
The symptoms he was mostly concerned about consisted of pain in his forearm and a limitation of the movement of his elbow. His neck was quite limited and his body mechanics were also dysfunctional. After some cervical traction, direct current ETPS (electrotherapeutic point stimulation), postural education and some exercises to stretch his neck and strengthen his scapular muscles, he was a new man with full range of motion and no pain. A home saunders cervical traction unit was also used on a daily basis to start to help maintain his pain relief.
The hand surgeon was very happy to be discharged with all goals met in about 6 visits. He turned to me on the last visit and said, “you know, I wonder if some of my hand patients are truly neck patients in disguise?” I responded that all problems can have a central origin so I choose to look at every problem from all perspectives and treat accordingly and hope that other physical therapists do the same. Most problems have a component of each and if you look at the spine as well as the extremity for any problems, you can usually pinpoint the answer to the dysfunction within a few visits.
Is it a neck in an elbow costume or an elbow in a neck costume? It doesn’t matter because practitioners should look at both when we are evaluating a particular problem. The assessment and treatment should include a look at both and the problem will be answered within a few visits through appropriate treatment choices.
