Mark: Hi, it's Mark from Remarkable Speaking. I'm here with Wil Seto of Insync Physio in Vancouver. And today we're gonna talk about arm pain coming from your neck. How you doing Wil?
Wil: I'm doing good. Thanks. How about you, Mark?
Mark: Good. So this doesn't seem to make sense really. How can you have arm pain from your neck?
Wil: Yeah. So I guess the first thing to really understand is the different kinds of neck issues that you can get. And you can have four basic types, I guess, to really narrow it down. And you look at what's called standalone neck pain. So you have this type of nonspecific neck pain that doesn't affect anything else. And so you have this pain that's happened, whether it's like a traumatic injury, you know, or something like that. Or you wake up in the morning and you sleep wrong on it. And you kind of have this neck pain that you're experiencing. And it's just neck pain, so there's no other symptoms. And it could be stiff. And it could be not be stiff.
And then you have neck pain, with a headache related symptom, like you have neck issue, neck pain related with headache stuff. And that's quite common when you have this referral of the things going on with your neck joints that refer up into the head. And so that neck joint related pain or the technical term is called cervicogenic headache. Because the headache is coming from referral points from joints in your neck. And so the muscles get all really tight too as well. And they can also refer right into the base of your skull.
And then the third type is sort of like this whiplash type of associated neck pain or disorder and there's all these classifications with that where it's like trauma. So I did mention trauma earlier, but I meant like more trauma.
That's kind of like, you know, you wake up, that's still, I consider that trauma, but it's not like acute trauma where you've had an accident. Right. So with the third type. The whiplash associated trauma is like a specific sort of acceleration and decelerated force. And basically you can either have pain in your neck without issues with motion, but you have pain. Or you can have limited range of motion. Or you can also have that with now it goes into the fourth category, which is neck pain with arm pain.
And so the technical term of that, I guess is, ridiculopathy or neuropathy. And so when you look at the neck pain with ridiculopathy or neuropathy, that's when the actual pain in your arm you know, and we've had this on our physio team where clients have said to our physios. Yeah, I think I've got tennis elbow and then they've been treated for, with some other healthcare providers and, you know, and it didn't help at all. Like they're treating their tennis elbow or what supposedly thought was tennis elbow or some kind of overuse thing going on in their arm. But in fact, if you do a thorough assessment and you do this clinical examination and look at where is their arm pain coming from, it's actually coming from their neck.
And so when you start treating that and you look at you know, the cause of that, and you start putting the pieces together and you treat that whole picture, then you start to actually affect that arm pain. Because you can get referral from your neck all the way down in your arm. And especially if, you know, someone that it may not even be an accident, it could be an accident, but it may not be an accident. And it may be like something that's just gradually happened over time.
So I can think of a client that one of our physios had. Who said, yeah, you know, like they were talking about this patient who had arm pain. They said, yeah, the other healthcare provider was basically treating them for tennis elbow and it just wasn't getting you better. Well it was because it wasn't really tennis elbow is what she told me.
And started treating this client for their neck issue. And within a few treatments, their arm pain was dissipated from like an eight out of 10, which they would feel, for like a 3 out of 10. It's a process. Because these things developed over time for this person, and it was something that wasn't just over like a traumatic incident and this person didn't have any issue with them to begin with.
I mean, like traumatically speaking. They did have other non sort of repetitive going on. Cause they were on the computer a lot, and they did some sports that probably wasn't super helpful, like boxing, but never had an injury that they could remember. So the proper diagnosis or the proper assessment of what's causing the arm pain is really important. It's the first step.
Mark: So as an athlete, can I diagnose this myself? Is there something that's obvious so that you could point to and say, well, this is often what it feels like that's different than just regular tennis elbow or arm pain that would indicate it or do I have to come and see you really to get the testing done to find out?
Wil: No, that's a good question. So I think one of the biggest things is like you know, you can confuse it. It's very confusing because you're like, oh yeah, you know, I'm hurt because sometimes that area, it becomes more sensitive. So you have this sensitization of that arm, so that's why it legitimately feels like it's just arm pain and you may not actually have neck pain.
Like it just maybe neck stiffness until we start poking around in there and be like, oh yeah, my neck hurts a little bit. It hurts a little bit there. And so some of the things that you can sort of just rule out quickly for yourself is you can just do a lot of like resist detecting. So if it's like a tennis elbow thing, you know, like aside from the fact that it feels more sensitive and it's a little bit sore.
Like with this person, they were, it was interesting because there's like two things really hurt it the most, like doing weighted chin ups and doing pushups. And so, oh, that's interesting. So then I was thinking, yeah, it could be maybe like something related locally. Around that area of their arm. But then when I actually put them through the test, which you can do on your own or an athlete can do on their own, like just test yourself, do some simple, wrist resistant testing with your arm bent, arm straight. And then do what I call like sort of the P symbol with the arm straight and then resist. And then do that with it bent. And if you're getting the reproduction of that pain that you're experiencing when it's sort of that yeah, when you touch it, then that's usually a good indication. Oh yeah, maybe there's something going on. Because that's actually testing the structures related to tennis elbow.
So I don't know if that helps if it's sort of a initial thing. Cause that is actually a really quick test that you can do. Because sometimes if you just touch it, it can be sensitive. But if you're doing specific things to test for if it's sore and weak, then it could be maybe a tennis elbow thing. But if it's just weak and it's not sore, then it might not be.
So the other key thing too, is if it is a tennis elbow thing, if it's an overuse thing, and if you're doing exercises to work on releasing the muscles, like tough massage and stretching, And then you're doing some specific strengthening for, and that doesn't get any better in like a couple weeks. And that's when you want to get it looked at. Maybe there's more to this that meets the eye. And you know, as great as Google can be, in terms of being a good resource you know, sometimes you just gotta get it looked at you know, if it's beyond that stage of like two weeks and especially if you're like, yeah, I want to start to play more tennis. I want to start to play more Ultimate Frisbee or rock climb or whatever it is that, you know, using your arm more.
Mark: When you're working on a person's neck to reduce the stiffness or the pain that's referring down into that person's arm. What kind of stuff are you doing?
Wil: Yeah. So really good question. So one of the biggest things is, so there's three things that we're looking at in terms of the rehab process. So there's increasing mobility. So we want to increase the mobility of like the whole thing that's affecting the arm.
So there's the neck. And the things that basically come up in attach neck, so the nervous system. So if we inspect the mobility to the neck and allow it to move better, then that's gonna allow things to move better all the way down. And then also the muscles around the neck. So if the muscles are just basically really super tight, if everything is always on like this. And then that's also gonna add more compression and also affect the movement patterning of how you rotate or how you flex or how you extend your neck. And so that's gonna also affect what's happening all the way down with the nervous system and how you use those muscles.
So that mobility issue with the muscles and the joints and the nervous system. And then being able to get your core strength to stabilize all that. And so then that way we can now focus on the third thing, which is basically the functional strength. So really getting in there and mobilizing and increasing mobility is one of the first key things to start.
Mark: There you go. If you suspect or been told you've got arm pain and it's not going away because you're doing the right things to heal it, come into Insync Physio and get it looked at. It might be something else. It could be referred from your neck for instance. And this is pretty common. I'm guessing is that accurate Wil?.
Wil: Yeah, it's actually very common. I can't give you the exact percentage, but our team, our physio team, we see it a lot.
Mark: There you go, if you want experts helping you out. They can diagnose this and get you on the right path so that you're feeling better and can get back to your sports sooner rather than later. Insync Physio. You can book at insyncphysio.com or you can call the Vancouver office at (604) 566-9716 to book or in North Burnaby, (604) 298-4878. Get in there. Thanks Wil.
Wil: Thanks Mark.