Neck Injuries, Neuropathies

Mark: Hi, it's Mark from Top Local. I'm here with Wil Seto of Insync Physio in Vancouver. Repeatedly voted one of the best physiotherapy offices in Vancouver and Wil has just been voted one of the top three physiotherapists in Vancouver. Congratulations Wil. How you doing? 

Will: Yeah, I'm doing great, Mark. Thanks, and that was a total surprise. It's always great to be recognized. And I really obviously appreciate that. Things are definitely going great on my end. Can't complain. 

Mark: Let's talk about neck injuries, that's what we have on the agenda today. Neuropathies, what's a neuropathy?

Will: So first of all, I think the easiest way to kind of get into it is, looking at a client that came in, that that actually presents with that. So, we had this 57 year old woman, who's a golfer, that walked into our clinic and she presented with some interesting symptoms. The first thing she said to me, "Hey, I've got this pain going down my arm in my hand and my wrist, and it's been going on since April. So, the last four months, four and a half months, and it's just not going away. I've been seeing a chiropractor and massage makes it worse." 

And she actually saw her family doctor and her family doctor diagnosed her with carpal tunnel syndrome. It was interesting in that I was you know, taking her history, kind of dived into the questioning of what was going on, you know. 

She's, like I said, she's a golfer, she's retired, but she ran a successful business where she  was on the computer lots. And so there's a lot of sedentary stuff involved. And so it turns out she has this thing called the neuropathy going on in her whole upper extremity and relating to her neck.

What it is essentially is basically a malfunction or dysfunction of the nerve, that causes a lot of hypersensitivity. The word hypersensitivity is the medical term that they used for when a nerve is not functioning properly. It's just basically over firing for whatever reason and it's usually due to a minor injury, right. 

A minor irritation and that irritation, it turned out that it was coming from the woman's neck because she definitely didn't have the range. And her specific joints in the neck were fixated and a lot of the muscles in her neck and leading down to sort of the shoulder area, which is all related, were shortening to the extent where they were basically causing a lot of alignment issues.

 There's specific tests that we do that are able to help us diagnose, is this a neuropathy? And so with the hypersensitivity, there really isn't a major injury going on and you do scans on it and you do whatever x-rays, and stuff like that, and it won't necessarily show much going on.

You do these other different tests and adds up to what we would call neuropathy in terms of the hypersensitivity of these nerves. And that's basically what it is. 

Mark: So what kind of treatment protocol did you initiate with her?  

Will: Looking at what her impairments were. There were three major things going on, right? So with her neck, she had limited mobility because of the neck joints, and that was causing a lot of other mobility issues. This is chronic, too. So other thing that as you're ascertaining this, and we're assessing this, that this isn't something that just happens overnight or the span of two weeks. She's been having symptoms since April, it's been going on way longer than April.

Because of that and her neck issue, it's causing a lot of this type of immobility or lack of mobility, not just in the joints, in the range of motion of her neck itself, but also the nervous system and the nerves related dermatomal myotomal spread of what was giving her symptoms down into her hand and her wrist.

So we did three major things. We helped to restore her mobility and her neck, a combination of manual therapy and then some exercises to reinforce that mobility. And then number two, we assessed her neurodynamic system. So that's a bit of a mouthful there. So what that means is we assessed how her nervous system and her nerves are moving and functioning and we mobilized it. We used some hands on therapy to increase the mobility of that. So it was very specific techniques. And then we gave her some exercises to reinforce that mobility. 

The third thing was, is really applying something. So her muscles were like this, and looking at how can we actually help to relieve that tension and that compression in all those multiple segments, so that way things can move better overall as a whole. One of the really effective treatment techniques was using something called IMS, and IMS stands for intramuscular stimulation. What it is is the application of acupuncture needles that basically restores these neuropathies and releases these is the spasms in these tight muscle bands, so that way it relieves pressure on the joints and allows things to move better. 

Essentially it allows like sort of a reset if you wanted to describe it, for that whole neurophysiological system. And then the last, actually major component of the treatment - so those are the three main areas, but then you have to actually look at helping the client understand the actual dysfunction or the issue and what this is, because the education component is actually one of the key things. Educate her about what neuropathy is and how we can fix it.

So those are the key things. And we do all these things and they make it a little bit better, but they're not going to get 100% better. They're not going to also understand how to prevent this from happening, because as much as I want to keep treating her, you know, lots and lots and lots, I don't like that actually.

What I want to do is I want to actually be able to help her in three visits. After the first visit, she no longer had any more of those symptoms, and all I did was treat her neck. It wasn't even carpal tunnel syndrome. 

Mark: So what was the final outcome of the treatments? 

Will: Basically she came in for third session earlier this week and she was pretty much she went from coming in to see me. She was like at 55, 60% over overall functioning and impairment to like almost a hundred percent. And she like hadn't played golf and then she would go and play golf this weekend for the first time.

Mark: Nice. So there you go. If you have a problem with your neck or any kind of phantom pains that are suddenly turned chronic, it's been a few months, the guys to see our Insync Physio. You can reach them at Vancouver office (604) 566-9716. They're on Cambie Street really convenient to find or in North Burnaby, (604) 298-4878. You can book online as well at the website. - both offices. You have to call and book. They're always busy. They're always popular. They're always helping people and they will help you get better and moving freely. Thanks Wil.

Will: Great. Thanks Mark. Hope that helps.