The arm can be divided into the upper arm and the forearm. There are many potential causes of pain in the arm. Sometimes arm pain can be referred from a structure elsewhere in the body. Here are some of the common causes of arm pain:

Shoulder conditions can cause upper arm pain-

• Arthritis
• Impingement
• Rotator cuff tendinopathy or tears
• AC joint sprain
• Fracture

Upper arm conditions can cause pain near the shoulder, upper arm and below the elbow-

• Bicipital tendinopathy
• Triceps tendinopathy
• Strain of the biceps, brachioradialis or triceps
• Fracture

Elbow region conditions causing pain-

• Cubital tunnel syndrome
• Arthritis
• Ligament sprain or tear

Forearm conditions causing pain-

• Carpal tunnel syndrome
• Golfer’s or Tennis Elbow
• Fracture

Referred or neuropathic pain-

• Thoracic outlet syndrome
• Cervical radiculopathy
• Complex Regional Pain Syndrome
• Brachial Plexus Injury

Determining the cause of arm pain is important. If you schedule a visit with a physical therapist before seeing your doctor, a process called direct access, your physical therapist will use observation, palpation, special tests and other exam elements to try and localize the cause of your pain. Though not always needed, when indicated, your therapist may refer you to an orthopedic physician to request imaging such as an x-ray, MRI or ultrasound to visualize the structures of the arm to diagnose the cause of your pain. In other cases, lab work or other tests may be indicated to rule out underlying medical conditions. Physical therapy is an excellent treatment option for arm pain, however, in some cases, you may need additional medical treatments or surgery to achieve full resolution of symptoms.

If you decide to work with a physical therapist to help correct your arm pain issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized rotator cuff physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your rotator cuff PT sessions yet in the comfort of your own home.

PHYSICAL THERAPY INTERVENTIONS FOR PIRIFORMIS SYNDROME

Conservative treatment for piriformis syndrome is the first line approach. This may include pharmacological treatments like NSAIDs or muscle relaxers and almost always physical therapy. Treatments for piriformis syndrome will always be individualized to address a patient’s impairments but several physical therapy interventions have been shown to be helpful in the management of this condition:

Lifestyle modification: lifestyle modification to reduce compression or irritation of the sciatic nerve can be helpful in reducing symptoms. Avoiding sitting for prolonged periods and daily stretching for example are often recommended.

Modalities: modalities like ultrasound, hot or cold therapy can be utilized to reduce inflammation, promote tissue healing and reduce pain and spasms which may be beneficial early on in a treatment session.

Manual therapy: addressing myofascial restrictions, trigger points and other restrictions in soft tissue around the glutes may be important to address your symptoms. Your therapist may perform these interventions using their hands or may employ other tools like dry needling, foam rolling or IASTM.

Stretching: stretching of the piriformis muscle can address muscle length issues and may help alter pain sensations and decrease muscle spasms to reduce compression on the sciatic nerve.

Lumbar and sacral spine-focused treatments: your therapist may direct their treatment to the spine itself if they feel this is a contributing factor to symptoms. Manual therapy techniques and exercises may be prescribed to address these impairments.

Muscle strength and performance exercises: if biomechanical factors are thought to be contributing to piriformis syndrome your therapist may prescribe a series of functional hip and gluteal strengthening exercises to ensure the small piriformis muscle isn’t trying to do the work of these larger muscles.

Functional training and restoration of activity: as underlying factors are addressed and symptoms subside, your therapist will incorporate more functional activities to ensure proper biomechanics, motor control and coordination when performing these activities. They will also educate you on how to return to your prior level of activity with an eye on prevention of piriformis syndrome in the future.

The symptoms of piriformis syndrome can surely be a pain but you should feel confident that the physical therapists at Evolve Physical Therapy know how to help. Call today to schedule an initial evaluation.