Wrist Wrath - Part 2

I thought I would write an update on the wrist pain patient.  Two weeks have passed since I saw this patient originally.  One treatment was applied and home-based pain-free active range of motion was prescribed as well as self-massage to the extensor muscle.  

I am pleased to report the patient is pain free and functioning near 100% after a total of about 4 months of living with this issue.  The patient is able to play the guitar at 100% function and work at 98% function.  Overall, the subjective end of things is incredibly positive for a good prognosis.  The most amazing thing is that one adjustment set the wrist on a path to heal rapidly.  Awesome stuff!

I palpated the previously taut extensor muscle in his forearm and it was definitely still tight and a little tender.  However, there was no swelling in the carpals like last time and each carpal was moving with joint play.  I compared sides and the side of the injury had less joint motion, so I went through the carpals like last time adjusting them in multiple directions.  No popping or cracking occurred like last time.  My hunch is there is still some Substance P left over in the joint capsules and soft tissues in the wrist due to the chronicity of the problem.  This will take time to filter out and over time, the brain will re-wire what it is like to have a pain free wrist again.

I used the Cold Laser on the carpals and the abductor pollicus muscle as well as the common extensor tendon of the forearm.  I stripped out the extensor carpi radialis and the abductor pollicus muscle as well. We went over stretches to do and I showed the patient strengthening exercises to do to balance the flexors and extensors.  If money was not a factor, I would likely see this patient twice next week to break up the extensor muscle and apply more modalities such as ultrasound.  Being that money is an issue, home-based therapy will have to suffice.

Overall, I am happy with the results this patient was able to obtain in such a short period of time, particularly the chronic nature of it all and the dramatic improvement.  It prides me to share these stories and all the positive attributes of outpatient care.  

All for now