Pain/Stiffness Neck/Upper Arms. RSI?

[rainbowdragon008]

I hope this isn’t too much; its symptoms that I’m pretty sure ultimately stem from long-standing bad posture from sitting and using my iPad too much. What I’m looking for is clues as to what is going on, so I can do further research, as I am delaying returning to my physio due to a cold I’m having difficulty getting over. Any clues or feedback welcomed

• I have head forward posture, have started doing neck/shoulder stretches and strengthening, and upper back strengthening, and have just purchased an iPad stand
• The problem flares up when I’ve been browsing/using my iPad/PC for any length of time, and especially when I play games I mostly use my iPad, only using my PC when I’m playing Skyrim
• It does improve with rest (which I have dropped the ball on a lot: my main stress relievers (as someone with anxiety) and hobbies have stuff I need to do online)
• I mentioned this to a previous physio a few months ago (at the end of a session about my lower back), and he, I think, did a trigger point release on a spot (joint?) on the right side of my neck. Very painful. And then I was able to straighten arm again. He also gave me stretches to do, “walking” arm up wall and stretching it out, which does help (I do both arms). Mentioned something about a part of my neck being fatigued)
• I have been mostly focussing on lower body problems with my physio sessions (have been dealing with lower back/piriformis/flat feet problems, so I haven’t had a session focussed just on this yet

Symptoms

• Pain upper right arm; it’s the upper side of arm, but more situated the left of that, and up into my shoulder
• Tightness and pain under right armpit
• Pain side and back of right shoulder
• Inability to completely straighten right arm overhead
• mild nerve pain side/little finger of right hand
• Soreness neck (right side of back of neck, sort of the corner between side and back of neck, if this makes sense)
• Left arm/shoulder has similar (but a bit less) pain/stiffness shoulder/armpit/upper arm (same areas), pain above left elbow, pain/twinges left wrist
• Similar soreness on left side of neck (equivalent areas), but less so
• I definitely have a feeling that both my arms/shoulders are (easily) fatigued, or maybe this referred from my neck

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[physiobob]

Hi rainbowdragon008 (nice handler) and thanks for your post. Firstly I'd like to let you know that your symptoms seem totally normal and very common in relation to people who do a lot of seated activity, with or without a computer screen. Gaming and tablet use perhaps contribute to the development of symptoms even more so in those beyond their teenage years. As you have pointed out you perhaps have a slightly bent over posture in your upper back, which means your neck has to extend more to compensate so your head remains balanced. The more kyphotic (bent over) your thoracic spine, the more the neck compensates, hence more muscle activity and thus more compression of the joints of the cervical spine. This positional change in the spine essentially locks off the bottom of the neck, upper part of the thoracic spine, from contributing to movement. So the rest of the cervical vertebra need to compensate for that too. I hope this is OK to follow.

Now if your thoracic spine remains bent over there is no way for your shoulder blades to drop into a more natural position. So without good thoracic (and lumbothoracic) extension they end up staying elevated and the compression on the bottom of the neck remains (this could be contributing to the pain in the little finger). So how to you approach this holistically? You need to do two things to gain mobility in your thoracic spine: firstly have your therapist/s do some releasing of those vertebrae and combine it with some releasing of the overactive/tight musculature on the front side of the body that will be resisting the opening of the thoracic movement. And then secondly, as you have mentioned, strengthen the back to provide support for that new position. Now this will take a long time as it takes years to develop the hunched position and we normally only notice it once we have discomfort. So longterm reversal take a long time and needs to be part of a lifestyle change to maintain it for the next 50 years.

One important point to make in relation to changing and maintaining spinal movement. The spine likes to move in a combination of directions. Rotation is often a combination of extension or flexion and rotation (e.g. in combination to create a side bending movement). The exercises you end up doing for maintenance should therefore include rotational movements so although you may being thinking about flexion and extension in a more passive way, ensure your therapist progresses your plan to add in rotational elements as movement becomes available.

I hope this gives you a little more insight into possible cause/effect and how to work towards a good long term goal.

regards
PB

[rainbowdragon008]

Thank you for giving me something to go on!

I understand it takes time; I’ve taken six years to get to the point where my sacroiliac joint isn’t being constantly thrown out, so I am prepared for this also to take to take a long while.

[ultracarepro]

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