Upper Extremity Pain

Shoulder, Elbow and Wrist/Hand Pain

Upper extremity pain is a very common issue among many people at some point in their lives. When a shoulder or elbow begins to develop functional or anatomic changes pain usually is first noticed during certain activities such as reaching above the head but as it worsens it is felt also at night while in bed or while at rest.

Shoulder exam by Dr. Meng ultrasound

Shoulder Pain

The shoulder is a unique joint of our body because it relies on help from its neighbors for assistance like  the shoulder blade, the rib cage, the neck and the thoracic spine. Shoulder pain is usually induced by movement and it’s often described as sharp pain with cracking, popping, grinding, snapping and crunching sound.  Shoulder pain is often diagnosed by providers as “referred pain” which means the pain is actually felt at a site different from the injured or diseased body part. That’s why it is very important to perform a very thorough ultrasound diagnostic test to find the root of the problem. Even though some of the shoulder tissues can heal with time and physical therapy, the underlying problem must be addressed to solve the problem for the long haul.

Common Shoulder Injuries includes:

  • Rotator cuff tear
    This type of tear appears with a pain behind the back or overhead movement or activities. Often referred to as shoulder impingement, prohibiting patients from lying on the affected side, a rotator cuff tear can produce characteristic clicks when moving the shoulder around. There are 4 rotator cuff muscles: the supraspinatus, the infraspinatus, the teres major and the teres minor. Like a rope, any one of these can be torn, but there are often a lot of fibers that remain in the rope.
  • Labral tear
  • Bursitis
  • Tendonitis, tendonosis, tendinopathytendinopathy
  • Shoulder dislocation
  • Acromioclavicular instability
  • Arthritis:
    Osteoarthritis is often felt as morning stiffness that improves with movement, however it’s also felt as pain later in the day or with increased activity.

Elbow Pain

Elbow pain is often caused by repetitive movements from sports, jobs and hobbies. Sometimes this leads to arthritis, tendinitis and bursitis.

Common Elbow Injuries includes:

  • Golfer’s Elbow
  • Tennis Elbow
  • Osteoarthritis 
  • Tendinitis
  • Bursitis
  • Trapped nerves
  • Tendon and Ligament tears

If you have elbow pain, weakness or swelling that has lasted for over 3 weeks, it’s a possibility your elbow won’t heal on its own, and it’s worth getting a musculoskeletal diagnostic examination to see the elbow in motion and find out exactly what is damaged or causing your pain.

Wrist/Hand Pain

Wrist and hand pain is common, as you use your wrists and hands every day while on the computer, when you drive, when you prepare your meals, and in your sports and hobbies, but it’s often hard to know “why” you have wrist pain until you take a look at your wrist anatomy.

Common Foot/Ankle Injuries includes:

  • Arthritis
  • Carpal tunnel syndrome
  • Fracture 
  • Ganglion cysts
  • Gout
  • Tenosynovitis or tendonitis
  • Trigger finger
  • Pinched nerves or peripheral neuropathy

Under high-resolution ultrasound imaging in live time, we can evaluate your wrist and hand and give you an accurate diagnosis and recommend treatment options. Sometimes, we even use the ultrasound to scan a nerve back from your hand, through your wrist, up your arm, all the way to your neck, where we may determine the source of the wrist pain originates

A nerve can get entrapped or injured at any point along its path from your neck down to your hand, and that entrapment can cause pain in your hand, even if the entrapment point is far from your hand. This type of non-invasive, live-time diagnostic evaluation of nerves is only possible with skilled musculoskeletal ultrasound imaging technology.

At JWP®, when you come for an exam, you are interacting with the provider and giving feedback on your pain as they look at your anatomy, and they’re not limited to just one set of images of your wrist, as with an X-ray or MRI, for example. Ultrasounds can visualize the nerves that come out of your spine better than other imaging modalities, so our providers can show them to you on the tv screen so you can understand exactly what is going on.

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