Upper Limb Pain

Upper limb pain may relate to the shoulder, elbow or wrist. Injuries to these areas can be caused by trauma, inflammation, and repetitive stress or overuse. The cervical spine (neck) may also be contributing to your upper limb pain. Among repetitive stress injuries (RSIs), neck and shoulder pain were most common at 25%, and wrist second at 23%. A large portion (55%) of RSIs occur while on the job and unfortunately some occupations are more at risk. There are also risks associated with common household chores and sporting activities. A chiropractor will do a thorough examination to determine the cause of your upper limb pain.

Dr Zuback performing chiropractic shoulder stretch on client

Rotator Cuff Injuries

A rotator cuff injury is an injury of your shoulder’s rotator cuff tendons.  Injury to the rotator cuff  can occur in two ways: 

  • trauma, and 
  • repeated micro-trauma.

Traumatic rotator cuff tears/injuries occur quickly or under heavy load eg a fall or lifting a heavy weight. However, the most common cause of a rotator cuff injury  is repeated micro-trauma, which can occur over several weeks, months or years. Repeated rotator cuff injury from straining or pinching the rotator cuff tendons will injure the soft tissue resulting in bruising or swelling.

Dr Zuback stetching clients rotator cuff

Shoulder Impingement

Tendons in the rotator cuff can be injured easily because they move within a tight space. When the shoulder is turned or lifted at the limit of its natural range of movement, the tendons in this tight space are moved, too. Occasionally, the rotator cuff tendons can bump or rub against a bony knob (the acromion) above them or against a ligament at the front of the shoulder. This friction is known as impingement syndrome and causes inflammation in the rotator cuff. Rotator cuff friction is most likely to cause pain if your shoulder movement is rough or repetitive.

Dr Zuback helping client lift weight with their arm

Tennis and Golfer’s Elbow

Tennis elbow involves the muscles and tendons of your forearm that extend to your wrist and fingers. Symptoms may develop gradually, with mild pain that slowly worsens over time. Tennis elbow usually doesn’t come from an injury, but rather from overuse of the tendons in your forearm.

Golfer’s Elbow also involves the forearm muscles. In this case, we’re talking about the muscles that attach from the wrist and go to the “funny bone” area of the elbow near the inner bump. These muscles are responsible for wrist flexion (or the twisting motion of the wrist), which explains its connection to golf.

overhead view of woman playing tennis

Frozen Shoulder

Frozen shoulder, or adhesive capsulitis, is a condition that causes severe, painful restriction of motion in the shoulder joint. Frozen shoulder causes the capsule surrounding the shoulder joint to contract and form scar tissue which prevents the shoulder bone from being able to move in the socket. The shoulder literally seems to be “frozen” which is why it is called frozen shoulder.

woman with frozen shoulder stretching


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Carpal Tunnel

Carpal Tunnel Syndrome (CTS) is a common condition that causes numbness, tingling, burning or pain in the hands and wrists. The disorder usually occurs in both hands, although sometimes only the dominant hand is affected. Classic symptoms include weakness, numbness and tingling in at least two fingers. Commonly, the fingers affected are the ones supplied by the median nerve – the thumb, the index finger, and middle finger.

woman with carpal tunnel holding her wrist

Tendinopathies/ OverUse Injuries

Tendinopathy is a general term that describes tendon degeneration characterized by a combination of pain, swelling, and impaired performance. Common sites include the rotator cuff (supraspinatus tendon), wrist extensors (lateral epicondyle) and pronators (medial epicondyle), patellar and quadriceps tendons, and Achilles tendon. The exact etiology is unclear. Studies suggest it is an overuse condition leading to inadequate tendon repair that predisposes the tendon to microtears and degeneration.

client having shoulder massaged

Nerve Entrapments

Neurological conditions can present in many forms either a pinched nerve or stemming from the central nervous system or metabolic/endocrine disease. Chiropractors are extensively trained in the assessment and diagnosis of such conditions, and are able to refer to an appropriate healthcare provider when needed or for additional imaging. Nerve entrapment (or “pinched nerve”) can occur when pressure is applied to a nerve by a structure or tissue including bone, cartilage, muscles or tendons. Yet, entrapment can also be secondary to other factors such as pregnancy due to the increase in water retention and swelling.

elderly woman with hurt hand

Have Questions? Here's what you can expect from your first visit

Dr Zuback may be treating your back, neck, headache, or other area of pain, but first she needs a complete picture of your health history and current health in order to provide the best possible treatment for you. On your first visit she will take the time to hear about the details of your pain and use a comprehensive exam to help determine the cause of your pain/injury.

Following the first visit, you will receive a comprehensive report of findings, where your questions will be answered and your pain/injury better understood. Dr. Zuback will go over her recommendations of care based on the evidence, her clinical experience and your preferences and goals.

If a condition should be treated by another health care professional, Dr. Zuback will make a referral. Click "learn more" to get a better understanding of what you should expect during your first chiropractic visit.