University of Pittsburgh

Causes of Upper Limb Pain I

Causes of Upper Limb Pain

As a wheelchair user, you know that transfers are essential for everyday living. On average wheelchair users perform 15-20 transfers every day. Unfortunately, the high number of required daily transfers makes individuals with SCI highly susceptible to upper limb injury and pain.

Many people develop pain in their wrist, elbows and shoulders after experiencing a spinal cord injury. This is caused by the increased amount of pressure that you place on your joints, muscles and nerves when using a wheelchair or transferring from one surface to another. Below is a list of common problems people have once they start using their wheelchair on a regular basis. It is possible that changing your transfer technique may help to decrease the likelihood that you will develop these types of injuries.

Carpal tunnel syndrome

  • Carpal tunnel syndrome occurs at the wrist and is a problem with the median nerve
  • The median nerve provides feeling to the thumb, index and middle fingers, and half of the ring finger. It also controls several muscles in the hand, the most important of which allows the thumb to touch the little finger.
  • This nerve passes through a narrow passage in the wrist called the carpal tunnel along with several muscle tendons which enable you to curl your fingers and make a fist.
  • When these tendons and other tissues in the carpal tunnel surrounding the nerve swell up or are inflamed, they put pressure on the nerve and cause it to malfunction. This pinching on the nerve, in turn, produces numbness, tingling, pain and weakness in the fingers, and eventually produces loss of grip strength.

  • Carpal tunnel syndrome is a repetitive strain injury, meaning the symptoms are caused by repeated movements and can get worse with continued wrist and hand use and overuse.
  • In persons with spinal cord injury, the most common cause of carpal tunnel syndrome is repeated use of your hands to to push your wheelchair or move from one surface to another. Symptoms of carpal tunnel syndrome can make it difficult for you to perform these tasks.

 

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