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Back behind the wheel: Is your arm pain a ‘pain in the neck?’

Upper back pain, neck pain and pain between the shoulder blades are common problems seen in the trucking industry.Shifting, sitting with poor posture, constant vibrations and stress combine to create ...



Upper back pain, neck pain and pain between the shoulder blades are common problems seen in the trucking industry.

Shifting, sitting with poor posture, constant vibrations and stress combine to create a perfect recipe for these types of complaints. Common conditions that I see with drivers in my office include spinal joint dysfunction, myofascial (muscle) pain, repetitive strain/sprain injuries and impingement syndromes.

The spine is divided into five regions; the cervical, thoracic, lumbar, sacrum and coccyxgeal region. The neck is known as the cervical region and the area from the top of the shoulders to the lowest part of the rib cage is the thoracic region.

Each thoracic vertebrae has a left and right rib attached to it.

The lower cervical spine can contribute to pain in the upper back.

The joints can become inflamed (facet irritation), discs can be herniated (rare), and improper motion can lead to joint and muscle dysfunction.

Have you ever slept wrong or turned your neck too quickly and then suddenly realized that you can no longer turn your head enough to check your blind spot?

When this happens, it is usually due to abnormal motion of the joints of the neck.

Pain is very sharp and is usually localized to the neck and occasionally spreads into the shoulder. It is important to determine the cause of your pain, in order to correct it and to prevent it from happening again.

Myofascial (muscle) pain is another source of neck and upper back pain.

The trapezius muscle (the large muscle mass between your neck and shoulders) contributes to a large proportion of discomfort in the upper back area. When you are stressed, gripping that wheel, or have your arm on the window ledge this muscle is contracted.

Constant contraction

This constant contraction can cause tight muscles with round pea sized nodule/lumps in them called trigger points. An active trigger point is a focus of hyperirritability (sore spot) in a muscle that causes pain and tenderness whether you are moving or not. That tender spot in your muscle that is always there, that dull achy feeling that you can never get rid of, is a trigger point. Sound familiar?

Don’t worry – you are not alone. A study done in Denmark showed that 37 per cent of males and 65 per cent of females have localized myofascial trigger points. I suspect that in the trucking industry the prevalence of trigger points is a lot higher due to the nature of the job. What causes these trigger points? Stress, poor posture, tight and fatigued muscles are all common causes.

Tennis elbow (trucker’s elbow) is a tendonitis of the forearm extensor muscles. The ending “-itis” means inflammation (or swelling). Appendicitis means inflammation of the appendix, laryngitis means inflammation of the larynx or throat, and gingivitis means inflammation of the gingiva or gums. Tendonitis means inflammation (swelling) of a tendon.

A tendon is a thick tissue at the end of a muscle that connects it to the bone. Every muscle has a tendon at either end which connects it to two different bones.

Warning signs

When the muscle contracts (shortens) the bones are pulled together. If either tendon is not connected properly to the bone (ie. torn) no movement is possible. Inflammation is the body’s normal response to injury or too much physical stress. Inflammation usually causes pain.

This is the body’s way of warning you that something is wrong and to prevent you from moving the injured area in a way that may lead to more injury.

Too much stress on a muscle (ex: a pulled muscle) or repetitive minor stress on a muscle can lead to inflammation of the tendon of that muscle.

In the truck, shifting, pulling tarps/chains, cranking the landing gear or tightly gripping the wheel can lead to this type of injury.

What to do? Avoiding these repetitive motions will aid in the healing process. Applying ice to the area will help decrease inflammation and deep massage will ensure proper healing.

A customized stretching and strengthening program is also essential in allowing for proper healing and in preventing reoccurrences.

Tendonitis, if treated properly is easily managed.

However, if left untreated it can become a serious problem which can lead to other injuries.

Impingement syndromes are another common problem in the trucking industry, resulting in arm, hand and upper back problems.

When nerves and blood vessels are impinged (compressed/squeezed) the result can be numbness, tingling, weakness or heaviness in the arm or hand.

Carpal tunnel and thoracic outlet syndrome are just two examples of common impingement syndromes.

Whenever you experience pain or tingling in the arm or hand it is essential to determine the source of the problem. The pain can be coming from the arm itself, however the source of the pain is often the neck.

The nerves that travel down your arm and into your hand originate from the neck.

If there is a problem in the neck, the nerve can become irritated and can refer pain or tingling down into the arm.

A proper examination will help determine the real source of your pain and this is the first step in determining whether your arm pain really is a “pain in the neck.” Next month…low back and leg pain!

– Dr. Jerry Singh, B. Kin., D.C., runs Trans Canada Chiropractic at 230 Truck Stop in Woodstock, Ont. He can be reached at 888 252-7327, or e-mail singhjerry@hotmail.com.

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