Anserine bursitis is most common in obese, middle-aged to elderly women with knee osteoarthritis. Other predisposing factors include genu valgum, hamstring contractures, and an out-toeing gait. Patients complain of medial knee pain that can sometimes radiate to the posterior medial thigh. It is accentuated with stair climbing. On examination, pain and tenderness are localized to approximately 3 to 5 inches below the medial knee joint line. Treatment consists of NSAIDs, stretching exercises of the adductor and quadriceps muscles, and corticosteroid injection into the bursa. 9
Tendonitis, more properly termed tendinosis, results from acute or chronic stress of the rotator cuff tendons. Rotator cuff impingement results from repeated irritation of the rotator cuff beneath the acromial arch. 20 Repetitive overhead reaching and weight training are frequent precipitants of rotator cuff tendinosis and impingement. Rotator cuff tendinosis is diagnosed by eliciting pain or weakness with stress testing of the rotator cuff muscles. There are two common tests used for diagnosis of impingement. The Hawkins' test elicits pain with the shoulder passively flexed to 90 degrees and internally rotated. 21 The Neer's test elicits pain with passive abduction of the shoulder to 180 degrees. 22 Radiographs, if obtained, may show calcific deposits in the subacromial space or at the insertion of the supraspinatus tendon to the greater tuberosity. In cases of impingement, curvature of the acromion process may be seen.
tingling in right thumb and index finger
While lifting weights during my regular exercise, I felt pain in my right shoulder and Bicep, but no tingling. My Orthopedic Doctor ordered an MRI that I had done the same day.
The very next day, before I could see the Orthopedic Doctor for MRI results, I had Shingles in my right arm. The shingles took 4 weeks to clear and the pain in shoulder/bicep continued.
Also, in the third week of Shingles, I started having tingling in my right hand thumb and index finger. When I saw the Orthopedic Doctor again. He said the MRI report showed Impingement Syndrome (IS) and possibly Carpal Tunnel Syndrome (RTS). He sent me to a Neurologist and prescribed Physical Therapy for IS and CTS.
The Neurologist did not find either IS or RTS. I am going through Physical Therapy for strengthening the shoulder rotator cuff and eliminating tingling. As part of therapy to reduce tingling, I am going through a 20 minutes Neck Traction that involves a 60 seconds pull and 30 seconds relaxation cycle.
Although my tingling is almost gone, I am concerned about adverse effects of the Neck Traction.
I have 3 more sessions of physical therapy left. Could you please advise me whether I should continue with the Neck Traction.
Most usually, when you have two conditions in the same arm, like IS and CTS, then the likelihood of a fixated first rib, or cervical facet syndrome is high. Unless these underlying causes are corrected, the arm stuff will continue. Do you have any associated neck pain?
There is no research confirming that neck traction, intermittent or continous, helps. That doesn't mean that it doesn't help, but the research is not there. My own experience is that continous traction PLUS release of those subluxations in the lower neck is beneficial, but on its own has minimal if any benefit. I know of no adverse affects of neck traction, done at the correct force. Something is obviously helping, so I'd stay with the programme.
You can make a home traction unit, if you are handy. https://-/Home-traction-
Does placing your hand on your head relieve or aggravate the tingling in your hand? https://-/Shoulder-Abduction-
It is indeed confusing that the two specialists are not in agreement.
The shingles probably is an incidental event, but confirms that you or your neurological system are under stress.
The fact that the tingling is very specificaly in the C6 dermatome (thumb and forefinger) definitely points to your neck.
I hope this has contributed.
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