Dr. David Kulla, DC provides individualized evaluation and conservative care for shoulder, arm, elbow, wrist, and hand problems at Synergy Wellness Chiropractic & Physical Therapy in New York City.
With more than 26 years of clinical experience, Dr. Kulla evaluates musculoskeletal and nerve-related conditions that may cause pain, stiffness, weakness, numbness, tingling, or loss of function in the upper extremity.
Our Manhattan office is located at 237 First Avenue near East 14th Street, convenient to Union Square, the East Village, and Gramercy.
What Causes Shoulder, Arm, Elbow and Hand Pain?
Upper-extremity symptoms can originate from muscles, tendons, joints, ligaments, peripheral nerves, or the cervical spine. In some patients, more than one condition may contribute at the same time.
Common problems include:
- Rotator cuff irritation or tears
- Frozen shoulder, also called adhesive capsulitis
- Shoulder bursitis or tendon irritation
- Shoulder or elbow sprains and strains
- Tennis elbow or golfer’s elbow
- Carpal tunnel syndrome
- Peripheral nerve irritation or entrapment
- Cervical radiculopathy
- Neck-related arm symptoms
- Arthritis and degenerative joint changes
- Sports and repetitive-use injuries
- Traumatic injuries involving the shoulder, elbow, wrist, or hand
The Brachial Plexus and Upper-Extremity Symptoms
The brachial plexus is a network of nerves that begins in the neck and carries motor and sensory signals to the shoulder, arm, forearm, and hand.
These nerves can be stretched, compressed, or injured by trauma. Symptoms depend on which portions of the nerve network are affected and may include burning pain, numbness, tingling, weakness, or loss of function in part of the upper extremity.
A true brachial plexus injury can range from a temporary “stinger” or “burner” to a significant neurological injury requiring medical or surgical evaluation.
Can Neck Problems Cause Arm or Hand Symptoms?
Yes. Nerves that supply the shoulder, arm, and hand originate from the cervical spine. A cervical disc problem, degenerative narrowing, or irritation of a cervical nerve root can sometimes produce symptoms that travel into the shoulder, arm, forearm, or hand.
Symptoms may include pain, numbness, tingling, weakness, or changes in reflexes. This is commonly referred to as cervical radiculopathy.
Because cervical nerve symptoms can resemble conditions such as carpal tunnel syndrome or other peripheral nerve problems, the location of the nerve irritation should be evaluated rather than assumed.
Shoulder Pain and Rotator Cuff Problems
The rotator cuff is a group of muscles and tendons that help stabilize and move the shoulder. Rotator cuff problems are a common source of shoulder pain, especially during reaching, lifting, overhead activity, or sleeping on the affected side.
Depending on the condition, symptoms may include:
- Pain with lifting or reaching
- Nighttime shoulder pain
- Weakness
- Reduced range of motion
- Pain when lowering the arm
- Difficulty performing work, exercise, or daily activities
A physical examination can often provide useful information about the shoulder. Ultrasound or MRI may be appropriate when a significant rotator cuff tear or other structural injury is suspected.
Frozen Shoulder
Frozen shoulder, or adhesive capsulitis, causes progressive pain and loss of shoulder motion. Both active movement and movement performed by an examiner may become substantially restricted.
The condition frequently develops gradually and can persist for many months. Treatment often focuses on restoring motion, reducing pain, and gradually improving shoulder function.
Physical therapy, mobility exercises, and other conservative approaches may be incorporated depending on the patient’s stage of the condition and tolerance.
Elbow Pain
Elbow pain may arise from tendons, muscles, joints, ligaments, or nerves.
Common conditions include lateral epicondylitis, often called tennis elbow, medial epicondylitis, sometimes called golfer’s elbow, repetitive strain, arthritis, and nerve irritation.
Treatment is based on the specific diagnosis rather than treating every elbow condition the same way.
Hand Numbness and Carpal Tunnel Syndrome
Carpal tunnel syndrome occurs when the median nerve is compressed at the wrist. It commonly produces numbness or tingling in the thumb, index finger, middle finger, and part of the ring finger.
However, hand numbness can also originate from the neck, elbow, another peripheral nerve, diabetes, neurological conditions, or other causes.
For this reason, Dr. Kulla may evaluate the neck, shoulder, elbow, wrist, and hand when determining the likely source of upper-extremity symptoms.
How Are Shoulder, Arm and Hand Problems Evaluated?
Dr. David Kulla, DC performs an individualized examination based on the patient’s symptoms and history.
The evaluation may include:
- Health and injury history
- Shoulder, elbow, wrist, and hand range of motion
- Muscle strength testing
- Orthopedic examination
- Neurological testing
- Reflex and sensation assessment
- Cervical-spine examination when nerve symptoms are present
- Evaluation of posture and upper-extremity mechanics
- Review of previous MRI, X-ray, ultrasound, or electrodiagnostic studies
Additional imaging or nerve testing may be recommended when examination findings suggest a significant tendon tear, fracture, nerve injury, or other condition requiring further evaluation.
Conservative Treatment Options
Treatment depends on the diagnosis, severity, neurological findings, activity demands, and individual goals.
Care at Synergy Wellness may incorporate:
- Physical therapy and rehabilitation
- Therapeutic exercise
- Shoulder and upper-extremity mobility work
- Strengthening and stabilization
- Soft-tissue techniques
- Chiropractic care when cervical or joint mechanics are relevant
- Ergonomic and activity modification
- Cold laser therapy when clinically appropriate
The goal is to address the structures and functional limitations identified during the examination rather than assuming every upper-extremity problem originates from the spine.
Physical Therapy for Shoulder and Arm Problems
Physical therapy may be particularly useful for conditions involving weakness, restricted motion, tendon injury, frozen shoulder, repetitive strain, or recovery following injury or surgery.
Rehabilitation may focus on restoring range of motion, strengthening the rotator cuff and shoulder-blade muscles, improving joint control, and gradually returning the patient to normal work, exercise, or sports activities.
Chiropractic Care for Upper-Extremity Symptoms
Chiropractic care may be considered when examination findings indicate that restricted joint motion, cervical-spine dysfunction, or other mechanical factors are contributing to the patient’s symptoms.
Depending on the condition, treatment may include gentle joint mobilization, manipulation, soft-tissue treatment, exercise, and rehabilitation.
Chiropractic treatment should not replace appropriate orthopedic, neurological, or surgical evaluation when significant structural or nerve injury is suspected.
When Shoulder or Arm Symptoms Require Prompt Medical Evaluation
Seek prompt medical evaluation for:
- Sudden or progressive arm or hand weakness
- Complete or significant loss of sensation
- Major trauma, deformity, or suspected fracture
- Inability to raise or use the arm following an injury
- Significant swelling, discoloration, or loss of circulation
- Severe burning pain or weakness after a neck or shoulder injury
- Rapidly progressive muscle wasting
- Symptoms involving both arms together with balance or walking problems
Arm or shoulder pain accompanied by chest pressure, shortness of breath, sweating, nausea, fainting, or other possible cardiac symptoms requires emergency medical evaluation.
Shoulder, Arm and Hand Treatment Videos
These videos from Dr. David Kulla and Synergy Wellness discuss shoulder and upper-extremity conditions and conservative treatment approaches.
Schedule an Upper-Extremity Evaluation in New York City
If you are experiencing shoulder pain, elbow pain, wrist pain, hand numbness, weakness, tingling, stiffness, or reduced mobility, Dr. David Kulla, DC can evaluate your condition and help determine appropriate next steps.
Synergy Wellness Chiropractic & Physical Therapy
237 First Avenue, 5th Floor
New York, NY 10003
Near East 14th Street in Manhattan
Call (212) 533-4900 or book an appointment online.