Synergy Healthcare: Shoulder, Elbow Wrist Pain

The Chronicle Getting You Back on Track

“Focus More on The Holidays &Less on Pain!” SHOULDER, ELBOW&WRIST PAIN

You try to get through the day, but that nagging pain in your shoulder, elbow or wrist just keeps your attention focused on it. It sure is hard to concentrate on work, your family, and other activities you need to do! It is common to fixate on the body part that hurts. It is often thought that because it hurts there, the problem is right there. However, this is typically not the case, as the cause of the problem is in another area. The body part that is painful is usually the one that is doing all the work, because other areas are not doing their job.

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Inside This Newsletter • Guest Spotlight • Patient Success Spotlights • What Is Causing Your Shoulder Pain? • Come to a Free Workshop

The Chronicle Getting You Back on Track

“Is Pain Relief on Your Resolutions List? SHOULDER, ELBOW&WRIST PAIN

Why it hurts The body is truly amazing, and all the parts work together as one whole. However, when an area of your body becomes weak or stiff because of poor posture, stress, or injury, other areas feel strain from the overwork. A common word that is used for this type of repetitive injury strain is called “tendinitis”. This is simply an inflammation of the tendons, which attach muscles to bones. The upper extremity works in 3 parts: the shoulder, elbow, and wrist.They rely on each other to make the incredible movements of your arm so you can reach, grasp, and do ordinary daily tasks we take for granted. Proper movement relies on your posture to be in good order. When you slouch or do a repetitive task, like reaching across your desk, certain muscles can become too tight or strong while others become weak. This muscle imbalance leads to that area not working as well as it should. For example, you sit at a desk all day and you slouch your shoulders. Now, your shoulder doesn’t work as well, but you still move your mouse

around with your arm, which causes your wrist and forearm muscles to overwork. As this happens over time, you start to notice aches and pains in your wrist and elbow. If this goes on too long, it becomes severe and you need to seek out medical help. Solving the problem Typically a brace may be put on the area, but that does not solve the cause of the problem. The real reason can be because your shoulder was stiff and weak from slouching. An expert physical therapist has the right medical training to spot where your posture is not optimum and how you are compensating. With the right evaluation and treatment from the experts at Synergy Healthcare, you can relieve your shoulder, elbow, or wrist pain quickly and be back to doing what you like to do. Our home programs make it easy for you to maintain your gains and stay well for the long haul. Call us today to learn more about how we can relieve your pain and get you back to enjoying your activities.


The majority of pain that travels to your shoulder from your neck is referred pain. Your shoulder may not necessarily be the problem. In fact, only the first 10 degrees of movement in your shoulder come from your shoulder joint. The rest relies on the movement of your upper back, neck, shoulder blade, and collar bones. If these areas work incorrectly then shoulder pain can occur. Most neck and shoulder pain is a result of prolonged poor posture, lifting heavy objects, and minor falls or injuries. These irritate the joints in the neck and upper back. This then makes the muscles around the upper back and shoulder tighten and become sore. Suddenly, you now have neck and shoulder pain. There are many nerves that come off of the cervical (neck) vertebral bodies that pass down in front of the shoulder heading towards the arm. Irritation of these nerves can refer pain to the shoulder. Poor posture, especially with sitting at work or at home, can cause this to occur. Rotation of the neck or tilting of the neck may create your shoulder pain if these nerves are involved. It is important that a physical therapist examine you thoroughly if you are experiencing these symptoms. If you have had a fall or injury and suddenly develop shoulder and neck pain, seek help immediately. Any injury may affect the many sensitive structures in your neck and upper back. Shoulder and neck pain, if they occur together, may relate to disc injuries. This is more likely if you are having neck and arm pain, rather than just shoulder pain. Pain that travels down the arm to any extent may indicate more severe problems.

Shoulder pain can result in restricted movement of your body. Pain involves the nervous system, immune system, digestive system, and respiratory system. To avoid referred shoulder pain or any kind of referred pain, you should have a strong immune system for prevention of diseases. A strong body can fight infection or disease and can enhance the functioning of all the body systems. A balanced diet, regular physical therapy exercises, and a stress-free mind are the keys to maintaining an active life. If you are experiencing shoulder pain, consult one of our expert physical therapists for a full evaluation to determine where your problem is originating from, so correct treatments can be applied to help you.

each of these systems helps us live healthier, happier lives inside and out. It’s my passion to teach tips and techniques for healing that can be easily integrated into everyday life. Qigong is one of the most impactful parts of my health care routine. I feel it helps me in all the activities I love to do: snowboarding, longboarding, rock climbing, hiking, biking - really all the year round play I can find. Qigong is the art of cultivating life force energy and bringing

Guest Spotlight

Marcus Munro, Licensed Massage Practitioner

Hi, my name is Marcus Munro. I have been in the health and wellness field since 2007 and a licensed massage practitioner since 2011. I began my journey after a motorcycle accident left me with severe tissue damage to my left leg. Iknew thiswasapivotalpoint inmy life.After receivingaprofessional massage, I was hooked! I felt how beneficial massage was for the healing process and knew it was something I was meant to share with others. After graduating from massage school in 2011, I began studying various styles of massage and bodywork including Ashiatsu (deep tissue massage with feet), Thai Massage, Hot Stones, Fire Cupping, stretching, mindfulness, emotional wellbeing, and Qigong. The more I studied the more I began to understand just how multidimensional we all are. We are mental, physical, emotional, and spiritual beings. Sustaining an injury in just one area can affect the restof thesystems, latermanifestingaspoorhealth.Strengthening

the mind, body, and spirit into harmonic balance. This is done through slow, purposeful movements, focused mind, and meditative breath. It is an ancient Chinese practice with the intent of accessing higher realms of awareness and assisting in the awakening of one’s true nature. It allows one to tap into their own natural healing ability through the activation of the parasympathetic nervous system. Benefits include increased vitality and improved immune, cardiovascular, and digestive systems, plus many more. I hope you’ll come and join me on a journey of self-discovery.

CDA (208) 666-0611

VALLEY (509) 413-1630 CALL TODAY!

Patient Success Spotlight

“I came in for physical therapy after a double mastectomy. I was having axillary cording issues and my expansion process was painful as a result. I also couldn’t lift my arms, which was a problem because it’s required for radiation therapy. Within a couple weeks, I was able to get the full range of motion required for radiation. My range has since returned to normal, and areas of scar tissue buildup that were painful have been taken care of. The ladies here at Synergy were concerned with my full care and what I wanted to accomplish for long term careand results. I would fully and happily recommend Synergy to anyone recovering from major surgery affecting range of motion. Everyone here has been attentive and caring and I am very pleased with my results. ” - Jennifer “I was able to get the full range of motion required for radiation!”

Aiko, Jennifer, and Shauna dressed for Halloween.

Always learning…Always growing…


ATTENTION PAIN SUFFERERS! Do you want a natural solution to your pain?

“You Help Us, to Help Others”


QIGONG Mondays 1-2 PM RESTORATIVE/GENTLE YOGA Wednesdays 3-4 PM • Natural relief for aches and pains • Less difficulty in reaching or bending • More social activity • More energy • More strength

FELDENKRAIS Tuesdays 12:15-1:15 PM GENTLE FLOW YOGA Fridays 2:30-3:30 PM

Thanks to all those who referred a friend or family! You will receive $20 Synergy Bucks – equivalent to cash to spend on services and products at Synergy! Below is a list of our most current Synergy Buck recipients. Thanks, everyone, for trusting us with your friends and family.


Rebecca S. Rachel B. Amy T. Tori F. Lisa M.

Bobbie A. Nicole A.

Brandon D. Kathleen S. Lawrence M. 12012EMissionAve SpokaneValley,WA99206

Synergy Healthcare can further assess your needs. Contact us today!


The Chronicle Getting You Back on Track

Hello everyone, I hope this season finds you well. I wanted to share with you an update on one of our staff, Kerri Lewis, who’s in need of support because of some family medical emergencies. But before I tell you what she needs, I want to let you know what she means to Synergy. Kerri came into my orbit about three years ago. She was seeing me because she was struggling with headaches and neck pain. She’s an occupational therapist like me, a specialist in her field. She lives in the Coeur d’Alene area and has quite a reputation for helping families and children who have sensory processing disorder. Kerri felt that she needed to expand her knowledge base and make a change in the way many services were being provided to children and families in the community. She was about to lose the job she was in because the owner was closing the practice to relocate. Because Kerri’s skills and reputation were so strong, I encouraged her to start her own practice. She was reluctant to do so, as are many smart therapists, lol. So being the adventurer and risk taker that I am, I said, OK, let’s start a practice for you. I have run two practices before, and knew I was not up to the challenge of creating another whole clinic from scratch. So we decided to keep it small, just a simple business with her as the only therapist. What could go wrong? Well, the trouble with Kerri is that people like her. Lots of people. She had more business than she could handle and soon other therapists were seeking her out. Finding good therapists has always been the hardest part of my job, so when excellent people called her looking for work, what choice did we have? We hired them. And moved into a larger building. And got more computers, equipment, etc. Somehow we even acquired a rabbit and 2 dogs! I gave her my business acumen, my marketing ability, my system implementation, and my pocketbook so that she could buy what she needed to create an environment where children could get the kind of care that she felt they needed to get. She provided the vision, and it was that vision that attracted so many families that needed her help, and so many other therapists to help do the work. She put everything into this dream of hers, so much time and so much of herself. Kerri understood what was most important to therapists, families, and children in order to have kids be successful at home and in their community. Unfortunately, in July of 2016, Kerri’s son Blake became very sick with pediatric acute-onset neuropsychiatric syndrome (PANS), and with the stress of his illness her own health problems increased as well, including being diagnosed with Lyme disease. She needed to cut back on the running of the clinic and we asked William Strong, SLP to run it for a while. They both have done great things and Synergy pediatric therapy in Coeur d’Alene has grown from nothing in June of 2015 to over 400 visits per month in 2½ years. I believe we’ve created something pretty special, in no small part due to Kerri. Our staff has been given the opportunity to share their accrued PTO with her. We as a Synergy family are helping as best we can but we knew that there were some that would want to help also.

My request to you is simple: If you have been supported and helped by someone in our Synergy family, we are reaching out to you if you are willing and able to support and help one of our own. Kerri has set up a Go Fund Me account to help with her son’s and her own medical treatment expenses. To date they have raised about $10,000 of the $75,000 that they need to get them both well again. We are including the PANS article again so you can see with what her family is struggling with. She has included a lengthy description of her situation on the gofundme website. Our newsletter goes out to about 1300 people and if everyone contributed $50 we would be done! We know some can do more, and others less. Everything helps, and we are so grateful for you thinking of her. Here is the link: https://www.

We wish you the very best in this holiday season.

Shauna Burchett Occupational Therapist, Owner

VALLEY SPECIALIZING IN: Lower Back Pain • Headaches & Neck Pain • Sciatica & Hip Problems • Stenosis • Shoulder Pain & Tendonitis • Knee Problems • Concussion & Traumatic Brain Injury • Scar Tissue Lymphedema • Myofascial Release • Craniosacral Therapy • Feldenkrais CDA SPECIALIZING IN: Sensory Integration/Processing • Listening Therapies • Gross Motor & Coordination Skills Development • Myofascial Release • Fine Motor/Visual Motor Skill Development • Oral Motor/Oral Sensory Development • Play Skills • Speech/Articulation Development Expressive-Receptive Language Therapy • Literacy Development Cognitive Development • Social Language Skills • Craniosacral Therapy • Visual Perception/Visual Processing • Lymphatic Drainage Therapy

What are PANS and PANDAS Conditions?

PANS and PANDAS are infection-induced autoimmune conditions that disrupt a patient’s normal neurologic functioning, resulting in a sudden onset of Obsessive Compulsive Disorder (OCD) and/or motor tics. PANS and PANDAS can include a variety of other symptoms, such as anorexia (food restrictions), anxiety, irritability, hyperactivity, sleep disturbances, mood swings, and urinary problems. PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infection. It is an autoimmune condition initially triggered by strep infections, which disrupts a child’s normal neurologic activity. PANS is an acronym for Pediatric Acute-onset Neuropsychiatric Syndrome, which is associated with a variety of different infections, whereas PANDAS is a disorder associated with only streptococcal infections—specifically group A strep. Although the etiology for PANS is different from PANDAS, the symptom presentation is nearly identical. The Difference Between PANS and PANDAS PANDAS is when specifically strep is connected to the sudden onset of OCD and/or tics along with other listed clinical symptoms. PANS removes the emphasis on the etiologic factor and concentrates on the clinical symptoms. PANS can be triggered by any infectious agent (NOT only strep) in addition to non-infectious triggers which are yet to fully determined, but may include metabolic disorders and environmental factors. Symptoms cannot be explained by any other neurological or medical disorder. Children with PANS and PANDAS Are Often Misdiagnosed All too often, children with PANS and PANDAS are misdiagnosed as having a psychiatric illness and may be treated solely with psychotropic drugs to manage their symptoms. Unfortunately, for PANS and PANDAS patients this does not address the root cause of the symptoms, which is an infection- triggered autoimmune condition. Studies have shown that when given appropriate anti-infective and/or immunological treatment, PANS and PANDAS patients experience symptom resolution, or their symptoms are dramatically reduced. Obtaining a correct diagnosis can be challenging, because PANS and PANDAS symptoms can mimic other illnesses. What Should I Do If I Think My Child Has PANS or PANDAS? Parents whose child has a dramatic onset of OCD, suddenly restricts their food intake, exhibits tics, and/or is also experiencing sudden severe neuropsychiatric conditions – anxiety, irritability, uncontrolled emotions, and/or depression – should have their pediatrician refer their child to our clinic for an urgent visit, and test their child for both a throat strep culture and a peri-anal rapid strep test. If the rapid strep is negative, ask for a strep culture. If any of these tests are positive, the child needs to

be put on antibiotics for strep. If strep is negative, the child should have blood tests for strep. If the child has had or been exposed to an illness with prolonged coughing, then your pediatrician may consider testing for a bacteria called mycoplasma. What is the Prognosis for a Child with PANS/PANDAS? For children who are diagnosed early and a cause has been identified, the prognosis can be very good. Some patients respond quickly and are back to 100 percent normal function, but that doesn’t happen for everybody. For those in whom the cause is unknown and who don’t respond as well to antibiotics, we continue to treat the children and work with their families to address their illnesses. Synergy Healthcare offers effective services for children suffering from neurologic conditions, like PANS and PANDAS. Our therapists are well experienced and trained in treating your child. We can also perform tests to determine if the brain is processing what your child is hearing. We offer age-appropriate tests for infants and children. From about 6 months of age and older, behavioral testing can be conducted. The testing process is safe, painless, and fast! Contact our office today to start treatment.


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