Symptoms at admission to Altai coMra Center:

1. Subjective:

The patient - female, 32 - suffered from:

• numbness of the left arm, more in the elbow and fingers;
• pain in the left arm appearing frequently, especially when holding something like a knife or after staying long time in one position;
• restricted mobility of the left arm.

All these were in place since the time of the injury.

2. Objective:

The patient was in good general condition.

Her local status as detected by MD was:

• No palpatory pain in the left arm;
• no oedema;
• no painful spots;
• mobility of the left arm restricted to 50-60% of the normal range in all planes;
• stiffness and blocked muscles under right scapula.

History of the disease:

Three months ago at home the patient fell from a chair on the floor and instinctively leant on her hand and forearm. As a result the left arm swelled.

X-ray scan was done to check for fracture.

No fracture was found and the diagnose was: Bruise of the left forearm and hand.

Following MD's prescription, the patient treated herself at home for 4-6 days with pain-relief drug (Pentalgin) and nonsteroidal anti-inflammatory drug (Ibuprofen).

No further examinations were performed.

Diagnosis:

1. Main Diagnosis:

• Post-Traumatic Neuropathy of the ulnar and radial nerves, as a consequence of a bruise of the left forearm.
• Moderate periodic pain syndrome: 3-4 points by the Visual Analogue Scale.

2. Other Diseases:

• Dorsopathy of the cervical-collar region;
• Myotonic syndrome;
• Hypothyroidism: sub-clinical, stable.

3. Rehabilitation Diagnosis:

The accident caused:

• Functional limitation of the movements of the left arm;
• Moderate pain syndrome, occurring frequently at all times of day and night and during movement;
• Deterioration of the quality of sleep due to pain;
• Worsening of the other disease in the neck spine region;
• Limitation of the social activity.

Treatment:

1. Treatment Goals:

First treatment course aimed at:

• Reducing the pain;
• Reducing the numbness of the left arm;
• Reducing the post-traumatic ischemic damage (pressure) of the nerve plexus in order to restore the movement of the left arm and prevent the appearance of contractures in the muscles of the left arm.
• Restoring the quality of sleep;
• Containing the other disease through minimising the consequences of the trauma;
• Improving the general quality of life.

2. Treatment at Altai coMra Center:

The first Treatment Course consisted of 10 treatments once a day for 10 days. coMra Pro 905 Medical was used. Each treatment session consisted of:

• Traumatology 4 on the left side;
• Traumatology 5 on the left side;
• Scanning of the left forearm and hand for 10 minutes at Variable frequency;
• Scanning of the right subscapular region (under the scapula and along it) and to the right of the spine for 10 minutes at Variable frequency;
• EHF (extremely high frequency) therapy at 3 points of the left elbow for 10-15 minutes (done every second day);
• Massage of the whole left arm - from the fingers up to the shoulder and collar region, and chest spine region.

3. Home Treatment:

The patient was instructed and trained to regularly perform special exercises for restoring the range of movements of the left arm.

Note: no pain-relief medications were applied.

During the first Treatment Course the patient noticed:

• From day 1 to day 3: steady decrease of the pain in the arm (she felt it somewhere inside), increase of the range of movement, better sleep;
• From day 4 to day 5: temporary increase of the pain in the elbow and sharp pain piercing the entire arm;
• From day 6 onward:
  • decrease of the pain in the arm and back until those completely disappeared;
  • she could better straighten her left arm;
  • numbness of the fingers disappeared;
  • her sleep improved;
  • she could feel lightness in the neck region and between the scapula.

Results:

After the first Treatment Course the patient reported great improvement of her condition:

• The pain in the left arm disappeared;
• The numbness of the fingers of the left hand disappeared;
• Better straightening of the left elbow joint;
• Better sleep.

The examination of the local status after the first Treatment Course revealed:

• No palpatory pain;
• Range of motion of the left arm restored up to 85-90% on all planes.

Conclusion: The goal of the first Treatment Course was achieved.

After the first Treatment Course the patient was advised to:

• Repeat the same Treatment Course after 2,3 weeks, but no later than 3,4 months;
• Repeat the Course each quarter of the first year and after that when she feels like it;
• Continue performing at home the exercises for developing and strengthening the muscles of the upper torso she has been taught at Altai coMra Center.
• Undergo a course of paraffin therapy on left forearm for 15 to 30 minutes daily at home;
• Undertake clinical general physiotherapy courses twice a year;
• In case of symptoms in the following 6 months,undergo Electromyoneurography (EMNG) of the left ulnar and radial nerves and their branches;
• Include physical activity in her lifestyle, like for example walking, swimming, workout, yoga etc; possibly under the supervision of a trainer;
• If needed, use elastic bandage on the arm when performing monotone movements for long time;
• Use of medication is not recommended.
• She could use some vitamins and food additives like for example B, E, A vitamins, aloe, caripain solution, nicotinic acid, glycine, magnesium, selenium, etc.

Follow-up:

The patient did two more coMra Treatment Courses 2 and 4 months after the first one.

These courses were mostly for settling the case and prevention, because the symptoms entirely disappeared towards the beginning of the second course, that is, two months after the beginning of the treatment.

After the third and final - prophylactic - course the patient reported full restoration of the function of her left arm and full restoration of her social activity.

Case provided by: Dr Anna Surazakova, MD
Country: Altai, Russia