Elbow Pain

Medial collateral ligament injury:

The ligament that provides stability to the elbow joint can be damaged by trauma to the elbow which is normally excessive outwards movement of the hand and forearm. This can lead to pain and excessive movement in the inner elbow if damage occurs. This can effect lifting and carrying with the arm.

Physiotherapy can provide diagnosis of the condition and the severity of the injury, provide an expert opinion on when to seek surgical opinion if the injury is severe and management of symptoms with soft tissue release, strengthening and taping. Pain can be managed with acupuncture if needed.

Ulnar nerve entrapment:

The ulnar nerve runs in a small groove between the bones of the inner elbow. This groove turns a tight corner and altered loading of the elbow, excessive repetitive activity or blunt injury can cause inflammation and trapping of the ulnar nerve. This commonly results in pain on the inner elbow that can radiate down the inside of the forearm, sometimes numbness in the 4th and 5th fingers and possibly weakness of the small muscles of the fingers with fine movements.

Physiotherapy techniques that may help include nerve gliding exercises, soft tissue massage techniques, joint mobilisations and taping. Your physiotherapist may also look at your neck to treat any central component of the nerve pain that could be causing the symptoms.

Referred pain from the neck

Some pain experienced in the upper limb can be caused by nerve injury or compression in the neck. This commonly occurs when a specific nerve root is involved, such as the C8 or T1 nerves which refer their pain to the inner elbow area. This pain can also be associated with burning, tingling or numbing sensations.

Your physiotherapist will be able to determine if your pain is referred from the neck and identify which structures might be causing the problem by assessing muscle length, disc and joint health and movement and nerve involvement. Your treatment with us can then be tailored to include nerve gliding exercises, neck mobilisations, soft tissue techniques and neck exercises.

Osteoarthritis of the elbow joint

This commonly occurs in older individuals but can occur earlier if there has been damage to the joint, heavy use or a family history. Symptoms include aching, stiffness and sometimes reduced movement of the joint with crepitus or loss of the ‘smoothness of movement’.

A physiotherapist can determine the possible causes contributing to the development of the arthritis and set you appropriate strengthening and stretching exercises. Techniques such as acupuncture, joint mobilisations and taping have also been shown to provide pain relief in osteoarthritis.

Medial epicondylalgia ‘golfers elbow’

The pain is located on the inner elbow and can radiate into the underside of the forearm. It is worsened by activities such as gripping and repetitive movements of the wrist and hand such as opening tins and golf. It has been known as ‘Golfers elbow’ in the past for this reason. The symptoms can be similar to ulnar nerve entrapment and so need to be clearly assessed and managed.

Physiotherapy techniques such as taping, massage techniques, ultrasound, joint/tissue mobilisations, mobilisations with movement and acupuncture can be used to relieve symptoms. A graduated exercise programme and activity modification can also be used by a physiotherapist to remodel the tissue and aid healing.

Rheumatoid Arthritis

Rheumatoid Arthritis is when the immune system goes haywire and attacks the body rather than defending it causing inflammation of the lining of the joints and tendons of the muscles. Affected joints in the body that have the arthritis become swollen, painful and stiff. Morning stiffness on waking is very common. Muscles around the joints often become weaker and doing certain activities of daily living can become more difficult.

We can provide experienced physiotherapists to see you at home and work with you to help manage your condition. The first time the physiotherapist visits they will carry out a thorough assessment which includes looking at your mobility and walking aids, muscle strength, joint movement, posture and function. Following the assessment the physiotherapist will discuss any treatments they can provide and set goals with you to improve your general function and mobility and achieve the maximum potential in your home, work and social life. These treatments can include advice on ice, exercise programmes, massage, taping, acupuncture and mobility programmes.

We can also provide occupational therapists to come to your home. They help people to regain the ability to carry out activities that have purpose and meaning to them and become or remain as independent as possible. Some of the services they can offer include:

• Home assessments including modifications such as rearranging furniture, building ramps, widening doorways, grab bars, special toilet seats etc
• Wheelchair assessments
• splinting

Fibromyalgia

This condition does not involve inflammation but affects the fibrous tissues in many parts of the body ie. tendons, muscles, connective tissue etc. There can be a large number of tender points and a feel of generalized aching. One of the common tender points is on the inside of the elbow. There a number of other symptoms including fatigue, sleep disturbances, sensitivity to temperature, morning stiffness, numbness and tingling, irritable bowel, depression and dry eyes and mouth.

Physiotherapy can help people with this condition. There are pain relieving techniques that can be used and they are experienced in pacing you back to being able to exercise again and return to activities whether sport, work or hobbies that you were able to do before the condition started. They also are able to provide advice on how to cope with your condition and manage flare ups of pain.

Chronic Pain

Acute pain is the pain we feel immediately after injuring ourselves and while the injury is healing. Chronic pain is pain that continues even though healing has occurred and it is not unusual to find no direct link between the pain and the original injury that may have healed a long time ago. Chemical changes happen in the brain and spinal cord to re-route signals to pain centres in the brain. Then any normal sensation such as a movement, touch, pressure, stretching etc can be felt as pain. In some instances the pain system can be activated without any physical stimulus ie changes in weather, mood, thoughts or no stimulus at all.

Physiotherapy for chronic pain has to involve many aspects and address other factors that come into play rather than just the pain itself. They will treat the pain and also use methods to help you manage your pain including advice on pacing and coping with flare ups and negative thoughts, graduated exercise programmes and goal setting. They will aim to return to you being able to participate again in activities you were involved in before developing chronic pain whether work, sport of hobby related. We can also recommend top Singapore pain consultants who can help you.

Other possible causes

Your physiotherapist will take a detailed history of your symptoms and past medical history before performing a full physical examination. There are a number of other possible causes of your symptoms which are not appropriate for a physiotherapist to treat in any way or that need a medical opinion alongside physiotherapy treatment. In this case they will recommend you to your GP or an appropriate specialist doctor or specialist consultant. These possible causes include:

• cardiovascular symptoms
• respiratory (breathing) symptoms
• gynaecological symptoms
• urinary or genital symptoms
• digestive symptoms
• immune system symptoms
• lymph system symptoms
• hormonal symptoms
• neurological symptoms
• dermatological (skin) symptoms
• medication side-effects
• virus
• infection
• cancer
• disease process
• psychological problem ie. depression, anxiety

Lateral Epicondylalgia (tennis elbow)

The pain is located on the outer side of the elbow and can radiate into the top of the forearm. It is worsened by activities such as gripping and repetitive movements of the wrist and hand such as typing and tennis. It has been known as ‘Tennis elbow’ in the past for this reason. The symptoms can be similar to radial nerve entrapment and so need to be clearly assessed and managed.

Physiotherapy techniques such as taping, massage techniques, ultrasound, manual treatment of to the joint/tissues and acupuncture can be used to relieve symptoms. A gradual exercise programme and activity modification can also be used by a physiotherapist, helping to remodel the tissue and aid healing. There is also a new treatment called electroshockwave therapy that can help this condition. We can recommend to you where you can have this treatment.

Superior Radio-Ulnar Joint Dysfunction:

This joint can be damaged by extreme twisting movements of the wrist such as with martial arts or trauma such as falling on an outstretched hand. Injury can include fracture or weakening of the ligament that holds the joint in place. X-Ray can exclude bony injury if significant enough but ligamentous injury may need full assessment by a physiotherapist, consultant or MRI to identify. We can recommend top Singapore consultants in this case. Injury leads to pain over the outside of the elbow, particularly with turning movement of the arm and gripping.

Physiotherapy techniques such as taping, mobilisations and strengthening exercises can be used to reduce symptoms.

Snapping Plica

The outside joint of the elbow between the end of the humerus and top of the radius has small synovial fold (plica). This plica can snap back and forth over the head of the radius. It can be caused by repeatedly bending and straightening in sport. There will be pain on the outside of the elbow and a snapping sensation when the elbow is bent.

Physiotherapy can help with advice on reducing the inflammation of the plica and avoiding aggravating activities. It may be recommended to have surgery on the plica and a medical referral is required to consider this option. We can recommend top Singapore consultants in this case.

Radial collateral ligament instability:

This ligament passes from the outside of the bottom end of the upper arm (humerus) to the head of the radius (main forearm bone). It can be injured with trauma to the elbow including extremes of golf or tennis swing. The pain will be catching in nature and may also be associated with a feeling of the elbow being unstable with clicking or clunking sensations.

Physiotherapy can identify the injury and level of instability, give you advice on when to consider a surgical option if the injury is significant and help on managing the symptoms. Many ligament injuries can be managed well with strengthening and control based exercises. If a medical referral is required we can recommend a top Singapore elbow consultant to you.

Pronator syndrome:

This is a condition in which the median nerve becomes pinched or trapped by the overlying musculature or tissue, commonly in the pronator muscles of the forearm. This muscle turns your forearm over so that your palm faces down. It is identified by an area of pain over the outer or front of the elbow but also by weakness in specific hand muscles used for gripping and sensory loss over the thumb and index finger due to the nerve compression.

Physiotherapy can provide symptom relief with soft tissue massage techniques, stretches, activity modification and advice on how to avoid the injury. Physiotherapy can also offer specific nerve gliding exercises to aid in the recovery of the nerve.

Fracture of the radial head:

The radial head can be fractured with heavy falls onto the hand or upper limb. This is commonly identified with an X-Ray and will present with pain over the outer elbow and forearm that is sharp on movement or with lifting and carrying.

Physiotherapy can aid in the healing and recovery after fracture by utilising joint mobilisation techniques to regain lost movement after being in plaster and using soft tissue techniques, to regain flexibility and strengthening exercises to provide support for the healing bone. Your physiotherapist can also provide you with loading exercises tailored specifically to the stage of healing to maximise bone strength. Sometimes there can be problems that interfere with the healing of bone and we can provide you with devices that have been proven to stimulate bony healing.

Osteochondritis dissecans

This is a result of the splitting of pieces of cartilage (lines the joint surfaces) into the elbow joint caused by repeatedly bending the elbow. Mostly likely is a dull ache and some swelling around the outside of the elbow. It becomes more difficult to straighten the elbow.

Physiotherapy can help by using anti-inflammatory treatments and advice on management to return to sport. Taping can be used to support the elbow during the healing process.

Pain referred from the neck (cervical referred pain):

Some pain experienced in the upper limb can be caused by nerve injury or compression in the neck. This commonly occurs when a specific nerve root is involved, such as the C5 or C6 nerves which refer their pain to the outer elbow area. This pain can also be associated with burning, tingling or numbing sensations.

Your physiotherapist will be able to determine if your pain is referred from the neck and identify which structures might be causing the problem by assessing muscle length, disc and joint health and movement and nerve involvement. Your treatment with us can then be tailored to include nerve gliding exercises, neck mobilisations, soft tissue techniques and neck exercises.

Osteoarthritis and Rheumatoid Arthritis

Osteoarthritis can occur in any joint in the body and is a the process of ‘wear and tear’ where the cartilage covering the area of bone that makes up the joint is gradually worn away over time. Rheumatoid Arthritis is when the immune system goes haywire and attacks the body rather than defending it causing inflammation of the lining of the joints and tendons of the muscles. In both conditions joints in the body that have the arthritis become swollen, painful and stiff. Morning stiffness on waking is very common. Muscles around the joints often become weaker and doing certain activities of daily living can become more difficult.

We can provide experienced physiotherapists to see you at home and work with you to help manage your condition. The first time the physiotherapist visits they will carry out a thorough assessment which includes looking at your mobility and walking aids, muscle strength, joint movement, posture and function. Following the assessment the physiotherapist will discuss any treatments they can provide and set goals with you to improve your general function and mobility and achieve the maximum potential in your home, work and social life. These treatments can include advice on ice, exercise programmes, massage, taping, acupuncture and mobility programmes.

We can also provide occupational therapists to come to your home. They help people to regain the ability to carry out activities that have purpose and meaning to them and become or remain as independent as possible. Some of the services they can offer include:

• Home assessments including modifications such as rearranging furniture, building ramps, widening doorways, grab bars, special toilet seats etc
• Wheelchair assessments
• Splinting

Chronic Pain

Acute pain is the pain we feel immediately after injuring ourselves and while the injury is healing. Chronic pain is pain that continues even though healing has occurred and it is not unusual to find no direct link between the pain and the original injury that may have healed a long time ago. Chemical changes happen in the brain and spinal cord to re-route signals to pain centres in the brain. Then any normal sensation such as a movement, touch, pressure, stretching etc can be felt as pain. In some instances the pain system can be activated without any physical stimulus ie changes in weather, mood, thoughts or no stimulus at all.

Physiotherapy for chronic pain has to involve many aspects and address other factors that come into play rather than just the pain itself. They will treat the pain and also use methods to help you manage your pain including advice on pacing and coping with flare ups and negative thoughts, graduated exercise programmes and goal setting. They will aim to return to you being able to participate again in activities you were involved in before developing chronic pain whether work, sport of hobby related. We can also recommend top Singapore pain consultants to help you.

Other possible causes

Your physiotherapist will take a detailed history of your symptoms and past medical history before performing a full physical examination. There are a number of other possible causes of your symptoms which are not appropriate for a physiotherapist to treat in any way or that need a medical opinion alongside physiotherapy treatment. In this case they will recommend you to your GP or an appropriate specialist doctor or specialist consultant. These possible causes include:

• cardiovascular symptoms
• respiratory (breathing) symptoms
• gynaecological symptoms
• urinary or genital symptoms
• digestive symptoms
• immune system symptoms
• lymph system symptoms
• hormonal symptoms
• neurological symptoms
• dermatological (skin) symptoms
• medication side-effects
• virus
• infection
• cancer
• disease process
• psychological problem ie. depression, anxiety

Triceps insertion tendinopathy:

The triceps muscle forms a thick tendon that inserts into the back of the elbow joint. This tendon can become overloaded or degenerate if used in repetitive activities, during heavy periods of gym and weights work and if the elbow tendon is leant on for long periods of time. The pain presents as a dull ache that may become sharper with loading activities. It is commonly localised to the back of the elbow at the tip.

Physiotherapy techniques such as specific soft tissue massage, taping, acupuncture and graduated loading exercises can help improve your pain, increase the function of the arm and aid in the healing of the tissue.

Bursitis:

Sometimes the bursa at the back of the elbow can become inflamed or irritated. This occurs with periods of leaning or repetitive use, commonly in a bent elbow position. The bursa is a small fluid filled sack that protects the insertion of the triceps tendon from rubbing on the underlying bone. Your symptoms may present as aching pain over the tip of the elbow that can be palpated.

Physiotherapy techniques such as taping, specific soft tissue techniques, biomechanical analysis of movement and strengthening exercises can be utilised to reduce the bursal irritation. Your physiotherapist can also advise you on activity modification and work station ergonomics to ensure that it doesn’t happen again.

Posterior elbow dislocation

This is an injury of the ligaments which leads to the ulna or radius or both dislocating backwards from the humerus. It usually occurs as a result of falling on an outstretched arm or if the elbow is bent backwards. It can also occur in some sports. The pain is normally severe with any attempt at moving the elbow and there will be a lot of swelling, Medical help is required to reposition the elbow and then it will need to be immobilised for period of time.

Physiotherapy is required to advise on swelling and avoiding aggravating activities and to later down the line to regain the movment of the elbow joint and the strength around.

Posterolateral rotatory instability of the elbow

The forearm bones slide below the bottom of bottom end of the humerus usually as a result of falling on an outstretched arm. Often there are snapping and locking sensations of the elbow which usually eases with time.

Physiotherapy can help with trialing strengthening exercises. If of no help then a medical referral is required and we can recommend a top Singapore specialist if this is the case.

Elbow fracture

Medical help is required with an elbow fracture.

Physiotherapy can aid in the healing and recovery after fracture by utilising joint mobilisation techniques to regain lost movement after being in plaster, soft tissue techniques to regain flexibility and strengthening exercises to provide support for the healing bone. Your physiotherapist can also provide you with loading exercises tailored specifically to the stage of healing to maximise bone strength. Sometimes there can be problems that interfere with the healing of bone and we can provide you with devices that have been proven to stimulate bony healing.

Pain referred from the neck (cervical referred pain):

Some pain experienced in the upper limb can be caused by nerve injury or compression in the neck. This commonly occurs when a specific nerve root is involved, such as the C7 nerve which refer their pain to the outer elbow area. This pain can also be associated with burning, tingling or numbing sensations.

Your physiotherapist will be able to determine if your pain is referred from the neck and identify which structures might be causing the problem by assessing muscle length, disc and joint health and movement and nerve involvement. Your treatment with us can then be tailored to include nerve gliding exercises, neck mobilisations, soft tissue techniques and neck exercises.

Rheumatoid Arthritis

Rheumatoid Arthritis is when the immune system goes haywire and attacks the body rather than defending it causing inflammation of the lining of the joints and tendons of the muscles. Affected joints in the body that have the arthritis become swollen, painful and stiff. Morning stiffness on waking is very common. Muscles around the joints often become weaker and doing certain activities of daily living can become more difficult.

We can provide experienced physiotherapists to see you at home and work with you to help manage your condition. The first time the physiotherapist visits they will carry out a thorough assessment which includes looking at your mobility and walking aids, muscle strength, joint movement, posture and function. Following the assessment the physiotherapist will discuss any treatments they can provide and set goals with you to improve your general function and mobility and achieve the maximum potential in your home, work and social life. These treatments can include advice on ice, exercise programmes, massage, taping, acupuncture and mobility programmes.

We can also provide occupational therapists to come to your home. They help people to regain the ability to carry out activities that have purpose and meaning to them and become or remain as independent as possible. Some of the services they can offer include:

• Home assessments including modifications such as rearranging furniture, building ramps, widening doorways, grab bars, special toilet seats etc
• Wheelchair assessments
• splinting

Fibromyalgia

This condition does not involve inflammation but affects the fibrous tissues in many parts of the body ie. tendons, muscles, connective tissue etc. There can be a large number of tender points and a feel of generalized aching. One of the common tender points is the elbow. There a number of other symptoms including fatigue, sleep disturbances, sensitivity to temperature, morning stiffness, numbness and tingling, irritable bowel, depression and dry eyes and mouth.

Physiotherapy can help people with this condition. There are pain relieving techniques that can be used and they are experienced in pacing you back to being able to exercise again and return to activities whether sport, work or hobbies that you were able to do before the condition started. They also are able to provide advice on how to cope with your condition and manage flare ups of pain.

Chronic Pain

Acute pain is the pain we feel immediately after injuring ourselves and while the injury is healing. Chronic pain is pain that continues even though healing has occurred and it is not unusual to find no direct link between the pain and the original injury that may have healed a long time ago. Chemical changes happen in the brain and spinal cord to re-route signals to pain centres in the brain. Then any normal sensation such as a movement, touch, pressure, stretching etc can be felt as pain. In some instances the pain system can be activated without any physical stimulus ie changes in weather, mood, thoughts or no stimulus at all.

Physiotherapy for chronic pain has to involve many aspects and address other factors that come into play rather than just the pain itself. They will treat the pain and also use methods to help you manage your pain including advice on pacing and coping with flare ups and negative thoughts, graduated exercise programmes and goal setting. They will aim to return to you being able to participate again in activities you were involved in before developing chronic pain whether work, sport of hobby related.

Other possible causes

Your physiotherapist will take a detailed history of your symptoms and past medical history before performing a full physical examination. There are a number of other possible causes of your symptoms which are not appropriate for a physiotherapist to treat in any way or that need a medical opinion alongside physiotherapy treatment. In this case they will recommend you to your GP or an appropriate specialist doctor or specialist consultant. These possible causes include:

• cardiovascular symptoms
• respiratory (breathing) symptoms
• gynaecological symptoms
• urinary or genital symptoms
• digestive symptoms
• immune system symptoms
• lymph system symptoms
• hormonal symptoms
• neurological symptoms
• dermatological (skin) symptoms
• medication side-effects
• virus
• infection
• cancer
• disease process
• psychological problem ie. depression, anxiety

Fracture

A fracture to the elbow usually happens as a result of falling on an outstretched arm or by a direct fall onto the elbow. The elbow pain will be severe and a lot of swelling will develop around the elbow with any movement being painful.

Immediate medical help is required if a fracture is suspected. Physiotherapy can help maintain function in the rest of the arm whilst the fracture is healing. Once healed physiotherapy is required to restore movement in the elbow and strength around the elbow as well as stability.

Anterior Interossous Syndrome

The anterior interosseous nerve branches off the main median nerve which runs over the front of the elbow. It can be directly injured or compressed. If this happens then often weakness of muscles that this nerve supplies such as the muscles, which bends the 2nd and 3rd fingers and thumb can occur.

Physiotherapy can help with advising on splinting, massage and ways to reduce any inflammation around the nerve.

Biceps tendinopathy

The bottom tendon of the biceps runs over the front of the elbow and this can become tender with overuse.

Physiotherapy can help by reducing any inflammation of the tendon itself and taking you through a specific exercise programme.

Referred pain from the neck:

Some pain experienced in the upper limb can be caused by nerve injury or compression in the neck. This commonly occurs when a specific nerve root is involved, such as the nerves which exit the lower neck which can refer their pain to the front of the elbow area. This pain can also be associated with burning, tingling or numbing sensations

Your physiotherapist will be able to determine if your pain is referred from the neck and identify which structures might be causing the problem by assessing muscle length, disc and joint health and movement and nerve involvement. Your treatment with us can then be tailored to include nerve gliding exercises, neck mobilisations, soft tissue techniques and neck exercises.

Osteoarthritis of the elbow joint:

This commonly occurs in older individuals but can occur earlier if there has been damage to the joint, heavy use or a family history. Symptoms include aching, stiffness and sometimes reduced movement of the joint with crepitus or loss of the ‘smoothness of movement’.

A physiotherapist can determine the possible causes contributing to the development of the condition and set strengthening and stretching exercises. Techniques such as acupuncture, joint mobilisations and taping have also been shown to provide pain relief in osteoarthritis.

Rheumatoid Arthritis

Rheumatoid Arthritis is when the immune system goes haywire and attacks the body rather than defending it causing inflammation of the lining of the joints and tendons of the muscles. Affected joints in the body that have the arthritis become swollen, painful and stiff. Morning stiffness on waking is very common. Muscles around the joints often become weaker and doing certain activities of daily living can become more difficult.

We can provide experienced physiotherapists to see you at home and work with you to help manage your condition. The first time the physiotherapist visits they will carry out a thorough assessment which includes looking at your mobility and walking aids, muscle strength, joint movement, posture and function. Following the assessment the physiotherapist will discuss any treatments they can provide and set goals with you to improve your general function and mobility and achieve the maximum potential in your home, work and social life. These treatments can include advice on ice, exercise programmes, massage, taping, acupuncture and mobility programmes.

We can also provide occupational therapists to come to your home. They help people to regain the ability to carry out activities that have purpose and meaning to them and become or remain as independent as possible. Some of the services they can offer include:

• Home assessments including modifications such as rearranging furniture, building ramps, widening doorways, grab bars, special toilet seats etc
• Wheelchair assessments
• splinting

Fibromyalgia

This condition does not involve inflammation but affects the fibrous tissues in many parts of the body ie. tendons, muscles, connective tissue etc. There can be a large number of tender points and a feel of generalized aching. One of the common tender points is on the elbow. There a number of other symptoms including fatigue, sleep disturbances, sensitivity to temperature, morning stiffness, numbness and tingling, irritable bowel, depression and dry eyes and mouth.

Physiotherapy can help people with this condition. There are pain relieving techniques that can be used and they are experienced in pacing you back to being able to exercise again and return to activities whether sport, work or hobbies that you were able to do before the condition started. They also are able to provide advice on how to cope with your condition and manage flare ups of pain.

Chronic Pain

Acute pain is the pain we feel immediately after injuring ourselves and while the injury is healing. Chronic pain is pain that continues even though healing has occurred and it is not unusual to find no direct link between the pain and the original injury that may have healed a long time ago. Chemical changes happen in the brain and spinal cord to re-route signals to pain centres in the brain. Then any normal sensation such as a movement, touch, pressure, stretching etc can be felt as pain. In some instances the pain system can be activated without any physical stimulus ie changes in weather, mood, thoughts or no stimulus at all.

Physiotherapy for chronic pain has to involve many aspects and address other factors that come into play rather than just the pain itself. They will treat the pain and also use methods to help you manage your pain including advice on pacing and coping with flare ups and negative thoughts, graduated exercise programmes and goal setting. They will aim to return to you being able to participate again in activities you were involved in before developing chronic pain whether work, sport of hobby related. We can also recommend top Singapore pain consultants who can help you.

Other possible causes

Your physiotherapist will take a detailed history of your symptoms and past medical history before performing a full physical examination. There are a number of other possible causes of your symptoms which are not appropriate for a physiotherapist to treat in any way or that need a medical opinion alongside physiotherapy treatment. In this case they will recommend you to your GP or an appropriate specialist doctor or specialist consultant. These possible causes include:

• cardiovascular symptoms
• respiratory (breathing) symptoms
• gynaecological symptoms
• urinary or genital symptoms
• digestive symptoms
• immune system symptoms
• lymph system symptoms
• hormonal symptoms
• neurological symptoms
• dermatological (skin) symptoms
• medication side-effects
• virus
• infection
• cancer
• disease process
• psychological problem ie. depression, anxiety