Specialized attention must be given to all of the different issues that make healthy function of the hand and upper extremity possible.
Santa Rosa, CA (PRWEB) January 26, 2014
No matter how old a person is or how they spend their days, the condition of the hands and arms play an important role in maintaining quality of life, and can contribute significantly to an ability to work and pursue day-to-day activities. Some very treatable hand and arm injuries that can impact quality of life and restrict normal movement include:
- Carpal Tunnel Syndrome (CTS)
- Cubital Tunnel Syndrome
- Dupuytren’s Contracture
Tendons are flexible cords of tough, fibrous connective tissue that attach muscles to bones and are found throughout the body. When the normal smooth gliding motion of a tendon is impaired for whatever reason the tendon will become inflamed and tendonitis will occur. When treated early, tendonitis will usually respond well to therapy and prescribed treatments.
A painful condition known as DeQuervains tendonitis involves tendonitis of the thumb or wrist, just beneath the thumb. It is also called the “Mommy Thumb and Wrist” as it is frequently diagnosed in new mothers. This condition can be treated with therapy, braces, medications, an injection or sometimes surgery.
Lateral epicondylitis (tennis elbow) and medial epicondylitis (golfer’s elbow) are common problems that involve degeneration of the tendon attachment at the elbow. Pain in this area can become quite severe and debilitating, leaving the patient feeling frustrated and unable to pursue preferred activities. These conditions and be caused by contusions, heavy lifting and constant repetitive activities. Treatment is similar to other types of tendonitis although recurrence is not an uncommon outcome. These conditions can persist for months to over a year, and are usually treated with a cortisone injection and sometimes surgery, particularly in several cases that don’t respond to therapeutic treatments.
Carpal Tunnel Syndrome (CTS)
Carpal Tunnel Syndrome (CTS) is the most common nerve compression disorder of the hand. It occurs when pressure is put on the median nerve located at the level of the wrist. It is most often idiopathic in nature (or has an unknown cause), although it can be aggravated by repetitive activities or even pregnancy. CTS is most often treated with the use of a brace at night, therapy and cortisone injection. If these treatments are not successful, then surgery may be necessary.
Osteoarthritis is the most common form of arthritis. It causes pain, swelling, and reduced motion in the joints. It can occur in any joint, but usually it affects the hands, knees, hips or spine. Risk factors for osteoarthritis include;
- Joint injury
- Repetitive use
Arthritis of the hand is an extremely common condition that affects a large cross section of the population, and people of all ages. While no single test can diagnose osteoarthritis, doctors generally use several methods, including; medical history, a physical exam, x-rays, or lab tests.
In healthy joints, the end of the bone is covered with cartilage, which acts as a shock absorber allowing smooth, pain-free movement. With arthritis the important bone-protecting cartilage layer becomes worn, resulting in direct bone-to-bone contact, which causes pain and often, deformity. In the hand, one of the most common joints to develop osteoarthritis is at the base of the thumb. In this situation, the sensation of pain can be intensified by activities that require a pinching motion such as turning a door knob, opening a jar and writing. Osteoarthritis (degenerative) is the most common form, although inflammatory arthritis such as rheumatoid, psoriatic, lupus, and gouty arthritis are conditions that may also occur.
- Degenerative arthritis can be painful but symptoms tend to come and go. Flare ups are treated with splinting, anti-inflammatory treatments, heat and ice, and occasionally cortisone injections. If symptoms persist or affect function, then surgery can be beneficial.
- Inflammatory arthritis is considered a systemic disease, meaning that it can invade the entire body including organs. It often involves the hand and can cause severe deformity. In order to prevent progression of the disease it is important that the systemic symptoms are treated by a physician.
- Basal joint arthritis (located at the base of the thumb) is one of the most common locations of arthritis in the hand. It usually responds to splinting, medication, and occasional cortisone. A small percentage of patients who do not respond to this treatment may require joint replacement or arthrodesis (fusion).
Treatments for these conditions range from starting an exercise program, to taking certain medications, and sometimes surgery. The surgeons at SRO’s Hand Center can evaluate your arthritis and determine the best course of treatment for you.
Cubital Tunnel Syndrome
Cubital tunnel syndrome is caused by increased pressure on the ulnar nerve (also known as the funny bone) located at the elbow. If pressure becomes so great that it interferes with the way the nerve works then sensations of numbness, tingling and pain may radiate from the elbow to the forearm, hand or fingers. Weakness, cramping and clumsiness are common complaints. Cubital tunnel syndrome may occur as the ulnar nerve moves back and forth over the bony bump of the elbow (medial epicondyle). This can happen as the elbow is bent and straightened - and if it happens too frequently, the nerve can become significantly irritated. Holding the elbow in a bent position for a long time will also put pressure on the ulnar nerve.
Symptoms can often be relieved without surgery, particularly in cases where pressure on the nerve is minimal. Simply changing the way the elbow is used can help to reduce the pressure on the nerve and alleviate symptoms. But, when symptoms are severe or do not improve over time, surgery may be indicated as the best way to improve the symptoms.
Dupuytren's contracture is a relatively rare disorder affecting the connective tissue causing the joints of the fingers to become fixed in a permanently flexed position, known as joint contractures. As the disease progresses, otherwise normal tissue becomes thickened and constricted due to scarring. Dimpling and puckering of the skin over the affected area can occur, ultimately making it impossible for the patient to fully extend the hand.
Although the exact cause of Dupuytren's contracture is unknown it is most prevalent in patients who have chronic health issues such as diabetes, thyroid problems, or epilepsy. It is also believed that a genetic predisposition may be a factor.
The treatment of a Dupuytren's contracture depends on the severity and the underlying condition of the patient. Surgical procedures may be considered to remove the scarred tissue to free the fingers and release the tendons depending on the severity this can be done percutaneously in the office.
Getting Back in the Groove
Specialized attention must be given to all of the different issues that make healthy function of the hand and upper extremity possible. Surgeons and ortheopeadic specialists at The Hand Center are specifically trained to provide just that care, tailored to fit your needs.
Both Dr. Mazur and Dr. Minatalucci specialize in the diagnosis and treatment of injuries and disease of the hand, wrist and upper extremities. Like all of the physicians at Santa Rosa Orthopaedics, they are dedicated to making sure you get the highest quality treatment that will facilitate a speedy recovery and a return to doing the things you love to do. Visit our website or call us at 707-546-1922 for more information.