Arthritis- Base of the Thumb
Arthritis is the thinning of the cartilage that makes up the smooth covering of a join. When joint surface deteriorates, the body forms bone spurs. People are genetically predisposed to arthritis at the base of the thumb. This form of arthritis is more common in women. Patients with arthritis in the base of the thumb have pain and weakness when pinching and grasping. Treatment for thumb arthritis is specific to the patient and changes as the patient progresses. Some patients use pain medicine and others decide to have surgery that reconnects their bones.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is most simply defined as a pinched nerve in the wrist. There is a space in the wrist called the carpal tunnel where the median nerve and nine tendons connect the forearm to the hand. Carpal tunnel syndrome occurs when swelling in this passage leads to pressure on the nerve. This syndrome is caused by swelling of flexor tendons, joint dislocations, fractures, arthritis, or fluid build up and it’s symptoms include pain, numbness, tingling, and a weak grip. Carpal Tunnel Syndrome can often be treated without surgery by changing hand use, splints, or steroid injections.
Cubital Tunnel Syndrome
Cubital Tunnel Syndrome is characterized by pressure of the ulnar nerve, commonly referred to as the “funny bone” nerve. This can cause numbness or tingling in pinky fingers, forearm pain, and hand weakness. This can be caused by direct pressure, nerve stretching, or the existence of extra muscle over the nerve that impedes its function.
De Quervain Syndrome
De Quervain syndrome is characterized by pain in tendons on the thumb side of the wrist. In patients with De Quervain syndrome, the thickening of soft tissues narrows the tunnel where the tendons run. This can make hand and thumb motion extremely painful, especially when grasping or twisting. Treatments include splints that stop thumb and wrist movement, ibuprofen, and cortisone injections.
Dupuytren’s disease is an abnormal thickening of the tissue just below the surface of the skin. This thickening occurs in the palm and can also affect the fingers. Firm pits, nodules and cords may develop, causing the fingers to bend into the palm. This disease is often genetic, but is also associated with diabetes, alcoholism, and aging. Dupuytren’s disease is treated with steroid injections, splints, and in some cases, surgery.
Elbow fractures can occur due to a fall, direct impact on the elbow, or a twisting injury to the arm. Sprains, strains, or dislocations may occur simultaneously. There are different types of elbow fractures. Radial head and neck fractures are characterized by pain during forearm rotation. Olecranon fractures are usually a result of extreme displacement and require surgery to realign bone fragments. Fractures of the distal humerus are common in child and the elderly and are often associated with nerve and artery injuries. These fractures also typically require surgery and the utilization of plates and screws.
Extensor Tendon Injuries
Extensor tendons are located right under the skin and can be injured by a minor cut or by jamming a finger, causing the thin tendons to become unattached from the bone. Finger jams are typically treated with splints. Other treatments include stitches or pins placed through the bone to act as an internal splint. After treatment, a patient may do physical therapy to help regain motion.
Flexor Tendon Injuries
The muscles that bend the fingers are called flexor muscles. These flexor muscles move the fingers through tendons, which connect the muscles to bone. An injury that appears to be minor on the outside can actually be extremely damaging internally. Deep cuts can injure the tendons and nearby nerves and blood vessels. When the tendon is cut, your finger cannot bend. A cut tendon cannot heal without surgery and physical therapy.
Ganglion cysts are extremely common lumps within the hand and wrist that occur next to joints or tendons. Ganglion cysts often look like small water balloons, and are filled with clear gel. The most common locations are the top of the wrist, the palm side of the wrist, the base of the finger on the palm side, and the top of the end joint of the finger. These cysts are benign and they will not spread to any other part of the body. In most cases, the cysts will disappear on their own, especially if they are not painful. If the cyst is painful, there are a few non-surgical treatment options available to give the patient immediate relief.
The hand is composed of many bones that create a supportive framework that act as a point of attachment for muscles, allowing them to move. When enough pressure is applied to a bone that it breaks, a fracture occurs. There are various types of fractures that can occur: simple, unstable, compound, and comminuted. In a simple fracture, the bone pieces are still aligned and stable. Unstable fractures occur when bone fragments shift and are displaced. Compound fractures occur when a bone fragment breaks the skin, leaving the area susceptible to infection. Comminuted fractures are characterized by the bone shattering into many pieces and occur when an extreme amount of pressure was applied. After a thorough examination and x-rays to determine which type of fracture you have, there are treatment options ranging from casts to surgery.
A mallet finger is a deformity of the finger caused when the extensor tendon, the tendon that straightens the finger is damaged. When an object hits the tip of the finger causing it to forcibly bend, the force tears the tendon that straightens the finger, and may pull away a piece of bone as well. This will cause the finger to droop and not be able to straighten on its own. You will experience pain, swelling, and bruising, especially if the finger is also fractured. The droopy appearance of the finger makes this easy to diagnose, and there are both surgical and non-surgical treatment options.
Tennis Elbow (Lateral Epicondylitis)
Lateral epicondylitis, also referred to as tennis elbow, is a painful condition involving the tendons that attach to the bone on the outside of the elbow. Tennis elbow causes degeneration of the tendon’s attachment, weakening the connection and placing great pressure on the area. This can cause extreme pain when participating in activities where this muscle is used, such as lifting and grasping. Tennis elbow typically occurs due to overuse or direct force and trauma. This condition is most common in people over 50 and treatment options include physical therapy, injections, and in extreme cases, surgery.
Trigger finger, medically referred to as stenosing tenosynovitis occurs when the pulley at the base of the finger becomes too thick and constricting around the tendon, making it hard for the tendon to move freely. The first sign of trigger finger may be discomfort were the finger meets the palm, followed by more severe pain, popping, limited motion, and lump formation. Trigger finger is associated with arthritis, gout, and diabetes. It is commonly treated using splints, anti-inflammatory medication, or steroid injections.
Wrist Fractures- Distal Radius Fracture
Wrist fracture is the medical term that refers to a broken wrist. The wrist is made up of eight small bones and the two forearm bones, the radius and ulna. The most common wrist fracture occurs in the radius. Some fractures are stable and can be treated using a cast or splint. In the case of an unstable fracture, bones may shift to a bad position before healing, making the wrist appear crooked. This type of fracture is typically best treated with surgery. Recovery from a wrist fracture also varies based on severity of fracture and type of treatment.
Wrist sprains are commonly incurred when a person falls or does another activity that causes the wrist to bend backward. After the injury, the wrist will typically swell, bruise, and is painful to move. A sprain indicates an injury to a ligament, which is the connective tissue that connects bones to bones. There are many ligaments in the wrist, but the most commonly injured is the scapho-lunate ligament. Treatment ranges from wearing a splint or cast to surgery based on the severity of the strain.