What is Trigger Finger?

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Article featured on MedicineNet

A trigger finger is a condition that can turn simple hand movements into a frustrating experience, often causing pain and discomfort. From gardening to repetitive motions, certain activities can put your fingers at risk. Learn about the causes, symptoms, treatments, and prevention tips to keep your hands healthy and functional.

 

A trigger finger is a “snapping” or “locking” condition of any of the digits of the hand when opening or closing. Stenosing tenosynovitis is the medical term for the trigger finger.

What causes trigger finger?

Local swelling from inflammation or scarring of the tendon sheath (tenosynovium) around the flexor tendons causes trigger fingers. These tendons normally pull the affected digit inward toward the palm (flexion). When they are inflamed, they tend to catch where they normally slide through the tendon sheath.

Usually, the trigger finger occurs as an isolated condition because of repetitive trauma. Activities such as gardening, pruning, and clipping are risk factors for trigger fingers. Sometimes, the trigger finger is an associated condition resulting from an underlying illness or medical condition that causes inflammation of tissues of the hand, such as rheumatoid arthritis.

Data presented at the 2005 American College of Rheumatology national meeting suggested that a majority of patients with rheumatoid arthritis have inflammation around the tendons of the palm that could develop into trigger fingers. The trigger finger most often affects the right or left index finger, the digits likely to pull the trigger on a gun.

What are the symptoms of trigger finger?

Symptoms and signs of trigger finger may occur when any of the four fingers of the hand attempts to flex closed while gripping. Instead of a smooth, continual closure, the digit hesitates, then snaps closed (causing a “trigger” effect), and is associated with a stiffness sensation of the digit. Symptoms and signs may occur in more than one digit.

When attempting to extend the digit, a similar hesitation may occur before it “snaps” into full extension. In severe cases, people must manually bring the digits into full extension or flexion because of the stiffness. The closure is frequently associated with pain at the base of the finger on the palm. Sometimes it’s possible to feel a tender nodule in the area of the inflamed tendon. There may be mild swelling in the affected area of the palm.

Triggering can also affect the thumb (trigger thumb, De Quervain syndrome), so many clinicians include the thumb in the diagnosis of the trigger finger.

Diagnosis of trigger finger

Primary care doctors, including general practitioners, family medicine physicians, and internists, commonly diagnose the trigger finger. Specialists who treat trigger fingers include orthopedic surgeons, sports-medicine doctors, plastic surgeons, hand surgeons, and rheumatologists. Occupational therapists and physical therapists can be involved in the care of patients with trigger fingers.

Health care professionals diagnose trigger fingers based on the history of “snapping” sensation that the patient experiences, as well as noting in the physical examination that there is tenderness and nodular irregularity of the involved flexor tendon in the palm. Typically, the nodule is not visible but can be felt in the palm. There can be contracture of the affected digit into a bent position.

What are the treatments for trigger finger?

Stretching, ice, and anti-inflammation treatments can be helpful. Oral anti-inflammatory medications may be helpful.

The quickest and most effective treatment is a local cortisone injection into the tendon sheath around the affected tendon. Most patients will respond well to the steroid injection . A trigger finger can recur after a period of normal function.

When a trigger finger persists after two steroid injections and is not responsive to the above nonsurgical treatments, consider surgical procedures to release the tendon sheath and/or remove the inflamed or scarred tissue. Trigger finger surgery is usually a permanent cure for this condition.

Initially, people can treat trigger fingers at home with remedies including cold packs, resting, and over-the-counter medications, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen. Massaging the involved area of the palm gently followed by a cold pack application can be helpful. Take care to avoid reinjuring the strained tendon in the palm.

What is the prognosis of trigger finger?

The prognosis of the trigger finger is excellent. Nearly all patients recover completely after medical professionals administer cortisone injections and the tendon again glides freely through the tendon sheath. Sometimes it may be necessary to get repeat injections. Surgical treatments may be necessary for rare instances.

Is it possible to prevent trigger finger?

People can prevent trigger fingers by avoiding activities that strain the finger flexor tendons in the palms of the hands.

Osteoarthritis of the Hands

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Article featured on Arthritis Foundation

About half of all women and one-quarter of all men will experience the stiffness and pain of osteoarthritis (OA) of the hands by the time they are 85 years old. A degenerative disease that affects all the tissues of a joint, OA leads to the breakdown over time of the smooth, protective cartilage on the ends of bones, so bones rub together, causing pain. The 29 bones of your hands and wrists come together to form many small joints that can be affected by OA.

Where OA Affects the Hand

OA most commonly affects three parts of the hand:

  • The base of the thumb, where the thumb and wrist join (the trapeziometacarpal [TMC] or carpometacarpal [CMC] joint)
  • The joint closest to the fingertip (the distal interphalangeal [DIP] joint)
  • The middle joint of a finger (the proximal interphalangeal [PIP] joint)

Causes of Hand OA

Osteoarthritis usually occurs later in life, with no specific cause. But several factors can play a role, including:

  • Age: the older you are, the more likely you are to have hand OA.
  • Sex: women are more likely to be affected than men.
  • Race: whites are more often affected than African Americans.
  • Weight: obese people are more likely to have hand OA than thinner people.
  • Genes: some people inherit the tendency to develop osteoarthritis, usually at a younger age.
  • Injuries: Even when properly treated, an injured joint is more likely to develop OA over time. Fractures and dislocations are among the most common injuries that lead to arthritis.
  • Joint issues: Joint infections, overuse, loose ligaments, and poorly aligned joints can also lead to hand or wrist arthritis.

Symptoms of Hand OA

Along with cartilage loss, OA also causes bone spurs to form. Bone spurs in and around the joints increase your stiffness and pain. With worsening OA, daily activities can become difficult and your finger joints may lose their normal shape.
Symptoms of hand OA can include:

  • Pain: At first, pain will come and go. It worsens with use and eases with rest. Morning pain and stiffness are typical. As the osteoarthritis advances, the pain becomes more constant and may change from a dull ache to a sharp pain. It may start waking you up at night.
  • Stiffness and loss of motion: As arthritis progresses, you may lose the ability to open and close your fingers completely.
  • Crepitus: When damaged joint surfaces rub together, you may feel grinding, clicking or cracking sensations.
  • Swelling: Your body may respond to constant irritation and damage to the tissues surrounding the joint by swelling and becoming red and tender to the touch.
  • Nodules: Bony lumps may form on the middle joint of the finger (Bouchard’s nodes) or at the joint near the fingertip (Heberden’s nodes).
  • Joint deformity: Bone changes, loss of cartilage, unstable or loose ligaments and swelling can make your finger joints large and misshapen.
  • Weakness: The combination of joint pain, loss of motion and joint deformity can leave your hands weak. Activities that once were easy, such as opening a jar or starting the car, become difficult.

Diagnosing Hand OA

Your doctor will examine how your hands look and work and may check other joints for signs of arthritis. X-rays may show loss of space in your joints – indicating cartilage loss – and formation of bone spurs. She’ll make a diagnosis by combining this information with your medical and family history.

Treatments for Hand OA

Osteoarthritis is a chronic disease. There is no cure, but healthy lifestyle habits and treatments can help manage your symptoms and keep you active.

  • Non-Drug Treatments: Reducing strain on joints with a splint or brace, adapting hand movements, doing hand exercises or using hot or cold therapy can help to ease pain.
  • Drug Treatments: Medicines to ease OA symptoms are available as pills, syrups, creams or lotions, or they are injected into a joint. They include pain relievers like acetaminophen, counterirritants like capsaicin or menthol and non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.
  • Surgical Treatments: If medications or self-care activities fails to give relief, surgery may be an option. An orthopaedic surgeon can remove the damaged cartilage and fuse bones together or replace the damaged joint with a plastic, ceramic or metal implant.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What’s to Know About Extensor Tendonitis?

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Article featured on MedicalNewsToday

The most common cause is overuse of the muscles, bones, and tendons in the feet or hands.

In the feet, it’s most often caused by:

  • spending a lot of time on the feet
  • wearing shoes that are too tight
  • using inappropriate footwear for a sport or activity

In the hands, the most common cause of extensor tendonitis is doing an activity that uses the hands and wrists in a repetitive motion such as:

  • prolonged or high-impact typing with a non-ergonomic keyboard
  • practicing or playing an instrument, such as piano or guitar, excessively
  • regularly playing sports that stress hands and wrists, including baseball or racquetball

Mallet finger is a common type of injury that occurs to the fingers, especially in athletes. It occurs when the tip of the finger is struck hard, such as with a ball, which injures the tendon that runs along the top of the finger.

Without treatment, the tendon can become permanently damaged, causing the tip of the finger to fail to straighten completely.

Symptoms and diagnosis

The most common symptom of extensor tendonitis, whether it occurs in the foot or the hand, is pain. In the feet, the pain is usually localized to the top of the foot, usually close to the center of the foot. In the hands, pain tends to occur on the top of the hand.

Other symptoms of extensor tendonitis include:

  • redness, warmth or swelling near the injury
  • increased discomfort with activity
  • crepitus, which is a crunchy feeling or sound over the affected tendon
  • stiffness of the joint

Diagnosing extensor tendonitis usually requires a physical exam and history with a physician. The doctor will ask questions about the pain and other symptoms.

Common questions are about whether anything makes the pain better or worse, the history of the symptoms, and if anything triggered the discomfort.

Sometimes, the doctor will order an X-ray or magnetic resonance imaging (MRI) test to get a detailed look at all the bones, muscles and tendons around the injury. These images can help the doctor look at the structures around the pain to see where the damage is and if there is another cause for the symptoms.

Treatment

Injuries to the hands and feet are common and usually resolve within a few days with basic care at home.

However, if the pain doesn’t start to improve after a couple of days, or a person experiences swelling, redness, warmth or other symptoms, they should visit their doctor.

There is a range of treatment options available for extensor tendonitis.

Rest and Relaxation

Resting the affected joint is crucial, especially if the tendonitis is caused by overuse. It is essential to stop the activity that is causing the pain until the tendon has healed, to prevent further injury. In less serious cases, rest may be all that is needed until the tendon has healed.

Finger or toe splints

Mallet finger may require splinting for several weeks so that the tendon returns to its previous position and completely heals in place.

It is important to clarify with the doctor about the length of time that the finger must remain in the splint. It is common to have to wear the splint continuously, even in the shower.

Removing the splint and moving the finger before the tendon has healed, could re-injure the tendon.

Physical therapy

Extensor tendonitis of the foot may require physical therapy and special stretches for a tight calf muscle. Also, some orthopedic surgeons or podiatrists will recommend the use of a splint or orthotic shoe inserts.

Surgery

Surgery to repair extensor tendonitis is rare and usually reserved for very special or unique cases. If considering surgical repair of the extensor tendons, people should ensure they see a surgeon who has experience performing these types of procedures.

Outlook

The prognosis of extensor tendonitis is excellent; in most cases, a person with this condition makes a full recovery without any lasting problems in the affected joints. How long it takes to recover depends on how severe the tendonitis was, and how well a person managed it.

For example, a person who rests properly will recover more quickly than someone who “pushes through” and continues to use the affected joint.

Although it can be painful, extensor tendonitis is a fairly preventable and easily treatable disease. It is important to see the doctor with any pain, especially in the hands or feet.

Quick diagnosis and treatment is the key to minimizing tendon damage and recovery.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Treating Hand Arthritis Without Surgery

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Article featured on American Society for Surgery of the Hand

What is arthritis?

A joint is where two or more bones meet each other. The ends of these bones are covered with a smooth substance called cartilage which allows the bones to slide past each other smoothly. This cartilage layer can be worn away with time or due to other things, and when this occurs the rough bone ends start to rub against each other. This is arthritis. Sometimes arthritis does not cause any problems, but sometimes it can cause pain, swelling, stiffness, and deformity.

What causes arthritis?

The most common causes of arthritis are different for different locations in the body. The normal arthritis that often comes along with age is called osteoarthritis. This is simply arthritis that occurs due to normal wear and tear on the body as we get older. Often this type of arthritis is partially hereditary, meaning that if your parents or grandparents had arthritis, you may be more likely to have it. Other things can cause arthritis as well. These include major joint injuries or infections, and certain medical conditions.

Just because you have arthritis doesn’t mean it’s necessarily a problem. Many people have arthritis that they don’t even know about. Arthritis only needs treatment if it bothers you or causes issues in the body.

My hand arthritis hurts! How can I treat it?

Once arthritis is present, it will always be there. This is because the body can’t regrow the type of cartilage found in the joints. But there is good news: just because arthritis is in the body doesn’t mean it will always cause pain or other issues. Even if arthritis causes pain, the pain may not be there all the time- it can often come and go. There are many things we can do to try to improve arthritis symptoms when they occur. Conservative management of arthritis- meaning treatment without surgery- is almost always the first step. There are many options to try. Usually these treatments work best when they are used all together over several weeks or months.

  • Splints: resting the inflamed joint with a splint, also called a brace or “orthosis”, can be very helpful in improving arthritis symptoms in certain places in the hand, especially arthritis in the base of the thumb. Splints may be “pre-fabricated”, meaning that you can buy them at the store or online and they are designed to fit most people. Other splints can be custom molded to your hand by a hand therapist.
  • Rest: avoiding activities that flare up the arthritis pain can make the pain less intense or less frequent.
  • Ice or heat: using ice on the skin over an arthritic joint before and after any activities that worsen the pain can improve discomfort. Heat applied with warm compresses, warm water, or wax baths may also improve symptoms. Experiment with both ice and heat to see if either helps.
  • Medications: anti-inflammatory medications like ibuprofen or naproxen may help improve pain. Acetominophen can also be helpful. If you have medical problems or take medications, check with your primary care provider to make sure it is safe for you to take these medicines.
  • Rub-on creams: Some creams and lotions rubbed into the skin over an arthritic joint can be helpful in decreasing pain there. There are multiple options which may be worth trying, most of which can be bought at your local drug store or online. Try one for a few days or weeks, and if it doesn’t help then try another.
  • Injections: In some arthritic joints, certain substances can be injected into the joint with a needle which can decrease pain. Depending on the location, receiving a needle injection may be temporarily painful, but can provide good pain relief for months or longer. Many hand doctors provide injections of steroid, a substance that is thought to decrease inflammation in a joint which may be able to improve pain for several months. Some hand doctors may also consider injections of hyaluronate, a substance which may temporarily allow roughened bone ends to slip past each other more comfortably. However, hyaluronate injections are less commonly used than steroid injections and may be more expensive.
  • Hand therapy: Working with a hand therapist on motion exercises and strengthening of the hand may help improve some people’s arthritis pain, but the scientific studies on therapy for arthritis do not prove that it helps a great deal.

What if none of these treatments work to improve my arthritis pain?

There are surgeries that can help make hand arthritis pain better. However, most people with hand arthritis never need to move forward with surgery- this is a personal decision that should be made after discussion with a hand surgeon. The safest and best plan is usually to try to maximize all non-surgery treatments to make arthritis feel better. If none of these treatments give you good relief from your arthritis symptoms, see a hand surgeon to discuss whether a surgical procedure could benefit you.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

How to Manage & Prevent Arthritis in the Hands

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Article featured on MedicalNewsToday

There is no known cure for arthritis, which commonly affects the hands. However, a person can take steps to lower the risk of arthritis developing or worsening and to reduce and manage pain. These steps include practicing specific exercises and making dietary changes and adjustments to daily habits.

Arthritis is a general term that describes several conditions that affect a person’s joints. There are more than 100 different types of arthritis. Arthritis is generally not preventable, but a person may be able to reduce their risk by changing the risk factors that they can control.

According to the Centers for Disease Control and Prevention (CDC)Trusted Source, the most common type of arthritis in the United States is osteoarthritis. Osteoarthritis can affect nearly any joint in the body, but it most commonly affects the joints in the knees, hips, and hands.

This article discusses how to reduce the risk of developing arthritis in the hands or prevent it from worsening. It also explains how to reduce and manage the pain of arthritis.

Osteoarthritis vs. rheumatoid arthritis

Osteoarthritis occurs over time as a person’s cartilage erodes, whether from general wear and tear or due to underlying inflammation. Once the cartilage has worn away enough, a person can experience pain and stiffness in their joints.

A person can take steps to help reduce the risk of osteoarthritis.

Rheumatoid arthritis is an autoimmune condition in which the body’s immune system attacks the joints.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a combination of genetic and environmental factors triggers the development of rheumatoid arthritis.

These factors can activate the immune system years before symptoms appear.

Both osteoarthritis and rheumatoid arthritis often affect the hands and fingers, and they can both cause joint stiffness or difficulty moving the joint.

However, there are some differences between the two conditions.

Osteoarthritis often affects the last joint on the finger, which is the one closest to the tip. Rheumatoid arthritis typically does not affect this joint.

In addition, the NIAMS note that osteoarthritis stiffness usually goes away within 30 minutes of waking up or resting, whereas the pain and stiffness associated with rheumatoid arthritis tend to last longer than 30 minutes.

General arthritis prevention

Not all forms of arthritis are preventable. However, a person can take some steps to reduce their risk of developing osteoarthritis in their joints.

According to the CDC, these steps include:

  • stopping smoking, if a smoker, or avoiding secondhand smoke
  • achieving or maintaining a moderate weight, as this helps protect the joints throughout the body
  • seeking treatment for any signs of infection, which can damage the joints
  • protecting against injury by performing exercises and stretches or avoiding activities that carry the risk of injury
  • using tools that do not place undue stress on the joints
  • avoiding repetitive motion when possible

Preventing arthritis in the hands

A person can try several techniques to help prevent arthritis in the hands from becoming debilitating.

Hand exercises

Several exercises may help with preventing or alleviating arthritis pain in the hand and fingers.

A person should talk to a doctor or occupational therapist about the best routine or exercises to help prevent disease progression or worsening pain or stiffness.

One simple exercise that many people should be able to do is making a fist.

To do this, a person starts with their fingers and thumb straight out. Then, they curl their fingers slowly into their palm and close their thumb around the outside of their fingers.

The person should not squeeze the hand too tight during this exercise, but they should hold the fist position for 2–3 seconds before releasing it. They can then repeat the action 10 times.

Another exercise that a person can try to prevent or alleviate arthritis symptoms is squeezing a stress ball or a tennis ball. Similar to making a fist, the motion should be slow and deliberate.

Learn more about hand exercises for arthritis here.

Daily habit adjustments

People who have not developed arthritis can take steps to help prevent joint damage in their hands. Some tips for preventing joint damage include:

  • using an ergonomic keyboard and mouse when working at the computer
  • avoiding lifting heavy items that can put strain on the fingers and hand
  • using splints or braces to reduce the risk of injury when using the hands for repetitive activities, such as sewing or chopping food

Methods to reduce hand pain

If a person is living with pain in their hands from arthritis, they may wish to try:

  • practicing gentle motion hand exercises that promote movement and help reduce stiffness
  • seeking physical therapy and occupational therapy from certified professionals
  • talking to a doctor about medications and topical pain relievers to help with the pain

The Arthritis Foundation add that a person can also:

  • use hot or cold therapy
  • modify their daily routine to avoid putting stress on the hands and fingers
  • talk to a doctor about steroid injections

Some additional steps that a person can take to help prevent arthritis pain in the hands include:

  • using kinetic tape as a preventive measure
  • using dictation software instead of typing
  • avoiding placing excess strain on the fingers by using large joints, such as the elbows or shoulders, to carry the weight of shopping bags
  • using other body parts besides the hands to close a door
  • using the palm of the hand to hold a phone or tablet to avoid placing strain on the fingers
  • changing daily habits, such as stirring food using a shoulder motion
  • using utensils with large, easy-to-grip handles

A person should talk to a doctor if at-home methods or treatments are ineffective in managing their arthritis symptoms. It is possible that a doctor will recommend surgery as a treatment option.

Outlook

It is not possible to prevent arthritis, but a person may be able to manage the pain that it causes and slow its progression.

At-home techniques and modifications to everyday routines may help prevent pain and minimize the loss of joint function.

Summary

Arthritis is a common condition, and there are numerous different types.

Although arthritis is not usually preventable, a person can take some steps to help protect their joints and potentially reduce their risk of the disorder.

A person can also take several steps to manage the pain and discomfort of arthritis at home.

If at-home treatments do not work, a person can work with a doctor to identify therapies and treatments that may help.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What are Wrist, Hand or Elbow Dislocations?

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Article featured on Mercy Health

What are hand, wrist or elbow dislocations?

Hand dislocations occur when one of the eight carpal bones (bones located at the base of the hand) fall out of the joint to cause a hand dislocation. The capitate (largest bone in the hand) or lunate bones are the bones that most frequently dislocate.

Wrist dislocations occur when one of the eight bones of the wrist fall out of socket due to a fall.

Elbow dislocations occur when the joints of the elbows somehow separate. In a partial elbow dislocation, the joint surfaces are not completely separated (also known as subluxation), while in a complete dislocation, the joint surfaces are completely dislocated.

Causes of hand, wrist or elbow dislocations

  • Hand dislocations typically occur when direct, intense force is applied to the wrist and the hand is bent backward.
  • High impact sports such as basketball and football are common causes of hand, wrist or elbow dislocations – football and basketball players can dislocate finger joints when striking the ball, the ground or another player.
  • A hard blow to the joint, for example in a car accident, could cause a hand, wrist or elbow dislocation.

Risk factors of hand, wrist or elbow dislocations

Risk factors of hand, wrist or elbow dislocations are:

  • Participating in high impact, extreme sporting activities, such as football and hockey can put people at higher risk for a hand, wrist or elbow dislocation
  • Sports where falls are common, such as volleyball, gymnastics and downhill skiing put people at a higher risk of hand, wrist or elbow dislocations
  • Some people are born with ligaments and joints that are more prone to injury
  • Patients who are more susceptible to falls (such as the elderly) are at a higher risk for hand, wrist or elbow dislocations

Symptoms of hand, wrist or elbow dislocations

Symptoms of hand, wrist or elbow dislocations include:

  • Visible deformities in the hand, wrist or elbow after trauma
  • Inability to move your hand, wrist or elbow
  • Severe pain in the affected area
  • Swelling in the hands, wrists or elbow
  • Misshaped appearance of the hand, wrist or elbow
  • Numbness

Diagnosis of a hand, wrist or elbow dislocation

If you suspect you have a hand, wrist or elbow dislocation, visit the ER right away. It is crucial to treat a hand, wrist or elbow dislocation right away to avoid developing arthritis or death of bone tissue. When possible, ice the joint and keep it immobile while waiting to see the physician.

Hand, wrist or elbow dislocations are diagnosed in a physical exam and with an x-ray, MRI or CT scan to evaluate the extent of the injury and determine the best course of treatment.

Treatments for hand, wrist or elbow dislocations

Wrist dislocations typically require surgery by a hand or wrist orthopedic surgeon.

The hand surgeon will place the bones back into the correct location as well as repair the ligaments and soft tissue surrounding the injury during the procedure.

After the procedure, the wrist will be immobilized in a cast for eight weeks to ensure proper healing.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Hand, Wrist, And Arm Pain While Exercising

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Article featured on American Society for Surgery of the Hand

Is it normal to have pain or soreness in my hands, wrists, and arms while exercising?

It depends. When you start with exercises you have never done or when you exercise some muscles you have not used in a while, these muscles can become sore. That is normal. Muscle activity produces lactic acid, which causes soreness in the muscles. Soreness means your muscles have been stressed, and they will likely recover after a few hours or a few days, when the lactic has been cleared away. If the exercise causes too much stress, your muscles may become sore to the touch and even might feel swollen.

Is there a difference between discomfort and pain in the hands, wrists, and arms?

“Discomfort” is an annoying sensation of mild pain; actual “pain” is when you feel that there is something wrong. In your physician’s office or in the hospital, you are often asked to rate your pain as a number or point to a picture of a face indicating your discomfort. The level of discomfort or pain is very different in each patient. It depends much on how you have been able to deal with uncomfortable situations in the past.

When should I pay special attention to my muscle or joint pain in my hands, wrists, and arms while exercising?

Most exercise-related pain is dull and spreads over a larger area of your arms or legs. This is normal. When it seems to be sharp pain focused in one spot that you can pinpoint with a finger, it may indicate a muscle strain of a tendon inflammation. Popping, clicking, or grinding in the muscles or tendons are signs of strain. You should cut back on the exercise or activity until the problem settles down. Also, you should watch for painful swelling, especially when compared to the other arm or leg. If rest or over-the-counter medications do not help, you should seek your doctor’s advice.

How can I prevent pain in my hands, wrists, and arms while exercising?

Athletic exercises or exercises in your occupation/physical therapy department are meant to make your muscles and tendons more tolerant to stress and strain, so some soreness is normal. The best way to ease into exercises is to work your muscles gradually to the point of discomfort but not pain. Your occupational therapist can assist you to become more flexible and stronger.

How do I treat pain in my hands, wrists, and arms after exercise?

It is helpful to know that discomfort is often the result of exercise. It does not mean that there is anything wrong with your muscles or your body. Staying active and exercising regularly is healthy and will make it easier for your muscles to recover. It is best to “listen to your body” and back off if exercises are too uncomfortable. Over-the-counter medications, such as a cream applied to the sore area or an occasional anti-inflammatory tablet, can be used.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

5 Causes of Thumb Pain

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Article featured on American Society for Surgery on the Hand

The thumb is involved in about 50% of all hand functions. When the thumb is painful or injured, it becomes very difficult to use the hand. During normal life, we take our thumbs for granted. When the thumb is not working properly, tasks are more difficult, and we then realize how important the thumb is. There are several causes of thumb pain including:

  1. Trigger thumb
  2. Arthritis
  3. Tendonitis
  4. Carpal tunnel syndrome
  5. Skier’s thumb.

Read below to learn more.

1. Trigger thumb

The tendon that bends or flexes the thumb is called the flexor pollicis longus (FPL). If there is swelling or inflammation around the thumb tendon, it will not glide smoothly. Sometimes the tendon gets stuck in the thumb pulley, causing the thumb joint to click, catch, or lock. This is called a trigger thumb. The thumb can also become swollen, stiff, and very painful. Treatment includes rest, anti-inflammatory medications, splinting, and steroid injections. Most patients improve without surgery. If symptoms persist with treatment, trigger thumb release surgery is very effective and has low risks.

2. Thumb arthritis

The human thumb is unique. We can touch the tip of the thumb to the small finger — a function called opposition. Most animals do not have an “opposable” thumb. This gives us the ability to write, use a needle and thread, and use hand tools. The joint at the base of the thumb which allows opposition is called the carpometacarpal (CMC) joint. Normal, every day activities can cause wear and tear in the thumb CMC joint. When the joint wears out, it can become inflamed and painful. This process is called osteoarthritis or degenerative joint disease.

Anyone can get osteoarthritis if they live long enough. So far, we have not found a way to prevent osteoarthritis. Wear and tear is part of the normal aging process. However, the symptoms of osteoarthritis can be treated by reducing inflammation in the joint. Ways to reduce inflammation and treat thumb CMC osteoarthritis include topical anti-inflammatory gels, oral over-the-counter medications, adjusting hand activities, using a thumb splint, and steroid injections. Most patients improve without surgery. If symptoms persist with treatment, thumb CMC surgery can greatly improve quality of life.

3. DeQuervain’s tendonitis

The tendons in the wrist that lift the thumb up are prone to tendonitis. These tendons travel through a tight compartment on the thumb side of the wrist. If there is friction on the tendons, they can become inflamed and very painful. This is classic in young mothers, and is sometimes called mommy’s thumb. Treatment consists of splinting, anti-inflammatory medications, therapy, and steroid injections. DeQuervain’s release surgery is occasionally necessary to resolve this condition.

4. Carpal tunnel syndrome

Carpal tunnel syndrome is a type of pinched nerve. When the nerve is pinched in the carpal tunnel, patients have numbness and tingling in the thumb, index, middle, and/or ring fingers. Initially symptoms come and go, and are often worse at night. Some patients feel electric shock sensations or burning pain in their thumbs. In severe cases, the thumb muscles can become weak and atrophied. Treatment for most patients includes wearing a wrist brace at night, stretching exercises, hand therapy, and steroid injections. Carpal tunnel surgery is very effective for most patients if non-operative treatment is not successful or if nerve compression is severe.

5. Skier’s thumb

Trauma to the thumb is common. During a fall, most people land on an outstretched hand to brace themselves. Unfortunately the ligaments in the thumb can become injured in this way. The ulnar collateral ligament (UCL) of the thumb is vulnerable to tearing as the thumb is bent backwards and away from the hand. If this ligament does not heal properly, patients can have pain and weakness with pinch tasks. For most minor sprains of the thumb, temporary immobilization in a splint or cast is successful to allow healing. If the ulnar collateral ligament is fully torn, however, surgery is usually recommended to fix the injury. Hand therapy is often helpful during the recovery process to regain range of motion and strength.

If you have an injury to your hand or thumb, or pain which does not go away with conservative treatment, make an appointment with a hand specialist to get an accurate diagnosis and good treatment plan.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

How to Treat a Broken Finger Tip

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Article featured on American Society for Hand Surgery

The finger tip is one of the most commonly injured areas of the upper extremity because we use our finger tips in so many daily activities. Your finger tip can be injured in a variety of different ways, including being crushed by a door, hit with a hammer, getting stuck under a heavy object, or cut with a knife.

While some finger tip injuries may be minor, others can be more severe. You can the bone, nail bed, tendons or even the nerve endings, which allow you to have sensation in the finger tips. Here’s how to treat a finger tip injury, depending on the severity:

  • Dressing (a gauze wrapping or tape): Dressings can treat more minor finger tip injuries, such as when just the skin is affected or if there is a small amount of bone exposed.
  • Splints or metal pins: These can be used if you’re suffering from a broken finger tip. The metal pins will hold the bone fragments in the proper position.
  • Drainage: If blood is collecting under your nail, your hand specialist may make a small hole in the nail to drain it.
  • Surgery or amputation: These treatment options are reserved for more severe nail bed injuries.

Regardless of which treatment you receive, it’s important to remember that your finger tip may never look or feel the same after an injury, especially a severe one.

Your treatment plan will vary based on your specific circumstances. Visit a hand specialist as soon as you’ve injured your finger tip to determine the best plan. The sooner you receive treatment, the better. Delaying treatment may result in loss of feeling in your finger tip.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Is My Hand Pain from Carpal Tunnel Syndrome or Something Else?

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Article featured on Spine-Health.

We all wake up sometimes with a numb and tingly hand. But ongoing hand pain and numbness can be a disabling problem that requires diagnosis and treatment.

Here are 3 of the main causes of hand pain and numbness—and tips for how you can tell them apart.

 Medical illustration of the palmar view of the hand. Transverse carpal ligament, flexor tendons, and median nerve are labeled.

Carpal tunnel syndrome

When hand pain is experienced, it’s common to first suspect carpal tunnel syndrome. This condition is caused by the narrowing of a bony passageway in your wrist, which irritates or compresses the median nerve that runs through it.

Symptoms tend to be in the thumb, index finger, or middle finger, along the path of the median nerve. The pain may wake you up at night or be worse in the morning. In the early stages, shaking your hand may bring relief.

Rheumatoid arthritis

Another possible cause of hand pain and numbness is rheumatoid arthritis.

Hand pain from rheumatoid arthritis tends to be different from carpal tunnel syndrome in 2 main ways:

  1. It causes pain and stiffness in the large knuckles or joints of the wrist, rather than along a nerve path.
  2. Its pain is symmetrical, meaning it will affect both hands simultaneously.

Cervical radiculopathy caused by spine conditions

While it may not seem obvious, your hand pain and/or tingling may actually be caused by a problem in your neck.

The nerves that give sensation to your hands originate in your cervical spine. When one or more of the 8 nerve roots that exit the cervical spine become irritated, it causes pain and other neurological symptoms down the nerve path. This is known as cervical radiculopathy.

The most common conditions that can trigger radiculopathy include:

  • Cervical herniated disc
  • Cervical spinal stenosis
  • Cervical degenerative disc disease
  • Cervical osteoarthritis

Cervical radiculopathy pain can be mildly achy or sharp and stabbing. It can also cause numbness and/or pins-and-needles tingling sensations. Symptoms can affect different sections of the hand depending on what level of the spine is the source of the irritated nerve.

Since carpal tunnel syndrome and cervical radiculopathy can both affect the median nerve, it’s important to note one key difference: Carpal tunnel syndrome pain will only affect the hand and wrist. Cervical radiculopathy from the C6 spine level (where the median nerve originates) will often cause pain and symptoms along the arm and in the bicep, as well as in the hand.

Aside from these 3 causes, hand pain can also be caused by a variety of other conditions, including diabetes and nutritional issues.

The best way to tackle hand pain that doesn’t resolve is to see your doctor, who can diagnose the correct cause and start a treatment plan. Many conditions that cause hand pain are more easily treated if they’re caught early.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday