The initial symptoms may be innocuous and fleeting; an ache in the wrist which may then extend into the forearm or into the hand. Later, as the condition develops, you may notice numbness or tingling in the hands or fingers, or pain that begins radiating through the entire arm. Sometimes weakness is present in the arms or the hand, and grasping objects can be difficult. Oftentimes the symptoms will be most severe upon waking up in the morning, or when using your hands.
Here are some ways to minimize the stress on your hands:
When doing tasks, reduce your force and relax your grip. Try putting foam padding around gardening or other tools to cushion your grip. Most people use more force than is required when gripping an object.
Watch how you hold your wrists. Repetitive motions performed by cashiers, hairdressers, sewers and workers using a keyboard can contribute to Carpal Tunnel syndrome. Ideally, you should keep your wrists straight or very slightly bent.
Take frequent breaks; set a timer for every hour or two to remind you to take a break. Stretch, bend and massage your wrists and hands to promote circulation and blood flow
Be sure your form is correct when performing repetitive tasks on the computer, with tools, or in sports. Be sure your equipment fits you properly and consult a coach to make sure your posture and form are correct. When working on a keyboard, make sure your posture is correct. Incorrect posture can cause your shoulders to roll forward, and shorten the muscles in the neck and shoulders, causing the nerves in your neck to be compressed. This in turn can affect your wrist, fingers and hands.
Ice can be helpful to reduce pain and inflammation, and non-steroidal anti-inflammatory drugs can often help.
Wearing a wrist splint may also help, especially to keep the wrist straight at night, when many people have a tendency to curl the wrists. Bracing the wrist at night will help you keep it straight, reducing the discomfort of carpal tunnel syndrome in the morning.
If you or someone you know is experiencing pain, tingling, numbness or pain in the wrist and hand, contact Dr. Rehman’s office today. She will do a complete evaluation, and her experienced team of hand therapists will use a variety of modalities to help you get relief and to return the wrist and hand to full functioning. And, if surgery should be required, Dr. Rehman is a hand specialist, and has performed many successful Carpal Tunnel release procedures. Contact Dr. Rehman today to get relief from the pain and back on the road to full strength and mobility.
Summer is the perfect time to instill in your children the love and the fun of outdoor activities. There’s no doubt about it; kids are much more sedentary these days, and childhood obesity is a chronic problem.
Kids play outdoors much less now than decades ago, and many factors go into the equation. Parents often have concerns about kids playing outdoors without supervision, and with the hectic lifestyle of most two-worker families, parents don’t have the time. Poor coordination skills and cuts to school recess and sports programs may have an effect. Children are often encouraged to play safely indoors, without the worry of outdoor activities. They have a lot of entertainment available to them now on their screens, which unfortunately promotes sitting and inactivity.
But grab the waning days of summer and reverse this trend! A simple walk to the park after dinner as part of the family routine can build bonds, happiness and physical health. Outdoor hopscotch on the driveway, trips to the local nature center or the zoo, skateboarding parks and events and even bike riding can help kids breathe in fresh air and work their muscles, helping them sleep better at night too.
As parents, the more active you are, the better example you set for your children, and the more likely they are to embrace physical activities. Experts have found that if children just moved around for an hour each day, the obesity rate would fall. Beginning at a young age, involve your kids in age-appropriate physical activities. Let them choose what they would like to try, and if one activity doesn’t fit, move on.
Activity promotes wellness and wellness yields health and happiness. If you or someone you know is missing out due to pain, stiffness, numbness or tingling in the hands, arms, wrist or elbow, reach out to Dr. Rehman today. She will conduct a thorough evaluation to determine the cause of the problem, and will design a comprehensive program to regain strength, mobility and range of motion. So you can get back out there and have outdoor fun with your family in the glorious remaining days of summer!
For more information, call the office today: 586-532-0803
Contracture: A shortening or distortion of muscular tissue.
When it occurs in the hand, it is called Dupuytren’s Disease or Dupuytren’s Contracture.
What it is:
For some reason, still unknown to doctors, collagen builds up in the palm of the hand, forming a thickening of the skin near the palm. Over a period of time, the collagen can build underneath the skin into long rope-like formations, that then pull on one or more of the fingers of the hand. Usually only one hand is affected, and the condition does not seem to be related to particular occupations, sports or other repetitive activities. Often the ring finger and the pinky finger are affected, but sometimes the middle finger can be involved. Usually the condition does not cause a great deal of pain, but in the later stages, if the formations pull on the finger and cause it to bend, this can be problematic.
How it is diagnosed:
An orthopedic hand specialist is the best person to consult for this condition. She will examine your hands, and compare one to the other. She will also feel your hands to see if toughened knots or bands of tissue are present. A simple exercise may be performed; she may ask you to place the affected hand flat on a table or countertop. If you are unable to flatten your fingers, Dupuytren’s Contracture is indicated.
How it is treated:
If the condition is mild, or in the early stages, regular monitoring and check-ups may be all you need to do. If it has progressed so that knots or bands are present under the skin and one or more fingers are bent, the doctor may implement a series of usually three injections of an enzyme that breaks up the bands of tissue. This enzyme is a collagenase; the brand name is Xiaflex. As the injections work to break up the tissue, the doctor will manipulate the hand to further break up the cords that are causing your fingers to bend. The advantages to this procedure are that there is no incision, and usually very little physical therapy is needed afterward.
In severe cases, surgery may be required. In this case the hand surgeon will make one or more incisions, usually in the creases of the hand, and will remove the fibrous bands of tissue. This procedure typically results in a long-term resolution of the condition, but the surgery is more invasive than injections, recovery will take longer, and physical therapy will be required.
Who to consult:
The hands are complex and delicate appendages, and a specialist trained in hand problems and their resolution is the best person to consult for such conditions. Be sure to engage a Board Certified Osteopathic Doctor, such as Dr. Rehman, for a thorough evaluation and comprehensive treatment program. She has a team of specially-trained hand therapists who will insure that your recovery is complete, with no pain and full range of motion and strength as the final outcome. To learn more, contact Dr. Rehman today or call 586-532-0803.
After one of the hottest summers on record, the cooler weather of fall is a welcome relief. Breezes blow, days are sunny, and homeowners’ thoughts turn to getting their castle ready for the blasts of winter. Gardens need to be put to bed, siding needs cleaning, windows need caulking and the leaves and abundant acorn crop need raking.
But injuries caused by strains or too many repetitive tasks in a short time span can occur.
The first step is to pace yourself. You can’t get it all done in one day, or even one week. Work for two or three hours, and then rest until the next day. Pay attention; if your hands or wrists start to feel numb or are tingling, you should stop the activity and come back to it later or the next day. Try to get leaf rakes that are the proper size for you, and that have ergonomically designed handles.
Do some warm-up stretches before you start, especially if you are not an active person. Lifting the arms overhead, bending side to side, toe touches or forward bends can help loosen up arms, back and legs for the demands of fall clean-up. A five to ten minute warm-up period will help to generate heat in your body. This in turn helps to make the tendons, ligaments and other connective tissue more pliable and less prone to injury.
Even when walking about your neighborhood, beware of fallen leaves. They can disguise holes or uneven pavement, and they are very slippery when wet. In the earlier hours of the day, patchy frost may form in shaded areas, making dangerous slippery spots. Falls onto an outstretched hand can damage the bones, ligaments and tendons in the hand and the wrist. The hand is comprised of 27 bones, and even a slight injury to one of these can be painful and require proper medical attention.
If you or your family are dealing with pain, stiffness, lack of mobility or numbness /tingling in the hands, wrist, arm or shoulder, reach out to Dr. Rehman today. Upper body injuries that are incorrectly diagnosed or left untreated can cause permanent damage. Seek a thorough examination and comprehensive treatment program by a Board Certified Osteopathic doctor with a team of rehabilitation experts. Call Dr. Rehman’s office today at 586-532-0803 to learn how she and her team can help.
Olympian long-distance cyclists are at risk for this condition, as are professional baseball pitchers, but you could be too. Do you notice numbness, tingling or pain radiating into your arm and hand on the side of the little finger? “Handlebar Palsy” or Ulnar Neuropathy can be caused by the repeated jarring of the wrists and hands when cycling. The result is an inflammation of the ulnar nerve, a major nerve in your arm that runs down your hand. Inflammation of the ulnar nerve can occur in several areas as it travels from your neck to your hand. Resting your elbows on hard surfaces for a long period may cause a slight inflammation, but intense physical activity such as long-distance biking or repeatedly pitching a baseball are more likely to cause the serious cases of this condition.
Watch for numbness, tingling or pain in the forearm or hand on the side of the little finger. Pain and numbness in the elbow may also be present, with decreased hand grip and the inability to pinch together the thumb and the little finger. The ulnar nerve often becomes trapped in the elbow, as the space it has to travel through in this area is limited. This is called “Cubital Tunnel Syndrome.”
Although ice, rest and anti-inflammatory medications may help initially, if the pain and tingling persist, seek the advice of a specialist trained to evaluate and rehabilitate the hands and upper body. This doctor will review your symptoms and ask about your lifestyle and activities. He or she will examine your neck, shoulder, arm and wrist. The doctor may order tests such as a nerve conduction study (NCS) or an electromyogram (EMG). EMG is a procedure where electrodes are placed into the muscles and on the skin to measure the health of muscles and the nerves that control them, to help identify the area of nerve damage and determine the severity of the condition.
The exact cause of the condition must be determined, and behavioral changes must be made to reduce the pressure on the nerve. Wrist splints may be prescribed to reduce discomfort. If the cause is from bicycling, it may help to wear padded gloves and to change your hand position on the handlebars frequently. Oral anti-inflammatory medications and B vitamins may also be prescribed. Typically these minimally invasive measures will alleviate the condition, but if not, surgery may be required. The vast majority of patients respond favorably to some type of surgery to correct this condition.
If the nerve is trapped in the elbow, Cubital Tunnel Release surgery can be effective. This is typically done on an outpatient basis, and individuals can go home the same day. The area known as the cubital tunnel is cut to allow more room for the nerve to pass through. As healing occurs, new tissue is formed and fills in this area. The recovery period for this type of surgery includes wearing a splint for a few weeks and physical rehabilitation therapy to return full range of motion and strength to the arm and hand.
Repetitious motions or constant jarring of the arm cause the inflammation of the ulnar nerve. Try to reduce activities that repeatedly stress this area, and take frequent breaks with arm stretching when you can. If you are a bicyclist, wear padded gloves and move your hand position on the handlebars frequently.
If you are experiencing pain, stiffness or tingling in your hands, arms or shoulder, contact Dr. Rehman for a comprehensive evaluation and treatment plan. Her team of hand therapists will help you return to your activity with full use of your arm or hand. Call 586-532-0803 for more information.
Bumps on the hand or wrist are most often ganglion cysts: a fluid-filled sac that bulges up. They can appear quickly, and disappear just as quickly. But sometimes the cysts remain, and are unsightly or cause impaired function or pain in the hand or wrists. Why these cysts develop is still unknown, but they are more common in younger people from ages 15 to 40, and they are more common in women than in men. One theory posits that they are caused by repetitive motion of the hand or wrist. Gymnasts have been noted to experience the problem more frequently, due to the extra stress and pressure on their hands and wrists.
Treatment for ganglion cysts is often non-invasive, and may involve the use of wrist splints to immobilize the hand, thus allowing the overworked area to rest. Sometimes this can reduce the cyst. If the cyst is quite bothersome or painful, an aspiration procedure may be performed. In this procedure, the affected area is numbed and a needle is inserted into the fluid-filled cyst, withdrawing the fluid. This can relieve the pressure that may have been placed on nerves or tendons, causing the tingling or pain in the hand or wrist. If the cyst grows back, sometimes this procedure can be repeated with success.
Failing that, and if the cyst is quite bothersome or creating pain, a surgical procedure may be required. In this case a special orthopedic surgeon such as Dr. Rehman will perform a procedure to remove the ganglion and its root. This is typically an outpatient procedure, and the patient can go home later in the day. Splints and dressings are required, and often Occupation Therapy is prescribed to return full strength and range of motion to the hand and wrist. Because the structure of the hands and wrists is so delicate, it is best to have a specially trained doctor, such as a hand surgeon, perform this procedure.
If you are experiencing pain, stiffness or tenderness in your hands, arms, should or elbow, contact Dr. Rehman today at 586-532-0803. Her team of orthopedic experts will implement a comprehensive treatment plan to help you attain a full recovery.
With slippery conditions everywhere, falls are common wintertime injures. Our first reflex is to extend our arms and hands when falling, and landing with our full weight on the delicate structures of the hand and wrist can cause damage.
Sometimes the break is obvious- as when the bone protrudes through the skin. But other times, a fall may cause a small crack, or fracture, which may not be as obvious as a shattered bone.
Signs to watch for after a fall are:
Swelling
Redness or pain
The inability to move a finger
A deformity of the fingers, where one crosses over another
Due to the delicate and intricate nature of the hand, it is best to seek a Board Certified Osteopathic doctor for a full evaluation of the condition.
Often, the injury can be treated by realigning the bones and casting or splinting the hand or finger to keep it immobile until healing occurs. In more serious cases, surgery may be required and pins, wires, plates or screws may be needed to repair the damage.
You rely on your hands for everything you do in life! Be sure to consult with a specialist such as Dr. Rehman if you are experiencing any signs of a hand or wrist fracture, or if you are having on-going pain, stiffness or swelling in your hands or wrists. Her expertise, coupled with her staff of trained hand therapists, will help you achieve full healing and a return to strength and dexterity in these most important appendages.
These terms can be easily confused when discussing conditions or injuries to the body. First remember: both tendons and ligaments are part of the musculoskeletal system, comprised of all the bones, muscles and connective tissues in your body.Tendons and ligaments are two types of connective tissues; they are both comprised of dense layers of collagen fibers.
Ligaments attach bones to bones
Tendons attach muscles to bones
Ligaments are the connectors, linking bones together at the various joints throughout the body. They allow for all the range of motion that joints can perform. Just look at the amazing variety of movements your hand and fingers and wrist can do. The ligaments in your body support, strengthen and stabilize the joints.
Tendons are the connectors that allow your muscles to be attached to the bones of your body. They aid in the overall movement of your body by transmitting force from the muscle to the bone. They vary greatly in size and shape, depending on the size of the muscle and the size of the bone to which it is attached.
Both tendons and ligaments are very sturdy for the most part, but excessive pressure, forceful trauma or even repetitious movements can cause damage and injury to these important structures.
Pain is the number one signal that a problem is occurring in the tendons or ligaments of the body. Other conditions that can also be present are redness, heat and/or swelling. If you are experiencing chronic or acute pain in the joints of your body, seek treatment from a board certified osteopathic doctor such as Dr. Rehman. A thorough evaluation will be conducted, and a multi-modality treatment program may be recommended to help you get back to living an active, pain-free life.
With the cold winds blowing and the snow beginning to swirl, thoughts turn to prevention of falls and injuries on slippery driveways and parking lots. By taking just a few moments to plan your attack on this dangerous terrain, you may be able to avoid a fall.
First – take your time and proceed slowly. Concentrate on the area in which you are walking, and glance ahead for possible hazards. Be especially aware of potholes created by heaving ground in parking lots.
Keep an eye out for obvious slippery areas, such as wet leaves or icy patches, and navigate around these. Also watch when entering buildings; snow and slush can accumulate here and cause slippery conditions as well.
It cannot be stressed enough: wear appropriate footwear! Boots or shoes should have rough soles with waffles or ridges to provide traction. If fashion is your forte, carry a change of shoes with you to events. The hassle of changing shoes is far less than the hassle of an injury due to a fall.
Always use handrails when they are provided. They will stabilize you if you lose your balance and begin to fall.
If you do feel yourself falling – try to roll with the fall if you are falling forward. If you feel yourself falling backward, try to sit down. It is natural to catch ourselves with our hands if a fall occurs. In this case an injury can occur to the wrist and/or the hands.
If such an event happens, contact Dr. Rehman for a full and complete evaluation of your condition. Her team of specialists will help you attain the best recovery possible, and if you should require surgery, she has extensive experience in hand, arm and wrist injuries and surgical repair. Don’t rely on home remedies – contact Contact Dr. Rehman today!
Carpal Tunnel Syndrome (CTS) is rare in children or young adults. It is seen more often in women than in men, and more frequently between the ages of 40 to 60.
Certain health issues can put individuals at greater risk of developing CTS. Health problems or illnesses that cause pain or swelling in the arm or hand, or that reduce blood flow to the hands can set the stage for the development of CTS. Obesity, diabetes, rheumatoid arthritis, lupus and multiple sclerosis can all initiate this problem.
People who work with their hands can develop the condition; even those who enjoy hobbies like knitting, sewing or hours of computer games may experience CTS. Some of the occupations that are especially at risk are laborers and freight workers, movers, and stock and material professionals. Office managers, administrative support personnel, janitors, maids and housekeeping staff also have a greater likelihood of developing the condition.
CTS can sometimes develop in women toward the end of a pregnancy, although often in this case the condition resolves on its own. And women in menopause are more likely to experience CTS, making a connection to hormone fluctuation a possible contributing factor.
If you are experiencing unusual pain or numbness in your fingers or your hand, seek a professional consultation from a qualified Orthopedic surgeon such as Dr. Rehman. She will provide a thorough medical exam to define the exact nature of the problem, and her team of hand therapists will help to implement a comprehensive treatment plan designed specifically for you.
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