Corticosteroid injections, sometimes called Cortisone, are often employed to reduce inflammation and pain following an injury, or in the degenerative conditions of arthritis or carpal tunnel syndrome. It is best to consult with a doctor who specializes in the area needing treatment. In the case of the hands and arms, a hand specialist should perform the injection. For the foot, ankle and lower extremities, a podiatrist should be consulted.
In the case of injury or degeneration in the hands or wrists, corticosteroid injections are just one part of an overall plan to return the patient to full health and mobility. Hand exercises, hot and cold modalities and massage therapy may also be employed by the team of hand therapists at Midwest Hand Therapy.
Here is a step by step description of what you can expect from a corticosteroid injection procedure:
The patient will be placed in a comfortable position, so that the area requiring the injection is readily accessible to the doctor.
The injection site will be disinfected with alcohol or iodine.
The patient will be encouraged to relax. If the muscles around the joint are relaxed, the injection will glide more smoothly and with less resistance and discomfort.
If ultrasound is being used, a gel will be applied near the injection site, and a technician will gently press an ultrasound transducer against the skin to show an image of the joint space.
If the affected joint or bursa contains excess fluid, the doctor may gently draw off the fluid with a needle and syringe. This is known as joint aspiration or arthrocentisis.
The doctor will then inject a small amount of cortisone into the joint; the cortisone may be mixed with an anesthetic such as lidocaine or bupivacaine. The patient may notice a pinching or a burning sensation.
The injection area will then be cleaned and bandaged, and the patient may be asked to flex the joint several times to help distribute the medication.
Usually patients wait about 30 minutes in the doctor’s waiting room, following this procedure, just to insure they have no unusually severe pain or an allergic reaction to the medication.
These injections can be helpful in reducing inflammation and its associated pain over varying periods, depending on the individual. Frequently the pain is reduced for several weeks or even months, allowing the patient to participate in therapy to strengthen and elongate the muscles and tendons around the joint, to help resolve the issue.
If someone you know is struggling with pain, swelling, tenderness or tingling in the fingers, hands, wrists or elbows, contact Dr. Rehman today. She specializes in injuries and conditions of the upper extremities, and will perform an in-depth analysis of the cause of the condition. Utilizing state-of-the-art technology, she will design a comprehensive program of therapy to return the affected area to full strength and mobility.
Anything that reduces the blood supply to the wrists, hands and fingers can cause nerve damage, and this damage creates the feeling of numbness or tingling in that area of the body.
A variety of activities and conditions can contribute to this reduced blood supply. Sometimes repetitive motions over a long period of time, such as in a work, hobby or sports setting, can be a factor. Diabetes can reduce the blood supply to peripheral areas of the body, resulting in nerve damage. Arthritis and Multiple Sclerosis can also cause this condition, as can certain chemotherapy drugs used for cancer treatment.
Some of the most common conditions causing numbness or tingling are:
Tendonitis is an inflammation of a tendon in the body. Tendons attach muscles to bones, and are responsible for helping to create movement. Normally tendons glide smoothly, but when they become inflamed, this process is affected. Stiffness, pain, and sometimes tingling is noticeable. Sports or other injuries can cause this sudden inflammation, but so can repetitive motions from working on a computer, repetitive manufacturing jobs, sewing, playing a guitar or other activities.
The carpal tunnel is a narrow passage through the wrist that houses and protects the median nerve, running from the hands all the way up the arm. When this tunnel becomes inflamed, pressure is placed on this nerve and pain, numbness and tingling can occur. Some people are genetically more prone to this condition; others can develop it over time from repetitive motions involving the wrists and fingers.
Again caused by inflammation, in this case the tendons in the fingers, this condition causes a finger or the thumb to become “stuck” in a bent position, and then to snap back when it releases, much like a trigger releasing. Early signs of trigger finger can include stiffness when you move the finger, your joint “popping” when you move it, or a bump at the base of the finger. Repetitive grasping or gripping motions are usually the source of this condition. If not treated properly, the digit can become permanently bent.
The most important step to take when you are experiencing numbness or tingling in the hands is to start with a proper diagnosis of the cause of the condition. It is best to consult a doctor who specializes in treating the hands and the upper body, as these are delicate structures involving complicated interactions between the tendons, ligaments, nerves, bones and muscles.
Most causes of tingling and numbness can be treated with a variety of non-invasive techniques, and will successfully resolve with proper treatment and time. Sometimes a surgical intervention is necessary, and in this case you definitely want a hand surgeon; an orthopedic doctor with specialization in the hands, wrists and upper body.
If you or someone you know is experiencing hand, finger, wrist or upper extremity pain, contact Dr. Rehman today. She will perform a thorough evaluation to determine the root of the problem, and will design a comprehensive treatment plan to help you attain a full recovery.
Some of us are chained to it, as we spend 8 or more hours a day peering at the screen and typing cogent replies to superiors, customers and team members. Sitting at a computer typing for hours on end is not a “natural” thing for humans, so take precautions to avoid repetitive motion injuries that can stem from this activity.
Repetitive motion injuries occur from too many uninterrupted repetitions of an activity or a motion. They can also be caused by repetitive awkward motions such as twisting the arm or wrist, overexertion or incorrect posture. They frequently occur in the hands, wrists, elbows or shoulders, and can result in numbness, tingling or pain.
A few simple steps can help you lessen the chance of developing a repetitive motion condition from working at your computer:
Take Frequent Breaks
This is the Golden Rule for preventing most repetitive motion injuries. For every ten minutes you work on the computer, try to schedule in mini-breaks for 30 to 60 seconds. Take a few moments to rest your eyes: let your gaze fall across the room in an unfocused way for a count of ten. Rest your hands and wrists by bending the hands down gently, and by using a hand washing motion to rub the hands and wrists. This helps bring fresh blood to these areas so tissue that is damaged can begin to repair. Rest your back by flexing your spine forward and backward gently. This also brings fresh blood to this critical area. Do shoulder rolls by rolling the shoulders up and around, in both directions, to release tension in the upper back and neck.
Type in a Neutral Position
Also called touch typing, this approach helps you keep your wrists straight, thus putting less stress on them. Keep your wrists elevated and off the surface of the desk or keyboard. The keyboard should lay flat on the desk; don’t angle it up. The tips of your fingers should be the only part of your hand touching the keyboard.
Sit Up Straight
Your mother was right. Proper alignment of the spine helps reduce problems with the neck, shoulders and lower back. Roll your shoulders back, and allow for a slight arch in your lower back. Keep your elbows and knees bent at near-right angles to support the position.
Evaluate Your Monitor Placement
Your screen should be between 20 to 40 inches from your eyes and should be directly in front of you. The top of the monitor should be at eye level, or slightly below. Don’t tilt the screen more than 10 to 20 degrees, for the best viewing and least eye strain.
Adjust Your Mouse Placement
Your mouse should be right next to the keyboard; you should not have to reach or stretch to use it. Invest in a mouse wrist rest so that your wrist can remain straight. Consider replacing your mouse with a trackball. These devices are better designed to fit the hand, and don’t require you to bend your wrist or to grip.
Tingling, numbness or pain in the hand, wrist, elbow or shoulder should be evaluated by a specialist in orthopedic medicine. Schedule an appointment today with Dr. Rehman for a comprehensive evaluation and an individualized treatment program to get you on the road to recovery. Many repetitive motion injuries can be treated with minimally-invasive procedures. Dr. Rehman’s team of hand rehabilitation therapists can help you reduce pain and regain mobility, so your work is enjoyable and you are pain-free for the fun activities of life.
The golfing season will soon be here, and most devotees are dying to get out on the links in the fresh air and sunshine of a fine Michigan spring.
What can you do to prepare yourself for the activities ahead?
Hopefully, you have not taken the whole fall and winter off being a couch potato! Golf is a rigorous, demanding sport, and proper conditioning will not only help your game, it will help you avoid injuries as well.
First, evaluate where you are now
You should be able to move fluidly, without pain or stiffness. You should also be able to perform the basics of strength conditioning: squatting, hinging, pressing, pulling, planking, jumping and throwing. Even though these moves seem unrelated to golf, they are essential for a powerful swing with maximum force, and to protect you from injury.
Before you head out to play, incorporate dynamic activities that get your body moving, your heart beating faster, and your muscles warmed up. Consider brisk walking, jumping rope and/or doing jumping jacks to fire up the system. Dynamic stretches, incorporating movement of the shoulders, arms, hands and wrists are also helpful to reduce the chance of injury.
If you begin to notice pain
On the bony bump on the inner side of the elbow, this could indicate the condition of golfer’s elbow, also known medial epicondylitis. The elbow joint is comprised of the bone in the upper arm (the humerus) and one of the bones in the lower arm (the ulna), joined together by forearm muscles and tendons. The bony bumps at the bottom of the humerus are called epicondyles. The bump on the inside of the elbow is called the medial epicondyle. The tendons of the muscles that work to bend your wrist attach at the medial epicondyle. Medial epicondylitis may also be referred to as wrist flexor tendonitis.
What causes it?
An overuse of the muscles that allow you to bend your fingers and wrist causes this condition. When these muscles are overused, the tendons are repeatedly tugged at their point of attachment, which is the medial epicondyle. As a result, the tendons become inflamed (tendonitis) and repeated, tiny tears cause pain. This is a common injury in sports such as golf, in throwing sports, and in racquet sports. It also may happen in occupational activities such as carpentry or data entry.
What are the symptoms?
Pain in the bony bump of the elbow on the side closest to the body is the most obvious indicator of this condition. The pain may also radiate along the entire inner side of the forearm when the wrist is bent. You may also notice pain when you make a fist.
How is it diagnosed?
A doctor who specializes in the hands, wrists and shoulders is the best person to diagnose this condition. He or she will examine your elbow and discuss your activities and occupation to make the diagnosis.
What is the treatment?
Ice packs applied to the elbow for 20 to 30 minutes, 3 to 4 times per day should be continued for 2 to 3 days, or until the pain goes away. If the elbow is swollen, you should elevate it on a pillow when lying down, or on the back of a chair or the couch when sitting up. You may be given an elastic bandage to wrap around your elbow to keep the swelling down.
While recovering from such an injury, you will need to change to a different sport or activity. The doctor may also prescribe a tennis elbow strap for you to wear just below the tender spot on the elbow. This will allow the forearm muscles to pull against the strap instead of against the tender area of your elbow.
Your doctor may also prescribe oral anti-inflammatory drugs, or give you an injection of corticosteroid medication around the injured area, to reduce inflammation. Exercises to regain range of motion and strength will also be prescribed. In severe cases of medial epicondylitis, surgery may be required.
When can I return to my activity or sport?
In general, the longer you have symptoms before you begin rehabilitation, the longer the time period of recovery. Returning to your sport or activity will be determined by your rate of healing, rather than a set number of days or weeks. Continuing to perform the activity while the arm is injured could cause permanent damage. Dedication to executing the exercises, and performing them with the correct form, will also positively influence the rate of healing. The goal of rehabilitation is to get you back to full function as soon as it is safe for you to do so.
When you can forcefully grip your tennis racquet, bat or golf club, or type on a keyboard painlessly, it is safe to return to the activity. In the case of an injury in gymnastics, it is imperative that you can bear weight on the elbow painlessly; that there is no swelling at the elbow and that your strength and range of motion in the injured elbow is equal to the uninjured one.
How can it be prevented?
Medial epicondylitis occurs due to overuse of the muscles that bend your wrist. Avoidance of this overuse is the best prevention. At the earliest signs of pain on the inner side of your elbow, slow down your activity and seek treatment. Wearing a tennis elbow strap and doing elbow stretching exercises will help you prevent medial epicondylitis.
If you or someone you love is experiencing pain in the hands, wrists, arms, elbow or shoulder, contact Dr. Rehman’s office today. She will conduct a thorough evaluation to determine the exact cause of the problem, and will begin with the least invasive treatment possible. Her team of experienced hand therapists will guide you in your recovery so you can regain full strength and range of motion in the affected area. Call Dr. Rehman today for more information at 586-532-0803.
It’s an odd feeling, and one that can be bothersome and problematic. Your hands and fingers may tingle, or you may notice numbness in one of the joints of your fingers or in your thumb.
Some of the more common causes of this condition are:
Carpal Tunnel Syndrome
The carpal tunnel is a narrow passageway located on the palm side of your wrist. A main nerve to your hand runs through this tunnel, as do the nine tendons that bend your fingers. Compression of the nerve causes the numbness, tingling, and eventual weakening of the hand itself. Sometimes this compression is the result of repetitive motion activities. But there may be a genetic predisposition to the condition as well. For some people, the carpal tunnel is narrower and more at risk for irritation of the nerve running through it.
Trigger Finger or Trigger Thumb
In this situation, numbness, tingling or weakness in the hand may be noticed. Typically the result of overuse injuries, trigger finger or thumb affects women more often than men, and is often associated with people who have diabetes. The affected appendage will “snap back” into place like a trigger releasing. Inflammation of the tendon in the affected appendage is the culprit here, and if the condition is severe, the finger or thumb may be locked into a bent position. People whose work or hobbies require repeated gripping actions are at higher risk of developing trigger finger or trigger thumb.
Tendonitis
Tendons are the thick cords in the body that attach the muscles to the bones. If tingling in the hands or fingers is present, or a burning sensation is noted, tendons in the wrist or near the hand may be irritated, inflamed or swollen. This can be the result of a repetitive motion injury, or it could be an acute injury such as occurs in sports. Tendons become less elastic as we age, and damage can occur more easily.
If you are experiencing numbness or tingling in your hands and fingers, contact a Board Certified osteopathic doctor for a complete evaluation. Many of the conditions described above can be treated with minimally invasive procedures such as rest, applying cold packs, anti-inflammatory medication and sometimes corticosteroid injections.
Dr. Rehman has a team of hand therapists who will design a program of hand and wrist exercises and occupational therapy to return your affected appendage to full function and strength. Dr. Rehman is a hand surgeon who specializes in conditions and injuries to the upper body. If the minimally invasive procedures don’t provide relief, surgery may be considered. The hand and wrist are delicate structures, and it is best to have a specialist who is trained and experienced in the hand and wrist to insure a good outcome and a full recovery.
With the changes in schedule summer brings, sometimes it’s difficult to keep up the exercise routines we’ve committed to. With a little bit of creativity, you can stay in shape and entertain your kids at the same time. A bonus: the more flexible and strong each family member is, the less likely they are to be injured in a sporting event.
Morning Family Stretch
Set aside five to ten minutes each morning for the whole family to do some stretching exercises. Stretching helps to get the blood flowing and warms up the muscles for the activities of the day. Make this a daily routine for your family; it is healthful and a quiet bonding experience to help balance the hectic life most kids have.
Kids Make Great Dumbells (and their giggling will keep you going)
Try this Russian Twist: While seated on the floor with your knees bent, hold your child in front of you, engage your core and twist from side to side. Repeat 10 to 20 times. This is a great one for arms and abs.
Squat Press: Stand while holding your child in front of you with your feet hip distance apart, arms extended, but elbows not locked. Slowly lower into a squat like you are sitting in a chair and then slowly stand back up straight. Be sure to keep your knees in line with your ankles. Repeat this 10 to 15 times. Great for the arms and lower body.
Throw a Dance Party
Push the furniture out of the way, round up your family’s favorite tunes, and crank up the speakers for a blast of exercise that will get everyone involved. Dancing is super fun and a great cardio workout. Make one afternoon or evening a week your “Dance Party Night” from now till the kids go back to school.
Family Competition
We’re all about competition in our culture, and most kids are involved in at least one organized sport by the time they are a few years old. Motivate your family by setting weekly goals, and create a chart and point system that helps your family track their activity or eating habits throughout the day. See who can be the healthiest!
All these suggestions should help, but if you or your child are injured in one of your organized sports—or at the company baseball game—be sure to reach out to Dr. Rehman and her team of rehabilitation professionals. Specialists in hand, arm and shoulder rehabilitation, they can help resolve tendonitis, golfer’s or tennis elbow, hand and wrist pain, and many other conditions. To learn more, contact Dr. Rehman’s office at 586-532-0803 today!
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.
We’ve all heard of splinting, and have a general idea of what it is. But today’s advanced, custom-designed orthopedic splints are so much more than the basic splints of years ago.
Particularly for hand and wrist involvement, a specially-designed splint that is custom made for the individual’s particular situation can make a world of difference in the healing process and the return to full use of the affected area. Custom splints are often used to treat conditions like muscle strain, neuritis, tendonitis, and sometimes are used following hand or wrist surgery. The splint acts to provide rest for the injured or inflamed areas, as well as holding the affected appendage in the correct position.
Especially after surgery, custom splints can help the patient with the early motion protocols that are needed to help facilitate a full recovery. Custom splints also help following surgery by providing a barrier against common post-operative injuries.
With today’s technology and the advanced skill set of the hand therapists at Dr. Rehman’s office, custom splints can be made for many applications. The therapist designs and fabricates the custom splint, which is manufactured from low-temperature thermoplastic material; it can be designed specifically for the injury, as well as the size of the patient.
Injuries and conditions of the hand and wrist that are not healing properly deserve the attention of an experienced, knowledgeable, Board Certified orthopedic doctor who specializes in this area of the body. If you are having pain in the hand, wrist or shoulder, seek a consultation from Dr. Rehman today.
The tendons in the body are the flexible bands of fibrous tissue that connect the muscles of our body to our bones. Normally the tendons glide smoothly when muscles stretch or contract. But inflammation in the tendons can cause the gliding motion to be impaired, causing pain and discomfort. At Macomb Hand Surgery we specialize in treating the hands and fingers, wrist, elbow and shoulder with a variety of methods. If you are experiencing pain, numbness, weakness, stiffness or tingling in these areas, you may have tendonitis.
Sometimes tendonitis can be caused by overuse of a muscle or limb; golfers or tennis players may experience tendonitis. Warming up the limb before use, stretching the muscles, and taking frequent breaks from the repetitive activity can rest the muscle and reduce the likelihood of tendonitis. Many tendon and nerve issues can be prevented by regular breaks and exercises to strengthen the muscle. Practicing the correct form while performing the activity can also prevent the injury and damage that leads to tendonitis. Maintaining a healthy weight and a regular exercise program is also helpful, as good blood supply to the tendons helps them to stay lubricated and reduces the chance of injury.
A variety of approaches will be used at Midwest Hand Therapy to treat your tendonitis. First, a thorough evaluation by Dr. Rehman, a Board Certified Orthopedic surgeon, will be performed. The treatment team may then implement solutions such as rest or immobilization of the affected area, the application of cold packs, anti-inflammatory medication, corticosteroid injections, hand, wrist or arm exercises and/or occupational therapy.
Most nerve and tendon damage can be treated successfully if intervention is undertaken early. If you are experiencing pain, stiffness or numbness in your upper extremities, contact Dr. Rehman today.
Although not technically a pain-relieving medication, injectable corticosteroids, commonly called ‘Cortisone”, have been used since the 1950’s to reduce pain following a muscle or tendon injury. Cortisone is naturally produced in the body by the adrenal gland and is released when the body is under stress. Injectable cortisone is synthetically produced and is similar to the body’s own product. By reducing the body’s reaction to the inflammation associated with the injury, the pain is reduced.
The medicine is injected directly into the inflamed area, such as the wrist or elbow, with a high concentration of cortisone administered with minimal side effects. Discomfort usually improves within a few days and can last for several weeks or permanently. However, cortisone injections must be coupled with appropriate rest and rehabilitation to produce the best results. Cortisone injections are contraindicated for athletes immediately before an event, as they may increase the risk of infection or contribute to additional injury.
Repeated injections can have deleterious side effects, with a softening of the cartilage and weakening of the tendons at the injection site, however this usually occurs only in patients who receive shots on a weekly or monthly basis over a period of months or even years. Diabetic patients must have their blood sugar monitored closely for 24 to 48 hours after an injection, since the absorption of cortisone into the blood stream can cause a significant elevation in blood sugar.
Most individuals tolerate the procedure well, and find significant relief from the pain of a muscle or ligament injury. Always seek a Board Certified orthopedic doctor such as Dr. Rehman for any type of hand or arm injury. And don’t wait to seek treatment! A hand or arm injury that is causing pain should be evaluated early on, when the chance for minimally invasive treatment leading to a full recovery is at its highest.
serving Detroit,Troy, Southfield, Warren, Rochester Hills, Sterling Heights,
Macomb Township, Shelby Township, Utica, Washington MI, Bloomfield Hills, Lake Orion, Clarkston, White Lake, Waterford,
Commerce Township, Mount Clemens, Clinton Township, Chesterfield, Harrison Township, Pontiac,
Center Line, Fraser, Roseville, Clawson, and all the surrounding areas
