Odd things happen to our joints and our appendages as we get older. Sometimes these quirks can be ignored, and they work themselves out. But other times, it is best to take heed of what the body is trying to tell us.
Trigger finger is one such condition. Initially it may begin with stiffness of the finger in the morning. Typically it occurs in your dominant hand, with one finger involved, but sometimes multiple fingers or the thumb are affected.
Later, you will begin to notice a clicking or popping sensation when you move your finger. You may notice tenderness or a bump at the base of your palm.
As the condition progresses, the finger will pop back from a bent position, much like a trigger releasing. When the condition is at its worst, you may not be able to straighten the finger at all.
Why is this happening?
Tendons allow the fingers to move, and attach the muscles of the hand to the bones in the hand. These tendons are covered by a protective sheath. When this sheath become irritated or inflamed, the normal gliding motion of the muscles is impeded. Sometimes a nodule or bump can form, and this protrusion can get caught on the edge of the tendon sheath. When it breaks free, the result is the popping or clicking of trigger finger as the finger straightens.
Who is at risk?
Women aged 40 to 60 are more at risk of developing this condition than men. People whose occupations or hobbies require repeated gripping are more likely to be affected, and individuals with diabetes or rheumatoid arthritis are more likely to develop trigger finger.
The good news
Most treatment for trigger finger involves conservative methods such as resting the hands, applying cold packs and taking non-steroidal anti-inflammatory medications. For more advanced problems, a corticosteroid injection may be performed, and specific occupational therapy exercises prescribed for remediation. Sometimes splinting of the finger is used, to keep the finger in the extended position at night for up to six weeks.
If the condition is severe, surgery could be required. This is typically performed in an outpatient operating room, and patients go home the same day. The surgeon makes a small incision in the palm of the hand, to cut the tendon sheath to allow the nodule to move freely. Most people can move their fingers freely following surgery, but soreness will be noticeable in the palm. Most of the recovery is complete within a few weeks, but physical therapy and exercises may be required to return the hand to full function over a period of several months.
How can I know for sure?
If you or someone you know is experiencing any of the symptoms of trigger finger, reach out to a qualified orthopedic doctor, such as Dr. Rehman, for a full and complete evaluation. The hands and fingers are delicate appendages, and it is best to consult with a doctor who specializes in this area of the body. Dr. Rehman and her team of hand therapists are the best qualified to diagnose and prescribe treatment to return your hand to full range of motion and strength. And as always, early intervention is most likely to generate the most favorable outcome. Contact Dr. Rehman for more information or with questions. 586-532-0803
Pain in the thumb is no laughing matter, and anyone who is experiencing it will tell you that. The thumb is a crucial structure that is in use constantly in daily activities. When it is working properly, we don’t give it a thought. But when it is sore, it is a painful presence, affecting most of what we do with our hands.
The thumb is connected to the wrist via the basal or carpometacarpal (CMC) joint. This joint, and its attached appendage, the thumb, are susceptible to arthritis for a number of different reasons. One condition that contributes to the problem is obesity, but other conditions may play a part as well; injury, aging, stress, genetics and overuse may also be factors that contribute to the development of arthritis of the thumb. When arthritis is present in a joint, the cartilage that protects bones from rubbing together has deteriorated, and the bone rubbing against the bone generates the pain. Other signs of this disorder can also be swelling, stiffness, or a reduction in strength or range of motion.
Oftentimes, this condition can be managed by non-invasive methods such as:
Rest
Ice
Anti-inflammatory drugs
Corticosteroid injections
Hand splints
Occupational therapy techniques specifically designed to ameliorate the problem
But don’t try to go it alone. Seek out a Board Certified Osteopathic doctor like Dr. Rehman for a complete evaluation and a thorough, comprehensive treatment plan. Her specialized team of hand therapists will work with you to attain the best success, and if it is eventually concluded that surgery is required, Dr. Rehman is an experienced, skilled hand surgeon. The delicate structure of the hand requires specialists to treat it gently and properly. If you are experiencing pain in the thumb or any other joint or hand pain, contact Dr. Rehman today.
Repetitive motion disorders (RMDs) are a multitude of muscular conditions that result from repeated motions performed in normal work or daily activities.
RMDs include:
Carpal tunnel syndrome
Bursitis
Tendonitis
Epicondylitis
Ganglion cyst
Tenosynovitis
Trigger finger
RMDs are caused by too many uninterrupted repetitions of an activity or motion, unnatural or awkward motions such as twisting the arm or wrist, overexertion, incorrect posture, or muscle fatigue.
RMDs occur most commonly in the hands, wrists, elbows, and shoulders, but can also happen in the neck, back, hips, knees, feet, legs, and ankles.
The disorders are characterized by
Pain
Tingling
Numbness
Visible swelling or redness of the affected area
Loss of flexibility and strength.
For some individuals, there may be no visible sign of injury, although they may find it hard to perform easy tasks. Over time, RMDs can cause temporary or permanent damage to the soft tissues in the body, such as the muscles, nerves, tendons, and ligaments and even compression of nerves or tissue.
Treatment of RMDs
Treatment for RMDs usually includes reducing or stopping the motions that cause symptoms. Options include:
Rest, and stretching and relaxation exercises
Applying ice to the affected area
Using medications such as pain relievers, cortisone, and anti-inflammatory drugs that can reduce pain and swelling.
Splints may be able to relieve pressure on the muscles and nerves.
Physical therapy may relieve the soreness and pain in the muscles and joints.
In some cases, surgery may be required to relieve symptoms and prevent permanent damage.
Many companies are now developing ergonomic programs to help workers adjust their pace of work and arrange office equipment to minimize problems, such as chairs, and keyboards.
Recovery
Most individuals with RMDs recover completely and can avoid re-injury by changing the way they perform repetitive movements, reducing frequency and including frequent rest. Without treatment, RMDs may result in permanent injury and complete loss of function in the affected area.
Repetitive motion disorders should always be diagnosed by a physician, as symptoms can be similar, but treatment different, depending upon the disorder. If you are experiencing hand, wrist, elbow or shoulder pain that could be indicative of a RMD, please contact us at Midwest Hand Therapy
Whether you are referred to a hand specialist for surgical care or decide to make the choice on your own, certain qualifications should not be overlooked. At a minimum, your operation should be performed by a hand surgeon that meets the following criteria:
Board Certification: Your hand surgeon should be board-certified by the American Osteopathic Board of Orthopedic Surgery, an organization committed to identifying and certifying physicians who have met stringent standards to assure competent performance in the field of orthopedic surgery.
Experience: Like any skill, practice makes perfect. In addition to obtaining an educational degree, be sure your surgeon has engaged in post-graduate training and fellowships. How many surgeries have they performed? How many years have they been operating?
Professional Memberships: Professional memberships with organizations such as the American Osteopathic Association and the American Osteopathic Academy of Orthopedic Surgeons are important because these organizations encourage and support their members through continuing education, high standards, professional development, accreditations, training and more.
Patient Testimonials: Don’t forget to do your research. Just because a surgeon looks great on paper doesn’t necessarily mean they’re a patient favorite. How does this surgeon rate in patient satisfaction on sites like Vitals.com? Can the surgeon refer you to past patients for testimonials and feedback?
Strong Ties To Hand Therapy: To aid patients in full recovery, many hand surgeries require followup hand therapy services. Does this particular surgeon have his/her own rehabilitation center or hand therapy services?
When it comes to having a surgical hand procedure, only trust a top-rated and experienced surgeon! To learn more about Dr. Uzma H. Rehman, D.O., click here. To learn about Midwest Hand Therapy, and its post-surgical regimens, click here.
There are many types of corticosteroid injections, but in general, a corticosteroid injection is a formulation of two or more medications to reduce inflammation, relieve pain and improve function and mobility.
Corticosteroids are derived from cortisone, a steroid hormone released by the adrenal gland in response to stress. When combined with other pain-killing and anti-inflammatory medications in a corticosteroid injection, they work more effectively and efficiently to treat discomfort. Depending on the condition that is being treated, injections can providepain relief for several weeks up to several months.
At Midwest Hand Therapy, we sometimes administer corticosteroid injections as part of a comprehensive approach to hand and wrist rehabilitation. Depending upon the condition and the particular patient, a corticosteroid injection may accompany hand exercises, hot and cold modalities, and massage.
Many patients that have never had one of these injections express concern regarding the amount of pain they will experience. These injections are very similar to any other type of injection; the initial needle stick is similar to the pain caused by a quick bee sting. There is temporary discomfort while the medication is being injected, but nearly all corticosteroid injection patients agree that a short moment of discomfort is much better than ongoing pain of the wrist or hand!
Corticosteroid injections should only be administered by a licensed physician, and to ensure the best results, patients should visit a doctor that specializes in the specific area being treated. For example: a hand specialist for the hand, fingers, wrist or forearm, and a podiatrist for the foot, ankle or lower extremities.
For more information on corticosteroid injections, or if you are experiencing hand, wrist or finger pain, please contact us at Midwest Hand Therapy.
Trigger finger or trigger thumb is a condition that causes a finger or the thumb to get caught in a bent position, then “snap,” back to a straight position upon extension. When someone experiences trigger finger they know they need a doctor to look at it, but what type of doctor should they see?
Orthopedic doctors handle injuries and conditions of the musculoskeletal system, and within the field there are specialists. For trigger finger, look for an orthopedic doctor who specializes in hands, wrists and elbows—sometimes called a hand surgeon.
While many orthopedic doctors are surgeons, not all trigger finger treatment involves surgery. In fact, trigger finger is often treated without surgery. An orthopedic doctor who specializes in the hand will work with you on proper diagnosis and treatment to help alleviate or minimize the activity or situation that may be aggravating trigger finger. Other treatments may include resting the hand, applying cold packs, medications, injections, exercises and occupational therapy.
Early signs of trigger finger can include stiffness of the finger, tenderness at the base of the finger or a popping sensation. If you are experiencing any of these, contact Dr. Rehman for a comprehensive evaluation and treatment plan.
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