Neuropathy is any disease condition of the nervous system. The ulnar nerve is the longest unprotected nerve in the human body; it is not shielded by bones or muscles as most other nerves are. This nerve runs from the neck, all the way down the arm, and is responsible for sensation in the fourth and fifth fingers of the hand, the palm of the hand and the underside of the forearm.
This sensitive nerve can become damaged from repetitive jarring motions. Individuals who work with jackhammers or other hydraulic equipment, and even long-distance cyclists and baseball pitchers can be at risk for developing this condition. When the ulnar nerve becomes compressed or “pinched” near the elbow, it is said to be “entrapped.”
Patients with this condition report symptoms of weakness or tenderness in the hand, tingling in the palm and fourth and fifth fingers, sensitivity to cold and tenderness in the elbow joint. Sometimes these symptoms will resolve on their own, but often, if the damage is more severe or the activities causing it are ongoing, medical intervention may be required.
A thorough examination by a specialist trained to heal the hands, arms and upper extremities of the body is the best person to diagnose this condition. The orthopedic doctor will examine the arm and hand, possibly tapping lightly on the ulnar nerve to determine sensitivity. She will take a detailed account of when the condition began and how it has progressed. Other tests may be ordered such as X-Rays, MRI or Nerve Conduction Velocity tests.
Often, Ulnar Neuropathy or Ulnar Nerve Entrapment can be treated through minimally-invasive methods. Non-steroidal anti-inflammatory drugs may be prescribed, and corticosteroid injections may be considered. Bracing or splinting, especially at night, may be undertaken. Occupational therapy exercises, when done faithfully, will help to rebuild flexibility and strength.
Occasionally, the condition is more serious and Cubital Tunnel surgery is required. Surgery is typically done on an out-patient basis, and the patient can go home that same day. In this situation, the cubital tunnel is cut to allow more space for the ulnar nerve. Splinting of the arm will be required for several weeks, and occupational therapy with home follow-up exercises will be utilized.
If ulnar neuropathy goes untreated, complications can result:
Partial or complete loss of feeling in the hands or fingers
Partial or complete loss of hand or wrist movement
Chronic pain
Emotional depression stemming from the pain or lack of ability to engage in sports or other life activities
If you or someone you know is experiencing tingling, numbness or pain in the hand, arm, wrists or shoulder, contact Dr. Rehman . She is a specialist in treating disorders, conditions and injuries related to the upper extremities, and will conduct a thorough evaluation and design a comprehensive plan to return you to full functionality. Her team of experienced hand therapists will follow up with exercises and other treatment modalities for a return to full strength and range of motion. Don’t endure pain for even one more day – contact Dr. Rehman today! 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.
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.
Ganglion cysts show themselves as lumps or bumps on the hands or wrist. The most common locations are the top of the wrist, the palm side of the hand, the base of a finger on the palm side and the top of the end joint of a finger. These cysts can be painful, but often they occur and don’t display any symptoms.
The cause of ganglion cysts is for the most part unknown, although cysts that occur at the far joint of a finger may have an arthritic bone spur associated with them.
Cysts occur on top of a joint or tendon, and are basically a sac filled with a thick, clear, colorless jelly-like substance. Sometimes they will go away on their own, but if discomfort is associated with them, it is best to seek professional treatment.
Problematic symptoms you should watch for are:
Pain
Numbness
Weakness in the hands or fingers
If these symptoms are present, the cyst may be pressing on a nerve or tendon in the hand or the wrist.
If the cyst is not causing pain or other complications, it can often be treated with aspiration. A sterile needle is inserted into the sac, and the fluid is removed in a simple in-office procedure. Following this, a steroidal compound is often injected to reduce inflammation; the patient will then wear a splint to stabilize the area until healing is complete.
If pain or numbness are present, sometimes surgery is required to remove the cyst. The areas of the wrists and hand are exceedingly delicate, and it is best to choose a surgeon with extensive experience who specializes in hand surgery. Dr. Rehman is a Board Certified Doctor of Osteopathy, and employs a team of professionals who assist her patients with a full recovery after surgery.
If you are experiencing a cyst that does not go away on its own, contact Dr. Rehman today for a full evaluation and a comprehensive treatment plan.
Going for that pop fly can be a game changer, but so can a finger injury. Getting the tip of your finger hit by a speeding ball can be painful and put an end to summer fun, if not diagnosed and treated properly.
Not just restricted to baseball, this type of injury is known in the medical community as “mallet finger”. It happens when the tip of a finger is hit with some force by any blunt object, and it can result in the tendon being partially or completely torn. One of the key indicators of this injury is the inability to fully extend the finger – the last joint will appear bent or will fold in toward the palm. Pain or swelling at the tip of the finger, or numbness at the tip can also be symptoms.
It is important to seek proper medical attention immediately after such an injury. Those who don’t risk having the inability to extend their finger become a permanent condition. Typically splinting of the finger will be employed, thus allowing the tendon to heal. X-rays may be needed to make sure a fracture is not present and to insure the joint is properly aligned for healing. If either of these conditions is present, surgery could be required.
Always seek out a Board Certified orthopedic doctor such as Doctor Rehman, for a full evaluation and comprehensive treatment plan. Her team of specialists each has more than ten years of experience rehabilitating conditions of the hand, arm and shoulder. A full recovery is your desired outcome, and you will have the best chance to achieve that by working with Dr. Rehman and her team. If you are experiencing pain in the hand or fingers, contact Dr. Rehman today.
With the advent of winter and the recent snowfalls, avid sports fans are ready to get out and have some fun! Sledding, ice skating and skiing are all attractive activities for a Michigan winter, but common injuries can occur.
What is the biggest problem when skiing? Falling down! And sometimes when you fall down, you forget to release your poles. When this happens, an injury to the thumb can occur. It is sometimes called Skier’s Thumb, and also called Gamekeeper’s Thumb. When a fall occurs and you fail to release your poles, or you try to use them as leverage, injury to the ulnar collateral ligament (UCL) can occur. This ligament is located in the joint where the thumb meets the hand; the UCL’s job is to assist your thumb and fingers to pinch objects. This type of injury is not only painful, but frustrating as well.
If you notice the following symptoms after an injury on the slopes, seek immediate attention from a qualified doctor who is certified by the American Osteopathic Board of Orthopedic Surgery:
Pain or swelling at the base of the thumb
Difficulty picking up objects
Tingling or numbness of the thumb and/or hand
Instability of the thumb at its base
Bruising at the base of the thumb
It is best to seek treatment as soon as possible after such an injury. Skier’s Thumb can turn into a chronic condition if damage is done that is left untreated. Most often, treatment by your doctor will consist of the application of ice packs, 4-6 weeks of immobilization, and the continued use of anti-inflammatory medications to help reduce swelling during the healing process. If quite severe, surgery may be required. Typically an outpatient procedure, the surgeon enters at the base of the thumb through small incisions, removes the damaged tissue and will re-attach the ligament to the bone.
Dr. Rehman is an experienced, Board-certified Orthopedic doctor who specializes in hand injuries. Contact her today for a thorough evaluation and treatment plan for your injury, so you can get back on the slopes before winter is gone!
Are you experiencing joint numbness or tingling in your hands? There are various conditions associated with joint numbness and tingling. While no amount of online research can substitute for a professional consultation and diagnosis, here are some of the most common causes of joint numbness:
Carpal Tunnel Syndrome: Carpal tunnel syndrome is a very common cause of joint numbness. It occurs when the median nerve that controls movement and sensation in the hand is squeezed or compressed as it passes through the carpal tunnel (a narrow passage in the wrist designed to protect the nerve). This pressure causes irritation of the nerve and often results in numbness, tingling, pain and weakness in the hand and fingers.
Trigger Finger or Trigger Thumb: Repetitive motion injuries such as trigger finger or trigger thumb can also cause numbness, tingling, and weakness in the hand. Trigger finger and trigger thumb often occur due to an occupation or hobby that requires intense and repetitive hand motions each day (for example, operating a hand tool, playing a guitar, or sewing).
Tendonitis: Tendonitis is similar to carpal tunnel syndrome but is the inflammation, irritation, and swelling of a tendon (no one tendon in particular). When tendons in the wrist or near the hand are affected by tendonitis, symptoms may include a burning sensation, hand numbness and tingling.
Until your condition is properly diagnosed, it cannot be treated. As mentioned earlier, there is no substitute for a professional consultation. For more information on joint numbness or to schedule an appointment, contact Midwest Hand Therapy.
Ulnar nerve entrapment (or ulnar nerve neuropathy) is a painful condition that affects the outer side of the arm and hand near the little finger. This pain is caused by pressure on the ulnar nerve (located within the arm) and is often a sign that the ulnar nerve is trapped or pinched.
Because the ulnar nerve passes through many tunnels within the arm, many conditions or injuries could cause the nerve to become compressed or pinched. Causes include:
Elbow fractures
Growth plate injuries
Wrist fractures
Infections
Tumors
Diabetes
Alcoholism
Even problems originating at the neck
Bicycler’s neuropathy
Cubital tunnel syndrome
Guyon or Guyon’s canal syndrome
The ulnar nerve provides sensation to the flexor muscles of the hands, allowing for bending, which makes this condition all the more painful – many of us rely on our hands all day long!
What are the symptoms?
Hand, wrist and arm pain can be an indication of a number of conditions. However, symptoms of ulnar nerve entrapment may include:
Weakness
Tenderness
Tingling in the little finger (your pinky finger)
Elbow tenderness
How do I know if I have ulnar nerve entrapment?
The very best thing you can do if you are experiencing arm, wrist or hand pain is to see a hand specialist. Hand specialists, such as Dr. Rehman, can diagnose and treat your condition before it worsens.
Upon an extensive evaluation, your doctor can recommend a course of treatment. Ulnar nerve entrapment can often be treated through occupational therapy, anti-inflammatory drugs, or splinting. In some cases, surgery may be recommended, depending upon on the severity of the entrapment.
Drive around town and chances are you’ll see lots of buildings belonging to doctors and dentists – many of whom are specialists in their own specific fields.
At Midwest Hand Therapy and Macomb Hand Surgery we’re often asked “What is a hand specialist?” … “What exactly does a hand specialist treat?” And most importantly, “Can you help me with my specific condition?”
A hand specialist is a term used to describe a hand surgeon; you may have also heard of them referred to as “orthopedists.” Hand specialists specialize in the orthopedic or plastic surgery of the hand, fingers wrist and forearm. Some orthopedists, such as Dr. Rehman, also specialize in elbow and shoulder conditions.
Now, before you get nervous or think that a “hand surgeon” may not be the right doctor for you, understand that a hand surgeon does not just do surgery. They care for a variety of conditions with and without surgery. They truly are specialists of the hand.
Hand specialists treat:
Carpal Tunnel Syndrome
Tennis/Golfer’s Elbow
Fractures
Dislocations
Sprains
Strains
Phalanx & Fingertip Injuries
Crush Injuries
Tissue Loss
Amputations
Extensor Tendons
Flexor Tendons
Scar Management
Nerve Compression Syndromes
Tendon & Nerve Injuries
Joint Replacements
Sports Injuries
Replants
And More!
And, hand surgeons will often recommend non-surgical treatment such as hand therapy to treat many of the above-mentioned conditions. If you have experienced an injury or are currently experiencing discomfort, pain, or lack of motion, contact our team.
Even if something within your hand, wrist or forearm just “doesn’t feel right,” it is best to consult a hand specialist. A certified hand specialist can identify and treat the condition before it progresses into something worse.
If your thumb gets stuck in a bent position and then “pops” or clicks upon bending it back into a straight position, you may be experiencing trigger thumb (also called trigger finger). Trigger thumb symptoms range from mild to severe and include stiffness, popping, and even locking for extended periods of time. You may also have visible symptoms such as an actual bump at the base of the thumb.
What causes trigger thumb?
Trigger thumb is caused by a narrowing of the sheath covering the tendon in your thumb. Oftentimes, people’s work or hobbies can result in this condition, especially if you are continually utilizing your hand. Occupations in which trigger thumb is common include tradesman (those that work with hand tools each day), farmers, and even musicians, because they’re continually relying on their fingers and thumbs to make repetitive movements.
How is trigger thumb treated?
Typically trigger thumb is treated by an Orthopedic Doctor trained in the treatment of hand and upper extremity conditions. X-rays or lab tests typically are not necessary; the condition can be identified with a physical exam of the hand and fingers. Trigger finger can usually be treated through conservative methods that include one or more of the following:
Resting the hands
Applying cold packs
Anti-inflammatory medication
Corticosteroid injections
Trigger finger exercises
Occupational therapy
Short-term splinting
Activities known to aggravate trigger thumb should be limited during the healing and recovery process. Your hand doctor may also prescribe anti-inflammatory medications such as ibuprofen to help comfort you, and speed up the recovery process. A corticosteroid injection may also be administered by your doctor.
In extreme conditions, hand surgery may be recommended to restore normal movement and functionality. Midwest Hand Therapy provides the highest quality assistance for each patient and their individual condition. If you are suffering from trigger thumb, or trigger finger, please contact our office today.
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