When the bony bump on the outer side of the elbow is painful and tender, this typically indicates the condition of Tennis Elbow, or Lateral 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 outer side of the elbow is called the lateral epicondyle. Men and women tend to be affected equally by this condition, often between the ages of 35 and 65. Some studies indicate that up to 50 % of tennis players may suffer from this problem at some point in their career.
What are the symptoms?
Pain or tenderness slowly increasing on the outer side of the elbow
Pain when straightening or raising your wrist and hand
Pain when lifting a heavy object
Pain when you make a fist, shake hands or squeeze an object
Pain may radiate from the elbow down into the forearm or up into the upper arm
What causes it?
This condition is typically the result of overusing the muscles in your forearm that straighten and raise your hand and wrist. Activities that require repetitious motion, especially while gripping something, can create this condition. Tennis players and golfers are at risk, as well as bowlers, gardeners and landscapers, home or office cleaners, and mechanics and assembly-line workers. Through overuse, the tendons are repeatedly tugged at the point of attachment, which is the lateral epicondyle. This tugging and overuse causes the tendons to become inflamed. Tiny tears occur in the tissue, resulting in pain and tenderness. Sometimes, due to the overuse, the tears never heal.
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 inquire about your daily activities and recreational sports. A physical exam will be conducted to determine where the pain is originating from. X-rays of the elbow may also be ordered. As with many health conditions, early detection, awareness and a comprehensive plan usually results in the most favorable outcome. If you are experiencing hand, wrist, elbow or shoulder pain, contact Doctor Rehman today for a full evaluation and comprehensive treatment plan to get you back in the swing!
(586) 532-0803
Unusual prickling sensations can happen in any part of the body, but the hands are wrists are especially likely for this condition to develop. Sometimes the sensations go away quickly, like when you sit on your feet and they “fall asleep”. But if numbness and tingling are on-going issues, the underlying cause could be more serious.
Common conditions that can cause numbness and tingling in the hands are:
Carpal Tunnel Syndrome: Caused by compression of the Median nerve that runs through your wrist, this often is the result of repetitive motion activities. Certain occupations are more at risk for this condition: butchers and meat packers, sewing and finishing workers, data entry personnel and some assembly line workers. Repetitive bending and straightening of the wrist causes tissues around the tendons to swell and impact the Median nerve.
Flexor Tendon Injury: Flexor tendons in the hand are responsible for helping us bend the fingers. An injury or a trauma to one of these tendons can result in a tingling or burning sensation.
Ganglion cysts: These are noncancerous, fluid-filled lumps that can develop along joints or tendons, putting pressure on nerves and causing a tingling sensation in the hand.
Skier’s Thumb: So called because it is a common snow skiing injury, in this situation an injury to the ulnar collateral ligament results in not being able to pinch the thumb and fingers together, and can involve numbness or tingling.
Since numbness and tingling are signals that something is not right with the nerves in the affected area, it is best not to self-diagnose or self-treat. The hands and wrists are delicate structures that can perform amazingly complicated maneuvers, and we want to keep them that way! If you are experiencing tingling or numbness in the fingers or hands, contact a Board Certified Orthopedic doctor such as Contact Dr. Rehman for a full evaluation and comprehensive treatment plan. She has a team of hand specialists that work with her, who can get you back to full mobility and make those annoying sensations go away for good!
Now that the fine weather is here, we are ready to get out and play! But activity sometimes brings injuries. The condition labeled “Tennis Elbow” can be caused by overuse of the arm and wrist, but it is not strictly caused by playing tennis. Many other activities that repeatedly stress the wrist, hand and arm can cause a burning pain to radiate from the outside of the elbow into the forearm or wrist. You might have trouble shaking hands or lifting a gallon of milk. Sometimes even lifting a coffee cup can hurt!
Occupations often at risk for this overuse and muscle strain injury are carpenters, plumbers, butchers, painters and cooks. Repetitive strain on the muscles of the forearm can cause tiny tears and subsequent inflammation to occur in the tendons that attach the muscles to the bones on the outside of the elbow. Vigorous games of tennis, and especially hitting backhanded with incorrect form, can have the same result. And it’s no surprise that tennis elbow and its associated pain and tenderness is more likely to occur as we age.
Typical remedies such as icing the area, resting the affected arm, and taking anti-inflammatory medications may help the condition. If, however, the pain persists or does not seem to be lessening, if weakness or numbness are still present, an orthopedic consultation may be needed.
An orthopedic surgeon such as Dr. Rehman will conduct a thorough evaluation of your condition, reviewing how and when the condition developed, and any other factors that may be influencing it such as other health conditions, medication you take, sports and work activities. Physical therapy may be prescribed, with exercises that can be done at home included as follow-up. Using a specialized brace over the back of the forearm may help to lessen the pain and promote healing by relaxing the muscles and tendons. Sometimes steroidal injections, such as cortisone, may be administered to help lessen the pain. In very serious cases, surgery to remove the damaged tissue may be required.
In all such cases, be sure to contact a Board Certified doctor such as Dr. Rehman, before the symptoms and pain become a chronic condition. Her entire team of therapists and staff are dedicated to your health and healing.
Carpal Tunnel syndrome occurs when the median nerve leading from the forearm into the palm of the hand becomes compressed. This nerve is carried through the carpal tunnel, which is a narrow, rigid passageway made up of bones and ligaments and located at the base of the hand. In some individuals, there may be a genetic pre-disposition to a smaller carpal tunnel. In other instances, the tunnel may become narrowed by injury or a thickening of tendons or other swelling. Carpal Tunnels syndrome can also be associated with underlying diabetes and arthritis.
Symptoms usually start gradually and build over a period of time. There may be tingling and/or numbness in the hand, wrist or fingers. As the symptoms worsen, shooting pain can be felt in the hand or even up the affected arm. The problem may be noticed initially in the morning upon wakening; many people sleep with their wrists flexed, and this may exacerbate the condition.
As with other conditions, early intervention will allow for the best use of minimally-invasive techniques to ameliorate the condition. Consult early with a Board Certified doctor who specializes in treating the hand and arm. Initially, the doctor will conduct tests to rule out the underlying conditions of diabetes or arthritis. Non-steroidal anti-inflammatory drugs may be prescribed, to lessen the swelling and pain. A period of rest may be required, and a splint may be used to immobilize the wrist and allow it to heal. Later in treatment, exercises may be employed to foster range of motion, build strength and reduce pain and swelling.
If these techniques and time do not control the condition, surgery may be required. A special hand surgeon, such as Dr. Rehman, performs this surgery using minimally invasive techniques and specialized endoscopic instruments. The special scope allows the surgeon to see the tissue and the ligaments inside the hand, and make the necessary adjustments using tiny instruments. This type of minimally-invasive Carpal Tunnel surgery usually results in minimal scarring and tenderness, and a quicker recovery time than traditional Open Release surgery.
If you are experiencing symptoms of carpal tunnel syndrome, consult with Dr. Rehman early for the greatest chance of success using the least invasive procedures.
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.
If you’re an athlete, or associate with athletes, you’ve likely heard of someone visiting a specialist for a soft tissue massage. Soft tissue massages are especially popular among athletes because they help prevent injury.
Soft tissues include muscles, ligaments, tendons and nerves. Applying firm direct pressure to an affected area can help prime an athlete’s muscle tissues before a heavy bout of exertion. This form of massage also helps muscles relax and minimizes an athlete’s stiffness after a race or sporting event. But, soft tissue massages, especially those conducted on the hand, wrist, and arm, offer benefits for a number of people, not just those who have a game tomorrow!
Soft tissue massage can support and benefit:
Those with a hand injury: Since soft tissues tend to tighten up following an injury, soft tissue massage helps to achieve relaxation, pain relief, and eventually a return to mobility.
Those with inflammation or swelling: Soft tissue massage has been proven an effective method for increasing the absorption of excess fluids and reducing swellinginsoft tissues.
Those with general discomfort: Recurring pain from past wounds, burns, breaks, fractures, and even amputations can be treated with soft tissue massage.
Every patient and situation is different, therefore soft tissue massage treatment at Midwest Hand Therapy is customized for each person. If you are an athlete, or someone that is experiencing discomfort, inflammation, or swelling, we’d love to hear from you.
Please contact our team for a comprehensive evaluation and consultation: (586) 532-0803.
Are you experiencing pain, stiffness, weakness, numbness and tingling in the wrist, hand and fingers? If so, you may have tendonitis. Tendonitis is the inflammation of tendons – the flexible bands of fibrous tissue that connect our muscles to our bones. Normally tendons glide easily when the muscles expand and contract. If a tendon becomes inflamed, however, this smooth gliding motion can become impaired, resulting in pain and discomfort.
The most common cause of tendonitis is overuse, which means that it canbe prevented. Did you know that you can prevent many tendon and nerve issues by taking regular breaks from working, exercising your hands to promote strength and mobility, and practicing correct posture and form while working?Maintaining a healthy weight and good cardiovascular health is important too, as good blood flow to the tendons keep them from becoming inflamed.
Mild cases of tendonitis can be treated by a professional that specializes in upper extremities. Midwest Hand Therapy sees patients of all ages including athletes, musicians, office workers, as well as people recovering from reconstructive surgery.
Preventing inflammation may involve resting or immobilizing the hands, applying cold packs, anti-inflammatory medication, corticosteroid injections, hand wrist and arm exercises, and occupational therapy.
Most nerve and tendon damage can be successfully treated when diagnosed early, which is why it is so important to seek medical treatment. If you are suffering from wrist or finger pain, contact Dr. Rehman at Midwest Hand Therapy for a comprehensive evaluation and consultation.
The carpal tunnel is a passageway within the wrist surrounded by wrist (carpal) bones and the transverse carpal ligament. Through this “tunnel” or passageway are nine tendons and the median nerve. Carpal tunnel syndrome occurs when the tissue around the tendons swells and puts pressure on the nerve.
While anyone can get carpal tunnel it tends to be more prevalent in women and older people. And while the exact causes may remain unknown, the following are some factors that can contribute to carpal tunnel.
Heredity. If this passageway within the wrist is smaller, due to heredity, an individual can be more susceptible to carpal tunnel syndrome.
Repetitive motion.Repeating the same motion over and over can aggravate the tendons and bring on swelling that leads to carpal tunnel symptoms.
Pregnancy. Due to hormonal changes and water retention, pregnant women can experience carpal tunnel syndrome.
Other health conditions. Anything that might cause swelling, like rheumatoid arthritis, tendonitis, diabetes, thyroid gland conditions and more can result in carpal tunnel syndrome.
While symptoms of carpal tunnel include hand pain, numbness, tingling, and weakness, these can be symptoms of other conditions. It is best to have any symptoms checked by an orthopedic doctor, who is extensively trained in the diagnosis and treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles and nerves. Proper diagnosis by your orthopedist insures you will get the proper treatment.
“Tennis elbow” can be a misnomer; in many cases tennis was never involved. Also called lateral epicondylitis, it occurs when the tendons that attach the forearm muscles to the outside of the elbow become damaged and/or inflamed. Sometimes it is a result of of racquet sports, but often it is also caused by repetitive motion. Common symptoms of tennis elbow are pain in the elbow when cocking back the wrist or when lifting heavy objects.
Stretching and strengthening exercises of the forearms and hand can help to prevent tennis elbow. It is also important for racquet sports players to adequately warm up and to insure their equipment is properly fitted. Whether at work, home or on the court, take periodic breaks from repetitive movement and stretch the arms, hands, wrists and elbows.
If you are currently suffering from pain on either the outside or inside of the elbow, see an orthopedic doctor or a hand surgeon to insure proper diagnosis and treatment of your condition.
If you suffer from hand pain and suspect you may have carpal tunnel syndrome, it is best to seek medical help sooner rather than later. Because the hand is a complex structure, hand and wrist pain can be indicators of many types of problems, from sprains to tendonitis. No matter what the cause, the sooner you see a specialist the less likely you are to lose strength and mobility in the hand.
Signs of carpal tunnel can range from tingling in the fingers to an ache in the palm and/or wrists. Carpal tunnel can be very disruptive and result in loss of coordination and strength in the fingers and/or thumb. Proper diagnosis and is necessary to treat carpal tunnel, and a qualified hand specialist can perform tests and an evaluation to help determine the right course of treatment.
Hand and wrist pain can be caused by a number of issues. While carpal tunnel is perhaps the best-known ailment, hand or wrist pain that seems to be aggravated by repetitive movement doesn’t necessarily mean you have carpal tunnel. A qualified orthopedic doctor or surgeon who specializes in the hand can work with you to determine the cause of hand, finger or wrist pain and help determine the proper course of treatment.
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