Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS)
is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel. The main symptoms are pain, numbness and tingling in the thumb, index finger, middle finger and the thumb side of the ring fingers. The Median nerve can also get trapped in the muscles of the forearm, upper arm, shoulder and or neck. At Advanced Pain Relief Clinic successful treatment starts by identifying the cause of the problem and then using the correct therapy or therapies
— which literally means “inflamed joint” — can affect any joint in the body, including the joints between the 29 bones of the wrist, hand, and fingers. Arthritis of the hand can hurt and keep you from being able to do what you want or need to do. The most common forms of arthritis in the hand are osteoarthritis, post-traumatic arthritis (after an injury), and rheumatoid arthritis. Osteoarthritis is a degenerative joint disease in which the smooth cartilage that covers the bone surfaces at the joints either is injured or wears over time.
A normal joint is made of two smooth, cartilage-covered bone surfaces that fit well together so that they glide when the bones move. If the smooth surfaces wear out, then they no longer fit together and arthritis develops. Injury, infection, gout, psoriasis, and other conditions can also cause arthritis of the hand.
SIGNS AND SYMPTOMS
The three most common sites where arthritis happens in the hand are:
• At the base of the thumb, where the thumb and wrist come together (the trapeziometacarpal or basilar joint)
• At the joint closest to the fingertip (the distal interphalangeal or DIP joint)
• At the middle joint of a finger (the proximal interphalangeal or PIP joint)
All forms of hand arthritis can cause stiffness, swelling, pain, and deformity. Osteoarthritis sometimes causes bony nodules at the middle joint of the finger (Bouchard’s nodes) or at the end joint of the finger (Heberden’s nodes). Osteoarthritis at the basilar joint can cause swelling, a bump, and a deep, aching pain at the base of the thumb. Weakness of grip and pinch can make it hard to open a jar or turn a key for those with osteoarthritis.
THE DIAGNOSIS OF OSTEOARTHRITIS
X-rays of joints with osteoarthritis can show loss of normal joint space, “bone spurs,” or other changes.
HOW TO TREAT OSTEOARTHRITIS
The goals in treating osteoarthritis are to relieve pain and restore function. Brief rest — either by changing activities or wearing a splint — can help. Soft, snug sleeves can help support a joint when rigid splints are too restrictive. Heat (for example, paraffin wax and warm compresses) can soothe the joints and help keep them mobile. It is important to keep as much finger motion and function as possible. Low intensity laser therapy can dramatically decreased the pain associated with Arthritis and can support health tissue production. At Advanced Pain Relief we often include other treatments to stimulate new cartilage production to create long-term improvements. This can include shockwave therapy and PRP. All our treatment plans are custom geared to our individual patients.
De Quervain’s Syndrome
De Quervain's tenosynovitis(dih-kwer-VAINS ten-oh-sine-oh-VIE-tis) is a painful condition affecting the tendons on the thumb side of your wrist. If you have de Quervain's tenosynovitis, it will probably hurt when you turn your wrist, grasp anything or make a fist.
Although the exact cause of de Quervain's tenosynovitis isn't always easy to discover, any activity that relies on repetitive hand or wrist movement — such as working in the garden, playing golf or racket sports, or lifting your baby — can make it worse.
Symptoms of de Quervain's tenosynovitis include:
• Pain near the base of your thumb
• Swelling near the base of your thumb
• Difficulty moving your thumb and wrist when you're doing something that involves grasping or pinching
• A "sticking" or "stop-and-go" sensation in your thumb when moving it
If the condition goes too long without treatment, the pain may spread further into your thumb, back into your forearm or both. Pinching, grasping and other movements of your thumb and wrist aggravate the pain. Resolution of the problem begins by temporarily removing the offending activity and using treatments that reduce inflammation and promote healing.