Treating Hand Arthritis Without Surgery

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Article featured on American Society for Surgery of the Hand

What is arthritis?

A joint is where two or more bones meet each other. The ends of these bones are covered with a smooth substance called cartilage which allows the bones to slide past each other smoothly. This cartilage layer can be worn away with time or due to other things, and when this occurs the rough bone ends start to rub against each other. This is arthritis. Sometimes arthritis does not cause any problems, but sometimes it can cause pain, swelling, stiffness, and deformity.

What causes arthritis?

The most common causes of arthritis are different for different locations in the body. The normal arthritis that often comes along with age is called osteoarthritis. This is simply arthritis that occurs due to normal wear and tear on the body as we get older. Often this type of arthritis is partially hereditary, meaning that if your parents or grandparents had arthritis, you may be more likely to have it. Other things can cause arthritis as well. These include major joint injuries or infections, and certain medical conditions.

Just because you have arthritis doesn’t mean it’s necessarily a problem. Many people have arthritis that they don’t even know about. Arthritis only needs treatment if it bothers you or causes issues in the body.

My hand arthritis hurts! How can I treat it?

Once arthritis is present, it will always be there. This is because the body can’t regrow the type of cartilage found in the joints. But there is good news: just because arthritis is in the body doesn’t mean it will always cause pain or other issues. Even if arthritis causes pain, the pain may not be there all the time- it can often come and go. There are many things we can do to try to improve arthritis symptoms when they occur. Conservative management of arthritis- meaning treatment without surgery- is almost always the first step. There are many options to try. Usually these treatments work best when they are used all together over several weeks or months.

  • Splints: resting the inflamed joint with a splint, also called a brace or “orthosis”, can be very helpful in improving arthritis symptoms in certain places in the hand, especially arthritis in the base of the thumb. Splints may be “pre-fabricated”, meaning that you can buy them at the store or online and they are designed to fit most people. Other splints can be custom molded to your hand by a hand therapist.
  • Rest: avoiding activities that flare up the arthritis pain can make the pain less intense or less frequent.
  • Ice or heat: using ice on the skin over an arthritic joint before and after any activities that worsen the pain can improve discomfort. Heat applied with warm compresses, warm water, or wax baths may also improve symptoms. Experiment with both ice and heat to see if either helps.
  • Medications: anti-inflammatory medications like ibuprofen or naproxen may help improve pain. Acetominophen can also be helpful. If you have medical problems or take medications, check with your primary care provider to make sure it is safe for you to take these medicines.
  • Rub-on creams: Some creams and lotions rubbed into the skin over an arthritic joint can be helpful in decreasing pain there. There are multiple options which may be worth trying, most of which can be bought at your local drug store or online. Try one for a few days or weeks, and if it doesn’t help then try another.
  • Injections: In some arthritic joints, certain substances can be injected into the joint with a needle which can decrease pain. Depending on the location, receiving a needle injection may be temporarily painful, but can provide good pain relief for months or longer. Many hand doctors provide injections of steroid, a substance that is thought to decrease inflammation in a joint which may be able to improve pain for several months. Some hand doctors may also consider injections of hyaluronate, a substance which may temporarily allow roughened bone ends to slip past each other more comfortably. However, hyaluronate injections are less commonly used than steroid injections and may be more expensive.
  • Hand therapy: Working with a hand therapist on motion exercises and strengthening of the hand may help improve some people’s arthritis pain, but the scientific studies on therapy for arthritis do not prove that it helps a great deal.

What if none of these treatments work to improve my arthritis pain?

There are surgeries that can help make hand arthritis pain better. However, most people with hand arthritis never need to move forward with surgery- this is a personal decision that should be made after discussion with a hand surgeon. The safest and best plan is usually to try to maximize all non-surgery treatments to make arthritis feel better. If none of these treatments give you good relief from your arthritis symptoms, see a hand surgeon to discuss whether a surgical procedure could benefit you.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

What’s to Know About Extensor Tendonitis?

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Article featured on MedicalNewsToday

The most common cause is overuse of the muscles, bones, and tendons in the feet or hands.

In the feet, it’s most often caused by:

  • spending a lot of time on the feet
  • wearing shoes that are too tight
  • using inappropriate footwear for a sport or activity

In the hands, the most common cause of extensor tendonitis is doing an activity that uses the hands and wrists in a repetitive motion such as:

  • prolonged or high-impact typing with a non-ergonomic keyboard
  • practicing or playing an instrument, such as piano or guitar, excessively
  • regularly playing sports that stress hands and wrists, including baseball or racquetball

Mallet finger is a common type of injury that occurs to the fingers, especially in athletes. It occurs when the tip of the finger is struck hard, such as with a ball, which injures the tendon that runs along the top of the finger.

Without treatment, the tendon can become permanently damaged, causing the tip of the finger to fail to straighten completely.

Symptoms and diagnosis

The most common symptom of extensor tendonitis, whether it occurs in the foot or the hand, is pain. In the feet, the pain is usually localized to the top of the foot, usually close to the center of the foot. In the hands, pain tends to occur on the top of the hand.

Other symptoms of extensor tendonitis include:

  • redness, warmth or swelling near the injury
  • increased discomfort with activity
  • crepitus, which is a crunchy feeling or sound over the affected tendon
  • stiffness of the joint

Diagnosing extensor tendonitis usually requires a physical exam and history with a physician. The doctor will ask questions about the pain and other symptoms.

Common questions are about whether anything makes the pain better or worse, the history of the symptoms, and if anything triggered the discomfort.

Sometimes, the doctor will order an X-ray or magnetic resonance imaging (MRI) test to get a detailed look at all the bones, muscles and tendons around the injury. These images can help the doctor look at the structures around the pain to see where the damage is and if there is another cause for the symptoms.

Treatment

Injuries to the hands and feet are common and usually resolve within a few days with basic care at home.

However, if the pain doesn’t start to improve after a couple of days, or a person experiences swelling, redness, warmth or other symptoms, they should visit their doctor.

There is a range of treatment options available for extensor tendonitis.

Rest and Relaxation

Resting the affected joint is crucial, especially if the tendonitis is caused by overuse. It is essential to stop the activity that is causing the pain until the tendon has healed, to prevent further injury. In less serious cases, rest may be all that is needed until the tendon has healed.

Finger or toe splints

Mallet finger may require splinting for several weeks so that the tendon returns to its previous position and completely heals in place.

It is important to clarify with the doctor about the length of time that the finger must remain in the splint. It is common to have to wear the splint continuously, even in the shower.

Removing the splint and moving the finger before the tendon has healed, could re-injure the tendon.

Physical therapy

Extensor tendonitis of the foot may require physical therapy and special stretches for a tight calf muscle. Also, some orthopedic surgeons or podiatrists will recommend the use of a splint or orthotic shoe inserts.

Surgery

Surgery to repair extensor tendonitis is rare and usually reserved for very special or unique cases. If considering surgical repair of the extensor tendons, people should ensure they see a surgeon who has experience performing these types of procedures.

Outlook

The prognosis of extensor tendonitis is excellent; in most cases, a person with this condition makes a full recovery without any lasting problems in the affected joints. How long it takes to recover depends on how severe the tendonitis was, and how well a person managed it.

For example, a person who rests properly will recover more quickly than someone who “pushes through” and continues to use the affected joint.

Although it can be painful, extensor tendonitis is a fairly preventable and easily treatable disease. It is important to see the doctor with any pain, especially in the hands or feet.

Quick diagnosis and treatment is the key to minimizing tendon damage and recovery.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Is Carpal Tunnel Syndrome the Same as Trigger Finger?

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Article featured on Movement Orthopedics

Are you one of those people whose occupation involves flexing of the wrist day in and day out? If so, you may be at risk for carpal tunnel syndrome. But did you know that there’s another condition that you could be susceptible to if your job involves repetitive hand movements? It’s called trigger finger.

So, what’s the difference between these two conditions? Keep reading to find out.

What Is Trigger Finger?

Also known as stenosing tenosynovitis, trigger finger occurs when a tendon in any of the fingers (including the thumb) becomes inflamed and unable to easily glide through its sheath – the thin layer of tissue surrounding a tendon. Prolonged inflammation can lead to the formation of nodules in the tendon, which ultimately renders the affected finger unable to freely bend and straighten.

The symptoms of trigger finger can range from mild to severe, and can become worse over time. If you have trigger finger, you will likely experience any or some of the following symptoms:

  • Clicking, popping, or snapping sensation when moving your finger
  • Difficulty carrying out basic hand movements, especially those that involve gripping
  • Locking of the finger in a bent position (can suddenly pop straight)
  • Pain and tenderness at the base of your affected finger
  • Stiffness in your finger (mostly noticeable in the morning)

Treatment

Your hand specialist will likely first take a conservative approach to treating your trigger finger. Your doctor may recommend that you rest your hands, wear a splint, and/or perform stretching exercises.

If your symptoms continue unabated, your hand surgeon may give you a cortisone shot to control the inflammation and allow the tendon to glide freely.

If your symptoms don’t respond to nonoperative treatment, your hand surgeon may recommend surgery, in which they will make an incision in the palm area of your hand to access the tendon sheath and cut it to give the tendon more room to move. Another option is percutaneous release, in which your doctor will use a needle to break up the constricting tissue around the tendon sheath, thereby allowing the tendon to move.

What Is Carpal Tunnel Syndrome?

Carpal tunnel syndrome (CTS) occurs when the median nerve – which provides sensation and motor function for the wrist, hand, and forearm – is compressed and unable to function properly.

CTS is also a progressive condition. However, unlike trigger finger, CTS is apparently neuropathic in nature, causing pain, shock-like sensation, numbness, and weakness, all of which can radiate up the forearm and make fine motor skills difficult.

Treatment

Rest, wearing wrist splints, and anti-inflammatories are the common nonsurgical treatments for carpal tunnel syndrome. If none of these provide adequate relief, your hand surgeon may administer cortisone injections to alleviate the inflammation and swelling.

If your symptoms persist despite a lengthy course of nonsurgical treatment, your hand specialist may recommend surgery. Carpal tunnel surgery involves your doctor severing the transverse carpal ligament to allow for more space in the carpal tunnel and consequently relieve pressure on the median nerve.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

How to Prevent and Manage Arthritis in the Hands

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Article featured on MedicalNewsToday

There is no known cure for arthritis, which commonly affects the hands. However, a person can take steps to lower the risk of arthritis developing or worsening and to reduce and manage pain. These steps include practicing specific exercises and making dietary changes and adjustments to daily habits.

Arthritis is a general term that describes several conditions that affect a person’s joints. There are more than 100 different types of arthritis. Arthritis is generally not preventable, but a person may be able to reduce their risk by changing the risk factors that they can control.

According to the Centers for Disease Control and Prevention (CDC)Trusted Source, the most common type of arthritis in the United States is osteoarthritis. Osteoarthritis can affect nearly any joint in the body, but it most commonly affects the joints in the knees, hips, and hands.

This article discusses how to reduce the risk of developing arthritis in the hands or prevent it from worsening. It also explains how to reduce and manage the pain of arthritis.

Osteoarthritis vs. rheumatoid arthritis

Osteoarthritis occurs over time as a person’s cartilage erodes, whether from general wear and tear or due to underlying inflammation. Once the cartilage has worn away enough, a person can experience pain and stiffness in their joints.

A person can take steps to help reduce the risk of osteoarthritis.

Rheumatoid arthritis is an autoimmune condition in which the body’s immune system attacks the joints.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a combination of genetic and environmental factors triggers the development of rheumatoid arthritis.

These factors can activate the immune system years before symptoms appear.

Both osteoarthritis and rheumatoid arthritis often affect the hands and fingers, and they can both cause joint stiffness or difficulty moving the joint.

However, there are some differences between the two conditions.

Osteoarthritis often affects the last joint on the finger, which is the one closest to the tip. Rheumatoid arthritis typically does not affect this joint.

In addition, the NIAMS note that osteoarthritis stiffness usually goes away within 30 minutes of waking up or resting, whereas the pain and stiffness associated with rheumatoid arthritis tend to last longer than 30 minutes.

General arthritis prevention

Not all forms of arthritis are preventable. However, a person can take some steps to reduce their risk of developing osteoarthritis in their joints.

According to the CDC, these steps include:

  • stopping smoking, if a smoker, or avoiding secondhand smoke
  • achieving or maintaining a moderate weight, as this helps protect the joints throughout the body
  • seeking treatment for any signs of infection, which can damage the joints
  • protecting against injury by performing exercises and stretches or avoiding activities that carry the risk of injury
  • using tools that do not place undue stress on the joints
  • avoiding repetitive motion when possible

Preventing arthritis in the hands

A person can try several techniques to help prevent arthritis in the hands from becoming debilitating.

Hand exercises

Several exercises may help with preventing or alleviating arthritis pain in the hand and fingers.

A person should talk to a doctor or occupational therapist about the best routine or exercises to help prevent disease progression or worsening pain or stiffness.

One simple exercise that many people should be able to do is making a fist.

To do this, a person starts with their fingers and thumb straight out. Then, they curl their fingers slowly into their palm and close their thumb around the outside of their fingers.

The person should not squeeze the hand too tight during this exercise, but they should hold the fist position for 2–3 seconds before releasing it. They can then repeat the action 10 times.

Another exercise that a person can try to prevent or alleviate arthritis symptoms is squeezing a stress ball or a tennis ball. Similar to making a fist, the motion should be slow and deliberate.

Learn more about hand exercises for arthritis here.

Daily habit adjustments

People who have not developed arthritis can take steps to help prevent joint damage in their hands. Some tips for preventing joint damage include:

  • using an ergonomic keyboard and mouse when working at the computer
  • avoiding lifting heavy items that can put strain on the fingers and hand
  • using splints or braces to reduce the risk of injury when using the hands for repetitive activities, such as sewing or chopping food

Methods to reduce hand pain

If a person is living with pain in their hands from arthritis, they may wish to try:

  • practicing gentle motion hand exercises that promote movement and help reduce stiffness
  • seeking physical therapy and occupational therapy from certified professionals
  • talking to a doctor about medications and topical pain relievers to help with the pain

The Arthritis Foundation add that a person can also:

  • use hot or cold therapy
  • modify their daily routine to avoid putting stress on the hands and fingers
  • talk to a doctor about steroid injections

Some additional steps that a person can take to help prevent arthritis pain in the hands include:

  • using kinetic tape as a preventive measure
  • using dictation software instead of typing
  • avoiding placing excess strain on the fingers by using large joints, such as the elbows or shoulders, to carry the weight of shopping bags
  • using other body parts besides the hands to close a door
  • using the palm of the hand to hold a phone or tablet to avoid placing strain on the fingers
  • changing daily habits, such as stirring food using a shoulder motion
  • using utensils with large, easy-to-grip handles

A person should talk to a doctor if at-home methods or treatments are ineffective in managing their arthritis symptoms. It is possible that a doctor will recommend surgery as a treatment option.

Outlook

It is not possible to prevent arthritis, but a person may be able to manage the pain that it causes and slow its progression.

At-home techniques and modifications to everyday routines may help prevent pain and minimize the loss of joint function.

Summary

Arthritis is a common condition, and there are numerous different types.

Although arthritis is not usually preventable, a person can take some steps to help protect their joints and potentially reduce their risk of the disorder.

A person can also take several steps to manage the pain and discomfort of arthritis at home.

If at-home treatments do not work, a person can work with a doctor to identify therapies and treatments that may help.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

What are Hand, Wrist or Elbow Dislocations?

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Article featured on Mercy Health

What are hand, wrist or elbow dislocations?

Hand dislocations occur when one of the eight carpal bones (bones located at the base of the hand) fall out of the joint to cause a hand dislocation. The capitate (largest bone in the hand) or lunate bones are the bones that most frequently dislocate.

Wrist dislocations occur when one of the eight bones of the wrist fall out of socket due to a fall.

Elbow dislocations occur when the joints of the elbows somehow separate. In a partial elbow dislocation, the joint surfaces are not completely separated (also known as subluxation), while in a complete dislocation, the joint surfaces are completely dislocated.

Causes of hand, wrist or elbow dislocations

  • Hand dislocations typically occur when direct, intense force is applied to the wrist and the hand is bent backward.
  • High impact sports such as basketball and football are common causes of hand, wrist or elbow dislocations – football and basketball players can dislocate finger joints when striking the ball, the ground or another player.
  • A hard blow to the joint, for example in a car accident, could cause a hand, wrist or elbow dislocation.

Risk factors of hand, wrist or elbow dislocations

Risk factors of hand, wrist or elbow dislocations are:

  • Participating in high impact, extreme sporting activities, such as football and hockey can put people at higher risk for a hand, wrist or elbow dislocation
  • Sports where falls are common, such as volleyball, gymnastics and downhill skiing put people at a higher risk of hand, wrist or elbow dislocations
  • Some people are born with ligaments and joints that are more prone to injury
  • Patients who are more susceptible to falls (such as the elderly) are at a higher risk for hand, wrist or elbow dislocations

Symptoms of hand, wrist or elbow dislocations

Symptoms of hand, wrist or elbow dislocations include:

  • Visible deformities in the hand, wrist or elbow after trauma
  • Inability to move your hand, wrist or elbow
  • Severe pain in the affected area
  • Swelling in the hands, wrists or elbow
  • Misshaped appearance of the hand, wrist or elbow
  • Numbness

Diagnosis of a hand, wrist or elbow dislocation

If you suspect you have a hand, wrist or elbow dislocation, visit the ER right away. It is crucial to treat a hand, wrist or elbow dislocation right away to avoid developing arthritis or death of bone tissue. When possible, ice the joint and keep it immobile while waiting to see the physician.

Hand, wrist or elbow dislocations are diagnosed in a physical exam and with an x-ray, MRI or CT scan to evaluate the extent of the injury and determine the best course of treatment.

Treatments for hand, wrist or elbow dislocations

Wrist dislocations typically require surgery by a hand or wrist orthopedic surgeon.

The hand surgeon will place the bones back into the correct location as well as repair the ligaments and soft tissue surrounding the injury during the procedure.

After the procedure, the wrist will be immobilized in a cast for eight weeks to ensure proper healing.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Hand, Wrist, And Arm Pain While Exercising

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Article featured on American Society for Surgery of the Hand

Is it normal to have pain or soreness in my hands, wrists, and arms while exercising?

It depends. When you start with exercises you have never done or when you exercise some muscles you have not used in a while, these muscles can become sore. That is normal. Muscle activity produces lactic acid, which causes soreness in the muscles. Soreness means your muscles have been stressed, and they will likely recover after a few hours or a few days, when the lactic has been cleared away. If the exercise causes too much stress, your muscles may become sore to the touch and even might feel swollen.

Is there a difference between discomfort and pain in the hands, wrists, and arms?

“Discomfort” is an annoying sensation of mild pain; actual “pain” is when you feel that there is something wrong. In your physician’s office or in the hospital, you are often asked to rate your pain as a number or point to a picture of a face indicating your discomfort. The level of discomfort or pain is very different in each patient. It depends much on how you have been able to deal with uncomfortable situations in the past.

When should I pay special attention to my muscle or joint pain in my hands, wrists, and arms while exercising?

Most exercise-related pain is dull and spreads over a larger area of your arms or legs. This is normal. When it seems to be sharp pain focused in one spot that you can pinpoint with a finger, it may indicate a muscle strain of a tendon inflammation. Popping, clicking, or grinding in the muscles or tendons are signs of strain. You should cut back on the exercise or activity until the problem settles down. Also, you should watch for painful swelling, especially when compared to the other arm or leg. If rest or over-the-counter medications do not help, you should seek your doctor’s advice.

How can I prevent pain in my hands, wrists, and arms while exercising?

Athletic exercises or exercises in your occupation/physical therapy department are meant to make your muscles and tendons more tolerant to stress and strain, so some soreness is normal. The best way to ease into exercises is to work your muscles gradually to the point of discomfort but not pain. Your occupational therapist can assist you to become more flexible and stronger.

How do I treat pain in my hands, wrists, and arms after exercise?

It is helpful to know that discomfort is often the result of exercise. It does not mean that there is anything wrong with your muscles or your body. Staying active and exercising regularly is healthy and will make it easier for your muscles to recover. It is best to “listen to your body” and back off if exercises are too uncomfortable. Over-the-counter medications, such as a cream applied to the sore area or an occasional anti-inflammatory tablet, can be used.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Causes, Symptoms & Treatments of Wrist Fractures

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Article featured on the American Society for Surgery of the Hand

A wrist fracture is a medical term for a broken wrist. The wrist is made up of eight small bones which connect with the two long forearm bones called the radius and ulna. Although a broken wrist can happen in any of these 10 bones, by far the most common bone to break is the radius. This is called a distal radius fracture by hand surgeons.

Some wrist fractures are stable. “Non-displaced” breaks, in which the bones do not move out of place initially, can be stable. Some “displaced” breaks (which need to be put back into the right place, called “reduction” or “setting”) also can be stable enough to treat in a cast or splint. Other fractures are unstable. In unstable fractures, even if the bones are put back into position and a cast is placed, the bone pieces tend to move or shift into a bad position before they solidly heal. This can make the wrist appear crooked.

Some fractures are more severe than others. Fractures that break apart the smooth joint surface or fractures that shatter into many pieces (comminuted fractures) may make the bone unstable. These severe types of fractures often require surgery to restore and hold their alignment. An open fracture occurs when a fragment of bone breaks and is forced out through the skin. This can cause an increased risk of infection in the bone.

Causes

A wrist fracture occurs from an injury such as falling down onto an outstretched hand. Severe trauma such as car accidents, motorcycle accidents or falls from a ladder cause more severe injuries. Weak bones (for example, in osteoporosis) tend to break more easily.

Signs and Symptoms

When the wrist is broken, there is pain and swelling. It can be hard to move or use the hand and wrist. Some people can still move or use the hand or wrist even if there is a broken bone. Swelling or a bone out of place can make the wrist appear deformed. There is often pain right around the break and with finger movement. Sometimes the fingers tingle or feel numb at the tips.

Diagnosis

Your hand surgeon will do a physical examination and obtain x-rays to see if there is a broken bone. Sometimes, tests such as a CT scan or MRI scan may be needed to get better detail of the fracture fragments and other injuries. Ligaments (the soft tissues that hold the bones together), tendons, muscles and nerves may also be injured when the wrist is broken. These injuries may need to be treated also.

Treatment

Treatment depends on many factors, including:

  • Type of fracture, whether it is displaced, unstable or open
  • Your age, job, hobbies, activity level, and whether it is your “dominant” hand
  • Your overall general health
  • Presence of other injuries

A padded splint might be worn at first in order to align the bones and support the wrist to provide some relief from the initial pain. If the fracture is not too unstable, a cast may be used to hold a fracture that has been set. Other fractures may benefit from surgery to put the broken bones back together and hold them in correct place.

Fractures may be fixed with many devices. Pins, screws, plates, rods or external fixation can all be used. A small camera might be used to help visualize the joint from the inside. Sometimes the bone is so severely crushed that there is a gap in the bone once it has been realigned. In these cases, a bone graft may be added to help the healing process. Your hand surgeon will discuss the options that are best for your healing and recovery.

Recovery

During recovery, it is very important to keep your fingers moving to keep them from getting stiff. Your hand surgeon will have you start moving your wrist at the right time for your fracture. Hand therapy is often helpful to recover motion, strength and function.

Recovery time varies and depends on a lot of factors. It is not unusual for recovery to take months. Even then, some patients may have stiffness or aching. Severe wrist fractures can result in arthritis in the joint. Occasionally, additional treatment or surgery is needed.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Why Does RA Often Occur in the Joints of the Hands?

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Article featured on MedicalNewsToday

In people with rheumatoid arthritis (RA), the immune system attacks healthy tissues in the lining of the joints. It often affects the hands, wrists, and feet. Over time, these joints can become stiff and deformed. Here’s why RA often affects these areas, along with treatments that may help prevent and treat pain.

Why does RA affect the hand joints?

RA tends to affect many joints at once. Often, symptoms first appear in the small joints of the middle fingers and in the bases of the hands and toes. It usually occurs in the same joints on both sides of the body.

RA may affect small joints in the hands first because there are many more joints in the hands than in other parts of the body.

The hands have 29 joints each. These joints are supported by a complex network of muscles, ligaments, and tendons that has evolved to perform complex tasks.

In people with RA, the immune system attacks and causes inflammation in the joint lining, or synovium. The synovium produces a fluid that lubricates the cartilage covering the ends of bones, allowing the bones to glide smoothly against each other when a person bends the joint.

A person with RA may experience symptoms such as pain, swelling, and stiffness in the joints. Over time, chronic inflammation in the joints may cause the cartilage to gradually wear away.

The condition may also progress to larger joints, such as the knees, ankles, or elbows.

In addition to affecting the joints, RA can cause inflammation that can also impact a person’s:

  • heart
  • lungs
  • eye
  • kidneys
  • skin

Common symptoms

Some research suggests that RA has a slow onset in more than 50% of cases.

Around 25% of people have abrupt RA onset. Experts believe that it is linked to gum inflammation from bacteria called Porphyromonas gingivalis. People will not experience gum inflammation or gingivitis (gum disease) from this infection unless they smoke.

RA is progressive, which means that the symptoms get worse over time. Treatments such as disease-modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs can help slow the progression of RA but cannot cure the condition.

Early signs and symptoms of RA include tenderness, pain, swelling, or stiffness in joints that:

  • affect more than one joint
  • usually start in small joints, such as the hands, wrists, or feet
  • affect the same places on both sides of the body
  • last for at least 6 weeks
  • may be accompanied by stiffness in the morning for 30 minutes or longer

The fingers may appear swollen, like sausages. Inflammation can eventually cause irregularities in the joints and an inability to properly bend or straighten these joints.

Some other common symptoms of RA include:

  • weight loss
  • fever
  • weakness
  • fatigue

Over time, inflammation can affect other parts of the body, leading to symptoms such as:

  • dryness, pain, and inflammation in the eyes
  • sensitivity to light
  • small bumps in the skin over bones called rheumatoid nodules
  • shortness of breath
  • a dry mouth
  • gum inflammation or infection
  • a low red blood cell count

Home remedies

Home remedies do not replace medical treatments such as DMARDs, which can help slow the progression of RA. A person should never stop or change their prescribed treatment plan before speaking with a doctor.

Several home remedies may help alleviate pain, swelling, or stiffness in the joints due to RA. These remedies include:

  • heating pads or warm baths, to loosen up stiff joints
  • ice packs, to relieve joint pain and swelling
  • meditation and deep breathing techniques, to help a person relax and take their mind off the pain
  • acupuncture
  • massage
  • splints for the fingers or wrists
  • assistive devices, such as ergonomic keyboards or jar openers
  • lotions with capsaicin, to help relieve localized pain

The following supplements have limited scientific evidence proving their benefits but are worth bringing up with a doctor:

  • cannabidiol (CBD) products
  • fish oil
  • turmeric
  • glucosamine
  • probiotics

Making certain dietary changes can also reduce inflammation throughout the body and help a person lose weight. This may help relieve RA symptoms. Having an anti-inflammatory diet includes eating:

  • less sugar
  • fewer processed foods
  • less red meat
  • less full fat dairy
  • more fresh fruits
  • more vegetables
  • whole grains
  • lean meat
  • fish
  • legumes
  • nuts
  • seeds

Some people with RA may find that avoiding gluten or eating more fermented foods, such as yogurt and sauerkraut, helps with symptoms.

A person should always talk with a doctor before trying any new supplements or making any major dietary changes.

Exercises

For people with RA hand pain, exercise may improve the symptoms and maintain joint mobility and function.

Some research suggests that performing therapist-recommended hand exercises may improve grip and hand function while also relieving RA symptoms.

A 2018 study in 841 people with RA suggests that hand exercises may improve mobility and function. The study also concludes that performing a hand exercise routine likely does not relieve pain or improve a person’s grip and strength in the short or long term.

  • Here are three simple hand exercises that a person can try:
  • Gently squeeze a small, squishy ball or a stress ball.
  • Place the hand out flat with the palm up. Bend each finger, one by one, into the palm. Hold, release, and repeat.
  • Place the hand flat on a table. Lift one finger off of the surface and release it back down. Repeat with each finger, one by one.
  • Getting regular, gentle, full body exercise helps increase strength and range of motion in the joints, which can improve daily functioning. It also helps a person maintain a moderate weight, which can improve RA symptoms.

A person should aim to incorporate the following into their routine:

  • cardiovascular exercises, such as walking or swimming
  • full body strengthening exercises
  • light stretching

Some exercise is always better than none. Although feeling some discomfort is OK, a person should stop exercising if they feel significant pain.

When to talk with a doctor

A person should talk with a doctor if they experience any early symptoms of RA, including:

  • persistent pain or stiffness in the joints
  • joints that are warm to the touch
  • difficulty moving or engaging in daily activities

For people who already have a diagnosis of and treatment plan for RA, a doctor visit is warranted if they:

  • experience any new symptoms
  • feel that their treatments are no longer managing their symptoms
  • develop any side effects from their medications

A person should also talk with a doctor before starting new supplements or a new diet. Also, they should always talk with a doctor before changing or discontinuing their medications.

  • A person should ask questions of their care team as needed. The team will often consist of the following healthcare professionals:
  • a primary care physician
  • a rheumatologist, who will specialize in treating musculoskeletal conditions such as RA
  • a rheumatology nurse, who can help educate the person about RA
  • a physical therapist, to help with mobility issues and teach hand exercises
  • an occupational therapist, to share devices and techniques that help a person live with their symptoms and go about their daily tasks
  • a mental health professional, to help with stress and anxiety, which are more common in people with RA
  • an orthopedic surgeon, to correct joint damage with surgery as necessary

The takeaway

RA is an autoimmune condition that affects many joints in the body. The condition causes the immune system to attack the lining in the joints, causing pain and swelling. Because there are many joints in the hands, people usually experience the first symptoms of RA in their hands.

Medications such as DMARDs help slow the progression of the condition. Several home remedies can also help manage the symptoms. Hand exercises may improve hand mobility, while full body exercise may relieve the symptoms and improve overall well-being.

A person’s healthcare team can help determine the best treatment plan to manage pain and improve functioning.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

How to Treat a Broken Finger Tip

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Article featured on American Society for Hand Surgery

The finger tip is one of the most commonly injured areas of the upper extremity because we use our finger tips in so many daily activities. Your finger tip can be injured in a variety of different ways, including being crushed by a door, hit with a hammer, getting stuck under a heavy object, or cut with a knife.

While some finger tip injuries may be minor, others can be more severe. You can the bone, nail bed, tendons or even the nerve endings, which allow you to have sensation in the finger tips. Here’s how to treat a finger tip injury, depending on the severity:

  • Dressing (a gauze wrapping or tape): Dressings can treat more minor finger tip injuries, such as when just the skin is affected or if there is a small amount of bone exposed.
  • Splints or metal pins: These can be used if you’re suffering from a broken finger tip. The metal pins will hold the bone fragments in the proper position.
  • Drainage: If blood is collecting under your nail, your hand specialist may make a small hole in the nail to drain it.
  • Surgery or amputation: These treatment options are reserved for more severe nail bed injuries.

Regardless of which treatment you receive, it’s important to remember that your finger tip may never look or feel the same after an injury, especially a severe one.

Your treatment plan will vary based on your specific circumstances. Visit a hand specialist as soon as you’ve injured your finger tip to determine the best plan. The sooner you receive treatment, the better. Delaying treatment may result in loss of feeling in your finger tip.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

5 Causes of Thumb Pain

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Article featured on American Society for Surgery on the Hand

The thumb is involved in about 50% of all hand functions. When the thumb is painful or injured, it becomes very difficult to use the hand. During normal life, we take our thumbs for granted. When the thumb is not working properly, tasks are more difficult, and we then realize how important the thumb is. There are several causes of thumb pain including:

  1. Trigger thumb
  2. Arthritis
  3. Tendonitis
  4. Carpal tunnel syndrome
  5. Skier’s thumb.

Read below to learn more.

1. Trigger thumb

The tendon that bends or flexes the thumb is called the flexor pollicis longus (FPL). If there is swelling or inflammation around the thumb tendon, it will not glide smoothly. Sometimes the tendon gets stuck in the thumb pulley, causing the thumb joint to click, catch, or lock. This is called a trigger thumb. The thumb can also become swollen, stiff, and very painful. Treatment includes rest, anti-inflammatory medications, splinting, and steroid injections. Most patients improve without surgery. If symptoms persist with treatment, trigger thumb release surgery is very effective and has low risks.

2. Thumb arthritis

The human thumb is unique. We can touch the tip of the thumb to the small finger — a function called opposition. Most animals do not have an “opposable” thumb. This gives us the ability to write, use a needle and thread, and use hand tools. The joint at the base of the thumb which allows opposition is called the carpometacarpal (CMC) joint. Normal, every day activities can cause wear and tear in the thumb CMC joint. When the joint wears out, it can become inflamed and painful. This process is called osteoarthritis or degenerative joint disease.

Anyone can get osteoarthritis if they live long enough. So far, we have not found a way to prevent osteoarthritis. Wear and tear is part of the normal aging process. However, the symptoms of osteoarthritis can be treated by reducing inflammation in the joint. Ways to reduce inflammation and treat thumb CMC osteoarthritis include topical anti-inflammatory gels, oral over-the-counter medications, adjusting hand activities, using a thumb splint, and steroid injections. Most patients improve without surgery. If symptoms persist with treatment, thumb CMC surgery can greatly improve quality of life.

3. DeQuervain’s tendonitis

The tendons in the wrist that lift the thumb up are prone to tendonitis. These tendons travel through a tight compartment on the thumb side of the wrist. If there is friction on the tendons, they can become inflamed and very painful. This is classic in young mothers, and is sometimes called mommy’s thumb. Treatment consists of splinting, anti-inflammatory medications, therapy, and steroid injections. DeQuervain’s release surgery is occasionally necessary to resolve this condition.

4. Carpal tunnel syndrome

Carpal tunnel syndrome is a type of pinched nerve. When the nerve is pinched in the carpal tunnel, patients have numbness and tingling in the thumb, index, middle, and/or ring fingers. Initially symptoms come and go, and are often worse at night. Some patients feel electric shock sensations or burning pain in their thumbs. In severe cases, the thumb muscles can become weak and atrophied. Treatment for most patients includes wearing a wrist brace at night, stretching exercises, hand therapy, and steroid injections. Carpal tunnel surgery is very effective for most patients if non-operative treatment is not successful or if nerve compression is severe.

5. Skier’s thumb

Trauma to the thumb is common. During a fall, most people land on an outstretched hand to brace themselves. Unfortunately the ligaments in the thumb can become injured in this way. The ulnar collateral ligament (UCL) of the thumb is vulnerable to tearing as the thumb is bent backwards and away from the hand. If this ligament does not heal properly, patients can have pain and weakness with pinch tasks. For most minor sprains of the thumb, temporary immobilization in a splint or cast is successful to allow healing. If the ulnar collateral ligament is fully torn, however, surgery is usually recommended to fix the injury. Hand therapy is often helpful during the recovery process to regain range of motion and strength.

If you have an injury to your hand or thumb, or pain which does not go away with conservative treatment, make an appointment with a hand specialist to get an accurate diagnosis and good treatment plan.

New Mexico Orthopaedics is a multi-disciplinary orthopedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.