By Richard Davis, MD, orthopedic surgeon with Samaritan Orthopedics & Podiatry
To carry out the normal activities of daily living, we need to be able to see and use our hands. Pain anywhere along the upper extremity can impair our ability to work, play or care for ourselves.
There are several common causes of pain at each joint – shoulder, elbow, wrist and hand. Here are some common sources of pain and what can be done to relieve them.
The shoulder allows us to position the hand in space over a wide area of locations. The shoulders are the most mobile joints and are prone to injury and wear over time. The most common sources of shoulder pain are tendinitis and bursitis. Friction and wear of the rotator cuff tendon results in pain over the upper outer arm. This is typically treated with medication, physical therapy or cortisone injections. Long-standing problems may require surgery to remove bone spurs and repair torn tendons.
The elbow is a single hinge and forms the basis of our forearm rotation, helping us position our hand to perform daily tasks. The muscles of the forearm originate from two bony bumps on the inside and outside of the elbow. Both of these areas can have pain due to tendinitis, medial epicondylitis (golfer’s elbow) and lateral epicondylitis (tennis elbow). These conditions can be treated with stretching, physical therapy, bracing and injections. In rare cases that persist more than six to 12 months, surgery may be necessary to resolve the condition.
The wrist can have areas of tendinitis, too. De Quervain’s tendinitis causes pain on the thumb side of the wrist, a couple of inches above the thumb at the end of the forearm. Again, the problem here is friction resulting in irritation of the tendons. It can be treated with topical anti-inflammatories (e.g. Voltaren gel), bracing or injections. Persistent pain that does not respond to these treatments is occasionally treated with surgery.
The hand is one of the most complex structures of the skeletal system. It enables a wonderful array of activities. As such, pain in the hand can be quite troublesome. Common examples of hand pain include trigger finger, originating where the finger meets the palm. Carpal tunnel syndrome is also quite common, caused by pressure on the median nerve as it enters the hand. Carpal tunnel syndrome can result in numbness, tingling, aching and clumsiness of the hand – particularly along the thumb and the index and long fingers. In patients 40 years of age and older, arthritis of the thumb is more common. This condition is most painful where the thumb meets the wrist. Activities involving span grasp, such as opening a jar of peanut butter, can be particularly difficult. Similar to the conditions above, hand pain can be treated with medication, injections, bracing, physical therapy and — if those treatments fail — surgical correction.
When you think about it, it is quite remarkable that we have such good use of our hands throughout most of our lives. The unique anatomy of our upper extremities allows us to do many things with dexterity. However, if your hand, wrist, elbow or shoulder becomes uncomfortable and limits your activity, an orthopedic specialist can help you choose a treatment option that’s right for your specific condition.
Richard Davis, MD, is an orthopedic surgeon with Samaritan Orthopedics & Podiatry – Newport, Samaritan Coastal Clinic and Samaritan Pacific Communities Hospital. He is accepting new patients and can be reached at 541-574-7235.
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