by Comp Ortho | Jan 3, 2024 | arthritis, Hand
Millions of people who live with the pain and stiffness of arthritis in their hands get steroid or hyaluronic acid injections directly into their finger joints in the hopes of feeling better.
Now, a new review shows that even though these injections are widely recommended in treatment guidelines, they don’t really work.
Joint injections to relieve the symptoms of hand osteoarthritis were no better than dummy (placebo) injections, the study found.
That’s not all current treatment recommendations for hand arthritis seem to get wrong, either. Most also call for topical pain relievers as the first-line therapy for hand osteoarthritis, but the evidence on those is iffy, said study author Dr. Anna Døssing, a rheumatology resident at the Parker Institute in Copenhagen, Denmark.
So, what does relieve the pain of hand arthritis?
“Oral nonsteroidal anti-inflammatory drugs [NSAIDs] and oral glucocorticoids effectively reduce pain in people with hand osteoarthritis,” Døssing said. Of these, glucocorticoids (steroid) pills were most effective, the study showed.
Oral NSAIDs also improved function and grip strength, and oral steroids improved function and people’s health-related quality of life, a measure that encompasses physical and mental health status. People who took either of these medications reported improvements in hand symptoms and their overall health.
For the study, Døssing and her colleagues reviewed 65 studies of close to 5,250 people with hand osteoarthritis. The studies looked at 29 types of treatment for the condition.
Injections were found to be ineffective, but most people in the study received injections for osteoarthritis in the base of their thumb. Hydroxychloroquine, an arthritis medication that affects the immune system, was also found to be ineffective for hand arthritis, and the effectiveness of topical creams and gels for pain wasn’t clear, the study showed.
The findings were published Sept. 28 in the journal RMD Open.
The article reveals a “surprising lack of effectiveness of intra-articular glucocorticoids, a widely employed and traditionally fundamental treatment for hand arthritis, specifically thumb-base arthritis,” said Dr. Daniel Polatsch, co-director of The New York Hand and Wrist Center of Lenox Hill Hospital and an associate professor in the department of orthopedic surgery at Zucker School of Medicine/Northwell in New York City.
“This discovery stands in stark contrast to the prevailing beliefs and experiences of most hand surgeons, myself included, in our clinical practice,” Polatsch said.
He said that treatment for hand arthritis should be individualized. “I consistently advocate for commencing treatment with the option that carries the lowest risk,” he said. “Short-term usage of oral NSAIDs or glucocorticoids is a reasonable approach.”
That said, long-term use of these medications can cause side effects. Prolonged use of NSAIDs has been linked to bleeding ulcers. Oral steroids, when taken for prolonged periods of time, can cause high blood pressure, weight gain, thinning skin and infections.
“My recommendation is to engage in a discussion about the different treatment options with your health care provider and formulate a plan together,” Polatsch advised.
It’s also a good idea to see a hand surgery specialist if symptoms persist.
“A hand surgery specialist … can thoroughly assess the full spectrum of alternatives, including medication, splinting, hand therapy, injections and, as a final resort, surgery,” Polatsch said.
More information
HealthDay has more on arthritis symptoms.
SOURCES: Anna Døssing, MD, rheumatology resident, Parker Institute, Copenhagen; Daniel Polatsch, MD, co-director, The New York Hand and Wrist Center of Lenox Hill Hospital, and associate professor, department, orthopedic surgery, Zucker School of Medicine/Northwell, New York City; RMD Open, Sept. 28, 2023
Copyright ©2023 HealthDay. All rights reserved.
by Comp Ortho | Jan 20, 2022 | Hand, pain, Wellness, Wrist
As the weather gets cooler, many people are affected by joint pain in the hands and wrists due to arthritis or injury. Bodily extremities are prone to “shutting down” circulation to maintain core body temperature. This might save your life in extreme situations; however, it just causes pain under most circumstances. Anyone with hand and wrist joint arthritis will tell you the harsh reality of increased body aches in the winter months.
Why Do My Hands Hurt More in Winter?
Cold weather joint pain doesn’t always indicate a new or more significant problem. People with arthritis often have chronic pain from inflammation and swelling, and the pain is much worse in cold weather. Scientists think that barometric pressure may be to blame. When the temperature goes down, the barometric pressure drops. As a result, the tissues in your hands and wrists expand, creating internal pressure and pain.
Fortunately, there are ways you can prevent and minimize your joint pain. If your hands and wrists ache during cold weather, here are ten ways to manage and avoid pain.
10 Ways to Manage Cold Weather Joint Pain in Winter
You probably won’t be surprised to learn that heat and a healthy lifestyle are critical when you’re trying to manage cold weather joint pain in the hands and wrists. A few small changes could make a big difference in your quality of life!
1. Stay Active
As tempting as it is to snuggle up and watch Netflix all winter, movement can significantly ease hand and wrist pain during cold weather.
Staying active with regular stretching and exercise keeps your muscles and joints healthy and your circulation strong. Not moving leads to stiffness and increased pain. General movements, like walking, yoga, or house cleaning, stimulate blood flow and boost circulation throughout your body. To exercise your hands and wrists, stretch and move your fingers and bend and rotate your wrists. Here are nine exercises for your hands and wrists from the Arthritis Foundation you can try.
2. Apply Heat
Heat helps soothe the pain of arthritis in hands and wrists that cold weather brings on. Use a heating pad or heated gloves to keep your hands and wrists nice and toasty. As a preventative measure, keep your hands and wrists warm all the time in cold weather. Invest in clothing with deep pockets and high-quality mittens. Mittens do a better job of trapping heat than gloves.
3. Eat Healthy
Joint health is tied to overall health. Maintaining a healthy diet can help reduce pressure and keep inflammation down in the hands and wrists. Consider adopting a diet rich in foods that mitigate joint pain. As a bonus, the foods that help are heart-healthy and delicious. Check with your doctor before making any diet changes if you have a condition that includes dietary restrictions.
4. Warm Up with Turmeric Tea
Is there anything more comforting than a hot cup of tea on a cold day? Turmeric (or curcumin) is a natural anti-inflammatory used for centuries in Chinese medicine. Flavor your tea with honey, lemon, or your favorite flavors, and wrap your aching hands around a warm, soothing mug.
5. Wear Compression Gloves
Compression gloves apply gentle pressure to achy joints and keep your hands warm. Good quality compression gloves are soft and flexible enough to wear all the time, and fingerless compression gloves are available if you prefer your fingertips uncovered.
6. Hydrate
Even slight dehydration can make you more sensitive to pain. Make sure you drink plenty of water every day, but especially when the temperature starts to drop. Your hands and wrists will thank you.
7. Take Vitamin D
Vitamin D plays a significant role in making you feel good, and that includes managing your joint pain. Unfortunately, vitamin D deficiency is common in the winter months, as people are outside much less and getting less sunshine. A vitamin D supplement might mitigate cold weather hand and wrist joint pain when sun exposure is limited. Check with your doctor before taking any supplements and get advice on how much vitamin D supplement you should take.
8. Wash Dishes
It may sound nutty, but washing dishes in a sink filled with hot, soapy water involves movement and is relaxing and soothing. Use a moisturizing dishwashing liquid to leave your skin silky and soft. Other options include soaking your hands and wrists in a warm Epsom salt solution or taking a hot bath.
9. Use a Topical Pain Relief Cream
A wide variety of over-the-counter and prescription analgesic creams are available to help minimize cold weather joint pain in the hands and wrists.
OTC medicated creams may contain:
- Capsaicin
- Salicylates (aspirin)
- Counterirritants such as camphor and menthol
- An anesthetic (typically lidocaine)
Topical prescription options include NSAID creams or steroid-based ointments.
10. Stay Positive
The winter months are often hard on mental health. Research has shown that people who experience negative moods and depression are more susceptible to pain. Their perception of pain levels is often magnified beyond expected levels. In the winter months, it’s important to stay active, healthy, and social—all aspects that help improve mental and physical health.
When to Call Your Orthopedic Specialist for Winter Joint Pain
At CompOrtho, we believe everybody deserves to live a comfortable life and have the best possible care. When you have hand and wrist pain, the orthopedic team will help you get back to living your active lifestyle. Call us immediately if you have:
- Persistent swelling
- Redness
- Difficulty putting pressure on or using the joint
- Constant or severe pain in the joints
by Comp Ortho | Jan 18, 2022 | Hand, pain, surgery, Wellness, Wrist
Carpal tunnel can be a painful and even debilitating orthopedic condition. But it’s one that can be prevented with some simple lifestyle changes.
Carpal tunnel syndrome, a progressive condition marked by pain, numbness and tingling in the hands and wrists, is an extremely common condition. While it is most often associated with typing on a computer, carpal tunnel syndrome can strike anyone who performs repetitive tasks with their hands, such as cashiers, knitters, and assembly line workers. Or it can occur after an injury to the wrist or hand. Some pre-existing conditions, like diabetes and rheumatoid arthritis, are also associated with a greater incidence of carpal tunnel syndrome. Additionally, women tend to suffer from the condition at higher rates than men because their carpal tunnels are smaller.
That’s relevant to the condition because, as the name suggests, carpal tunnel syndrome is directly related to the carpal tunnel. In carpal tunnel syndrome, your median nerve, which spans the length of your arm and ends in the wrist, becomes compressed due to any of the reasons described above. That median nerve passes through the carpal tunnel, a narrow pathway of bone and ligament at the base of your hand, which is the reason for the condition’s name. Because the nerve controls the movements of your fingers apart from the pinky, the first sign of carpal tunnel syndrome is typically a tingling or numb sensation in the fingers. Some people may also experience pain and a burning sensation radiating up their arm to their elbow in addition to a weak grip.
6 Tips to Prevent Carpal Tunnel Syndrome
Obviously it is best to avoid carpal tunnel syndrome if at all possible. The good news is that you don’t have to switch jobs or give up your hobbies to avoid carpal tunnel syndrome. You can take measures to ward off the condition before the pain starts. Check out these 6 tips for ways to stop carpal tunnel syndrome in its tracks:
Go for a Neutral Wrist Position. Avoid bending your wrists sharply up or down whenever possible, including when you’re at work or simply in your daily life. Such exaggerated positions stress the nerve. Lift the pressure off by keeping your wrist in a straight, neutral alignment.
Lighten Up. You probably don’t realize it, but you may be striking your keyboard too hard. Go for a lighter touch and relax your hand and wrist as you type.
Take a Break to Stretch. Stopping your task for 10 to 15 minutes gives your hand and wrist a chance to rest. But make good use of your break time by stretching your wrist! One good exercise to try is to make a fist then release your fingers and fan them out. Stretch them as far as possible. Repeat 5 to 10 times.
Switch Hands. If you always perform a task with one hand, switch to the other if you can. This gives each hand and wrist a break from a continual and stressful motion. Of course this isn’t always possible, but make a point of switching wherever you can.
Change Your Desk Setup. How your desk and chair are arranged may be causing extra strain on your wrists. Ideally, you want your desk, chair, and keyboard to be arranged so that your forearms line up with your work surface. The idea is to avoid bending your wrists as much as possible. Also try to keep your elbows tucked to your sides when working at a desk.
Stay Warm. Cold air stiffens up joints and muscles. Although you may be unable to control the office thermostat, you can slip on a pair of fingerless gloves to keep your hands warm and limber.
Treating Carpal Tunnel Syndrome
If you suspect you have carpal tunnel syndrome, it’s time to go to the orthopedist for a proper diagnosis and treatment. Your orthopedist will begin by performing a number of physical tests to assess any nerve damage. Once they’ve assessed the extent of the condition, treatment can begin.
Carpal tunnel syndrome treatments typically begin with recommendations of conservative therapies including:
- Avoiding repetitive motions for two weeks or more.
- Applying ice packs to reduce swelling.
- Taking non-steroidal anti-inflammatories medications.
- Wearing a brace for four to six weeks to keep the hand and wrist immobile.
- Working with a physical therapist on strengthening and stretching exercises after pain subsides.
In severe cases not helped by conservative treatments, your doctor may recommend carpal release surgery. In this procedure, the transverse carpal ligament is dissected to release pressure on the median nerve and enlarge the carpal tunnel.
Don’t Live with Wrist Pain
Healthy hands and wrists are critical when it comes to performing important functions in your everyday life. So don’t let pain stop you from doing your job or enjoying your hobbies! If you believe you may have carpal tunnel syndrome, it’s important to see a specialist right away to get to the bottom of the condition. The orthopedists at Comprehensive Orthopaedics can diagnose your condition and discuss treatment options with you to get you pain-free once again.
by Comp Ortho | Jun 15, 2020 | Elbow, Hand, pain, Wrist
Carpal tunnel syndrome and cubital tunnel syndrome share similar symptoms, but they are distinct conditions affecting different nerves in the elbow and wrist.
If you’re experiencing pain and numbness in your fingers, you may assume you have carpal tunnel syndrome. But did you know another condition — called cubital tunnel syndrome — could also be the source of these symptoms?
Both carpal tunnel syndrome and cubital tunnel syndrome result from nerve compression; however, the damaged nerve for each is located in a different part of the body. In cubital tunnel syndrome, the ulnar nerve within the elbow becomes compressed due to injury or repeated bending of the elbow. The ulnar nerve sits inside the cubital tunnel, a passageway consisting of bone, muscle, and ligaments.
On the other hand, the compressed nerve causing carpal tunnel syndrome is the median nerve in the wrist. Repetitive motions of the hand and wrist (such as typing), fractures, and sprains are typically to blame. In addition, chronic conditions such as diabetes and arthritis are considered risk factors for carpal tunnel syndrome.
Despite some similarities — compressed nerves, hand pain, weakness when gripping objects — cubital tunnel syndrome and carpal tunnel syndrome are characterized by several differences. Knowing the symptoms for each can help you identify which condition you may have and determine the right treatment.
Carpal Tunnel vs. Cubital Tunnel
Both syndromes affect the hand and fingers, but the pain, tingling, and numbness of carpal tunnel syndrome is felt most acutely in the thumb, index finger, middle finger, and half of the ring finger. It’s also characterized by pain and burning in the hand and wrist that sometimes radiates up the forearm to the elbow.
Meanwhile, cubital tunnel syndrome is marked by numbness, pain, and tingling in the little and ring fingers as well as the inside of the hand. If you have cubital tunnel syndrome, you may notice these symptoms flare up at night when you bend your elbow for long periods as you sleep.
Diagnosing cubital tunnel syndrome or carpal tunnel syndrome begins with a physical examination. An orthopedist may also perform a nerve conduction study to assess nerve impulses in the wrist or elbow. Weak nerve activity in a certain area could indicate, for example, carpal tunnel syndrome.
Treating the Symptoms
Treatment options differ for each syndrome, although conservative therapies are recommended at first to reduce symptoms and restore function to the hand. Because cubital tunnel symptoms are more pronounced at night, you might be advised to wear a brace that straightens the elbow while you rest. Wrapping your arm in a towel to keep it straight can work as well.
If conservative treatments fail to relieve the nerve compression or muscle wasting is severe, surgery is another option. Two types of cubital tunnel surgery are currently performed: a medical epicondylectomy and an ulnar nerve transposition. In a medial epicondylectomy, the bony bump inside the elbow (the medial epicondyle) is removed. This allows the ulnar nerve to flex and straighten without pain. For an ulnar nerve transposition, the surgeon creates a new cubital tunnel and moves the ulnar nerve to the recreated tunnel.
Treating carpal tunnel syndrome non-surgically usually entails resting the hand, avoiding activities that aggravate symptoms, wearing a splint for several weeks, and applying ice to reduce swelling. Anti-inflammatories and steroids may also be prescribed. Once the pain subsides, you can practice exercises to stretch and strengthen the wrist and hand.
If these conservative treatments don’t alleviate carpal tunnel symptoms, surgery to relieve pressure on the median nerve by cutting the transverse carpal ligament may be necessary. This procedure is followed by physical therapy to strengthen the wrist.
What’s Causing Your Hand Pain?
If you’re experiencing hand and finger pain, you may be suffering from either cubital tunnel syndrome or carpal tunnel syndrome. The doctors at Comprehensive Orthopaedics can diagnose your condition and prescribe the proper treatment regimen. Whether through conservative therapy or surgery, our goal is to help our patients live pain-free. Contact us today for an appointment.
by Comp Ortho | Aug 7, 2019 | Anti-aging, arthritis, Hand
(HealthDay News) — Arthritis is a collection of joint diseases that affect more than 50 million adults and 300,000 children in the United States.
The joint pain, swelling or stiffness that may come with arthritis can be debilitating, says the Arthritis Foundation.
To manage arthritis of the hands, the foundation suggests:
- Use cold packs to numb the joints and reduce swelling.
- For significant inflammation, heat packs may provide relief.
- Immobilize the hand with a splint or brace overnight.
- Use a grip or similar device if you have trouble grasping or holding things.
Copyright ©2017 HealthDay. All rights reserved.
by Comp Ortho | Jul 30, 2019 | Anti-aging, Elbow, Hand, pain, Wellness
MONDAY, July 29, 2019 (HealthDay News) — Repetitive strain injury (RSI) can affect anyone who uses his or her hands a lot and repeats the same movements over and over again. It can develop whether you’re working at a computer all day or spending hours of leisure time immersed in handicrafts.
At first, symptoms — like pain and tingling — may go away once you stop the motions or the activity. But without treatment, including lifestyle changes, symptoms are likely to become so severe that you could become unable to continue with your work or hobby.
Recognizing RSI Symptoms
- Pain or burning
- Tingling
- Numbness
- Weakness
- Swelling
- Soreness
Don’t hesitate to see your doctor if you experience one or more of these symptoms — don’t assume that a few days off is enough to stop RSI. If the source of pain isn’t addressed, symptoms can become irreversible.
Part of the solution is to take regular breaks from problematic but necessary activities throughout the day. Get up and move around for at least five minutes every half-hour, and stretch your arms, wrists and fingers.
Practice good posture. When sitting, your head and back should form a straight line from ears to hips. When at the computer, don’t let your wrists bend to one side. Keep them in line with your forearms, fingers slightly curved over your keyboard. Don’t self-treat by wearing a splint or using a wrist rest — both can interfere with natural movement and blood circulation.
More Typing Tips to Try
- Use all fingers to type, not just one
- Use keyboard shortcuts
- Take advantage of voice recognition software
Also, consider investigating the Alexander Technique, an approach to movement aimed at better posture and body mechanics helpful for RSI.
More information
You can learn more about the Alexander Technique online.
Copyright ©2017 HealthDay. All rights reserved.
