Experiencing Trigger Finger?

Experiencing Trigger Finger?

Can’t move your finger? It could be due to an orthopedic condition known as trigger finger. Learn more about the causes and treatments. 

We use our fingers so much in our daily lives — from typing to grasping objects to pointing and much more — that we often take these moveable joints for granted. But if your finger suddenly stiffens and you can’t accomplish your normal daily tasks, you’re sure to stop taking those joints for granted fast. What’s behind this stiffening? It’s most likely an orthopedic condition known as trigger finger.

Trigger finger can affect any finger, including the thumb, and may strike a single digit or multiple at once. Common trigger finger symptoms include general stiffness or a finger locking in a bent position. You may hear a clicking sound when you move your finger or feel soreness or a lump at the base of the finger. Treatment for trigger finger starts with conservative methods of rest and physical therapy. But first, let’s look at what causes trigger finger.

Trigger Finger Causes

Trigger finger, also known as stenosing tenosynovitis, or flexor tendonitis, is an inflammation of the sheath covering the tendon in the finger. The sheath allows the tendon to move freely. But when it’s irritated or inflamed, the finger stiffens and cannot straighten itself. Prolonged inflammation can also lead to scarring and bumps forming in the tendon, which further restricts the finger’s ability to move.

Similar to so many other orthopedic disorders, trigger finger develops as a result of repetitive motions. People who work at jobs requiring them to continually grasp or bend their fingers, such as musicians, tend to develop trigger finger in greater numbers. People who have diabetes, rheumatoid arthritis, or who have had carpal tunnel syndrome surgery before stand a greater chance of developing trigger finger. The condition also strikes more women than men.

Treating Trigger Finger: Home Remedies

Your orthopedist can diagnose trigger finger with a physical examination to feel for any areas of tenderness or swelling. During the examination you will also be asked to open and close your hand to pinpoint the center of the pain or see if your finger locks up.

Initial trigger finger treatments typically involve conservative methods, beginning with avoiding activities that cause the pain and stiffness. You may need to wear a splint to immobilize the finger and give the tendon time to heal. This period of rest could take between four to six weeks.

If your trigger finger is caused by an underlying chronic condition such as diabetes or rheumatoid arthritis (instead of just repetitive motions), treatment for those disorders can help relieve the symptoms of trigger finger.

Another treatment option to reduce pain and swelling is to take non-steroidal anti-inflammatory medications. A good home remedy for bringing down the swelling is to apply ice to the finger for 15 minutes three times a day is recommended. In some cases, your doctor may also prescribe a steroid injection into the affected finger.

Treating Trigger Finger: Physical Therapy and Surgery

One of the most effective ways to treat trigger finger is through physical therapy, which can effectively increase flexibility and strength in the finger and hand. Your physical therapist may also massage the finger gently to break up any scar tissue on the tendon, which can alleviate pain and improve your range of motion.

If conservative methods fail to restore mobility, surgery may be your next step. In a percutaneous release procedure, a needle inserted into the finger tendon loosens it so the finger can move smoothly again. This procedure is usually done on an outpatient basis. After surgery, you must keep the finger dry by covering it with plastic wrap when showering. You’ll wear a bandage for a few days. Once the bandage is removed, you should move your finger as much as possible to speed up the healing process.

It’s important to remember that surgery is only recommended when other conservative techniques are unsuccessful and your quality of life is significantly impaired by trigger finger. In most cases, trigger finger resolves without surgery and you can return to normal activities without pain or stiffness.

Treat Your Trigger Finger Today

The physicians at Comprehensive Orthopaedics are experts in treating painful conditions of the joints, including your hands and fingers. Our first priority is ensuring quality of life to your patients with conservative treatments and surgery when necessary.

NSAIDS, Steroids for Back Pain: Is Too Much of Them a Bad Thing?

NSAIDS, Steroids for Back Pain: Is Too Much of Them a Bad Thing?

THURSDAY, May 12, 2022 (HealthDay News) — Persistent use of steroids and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to treat acute lower back pain may actually turn it into a chronic condition, a new study warns.

However, some experts who expressed concerns about the study published in the journal Science Translational Medicine pointed out that it was not a clinical trial, which is the gold standard for medical research, The New York Times reported.

The findings by the team at McGill University in Montreal are based on observations of patients, an analysis of a large patient database and an animal study.

The study results suggest we “need to think further about how to treat our patients,” lead investigator Dr. Luda Diatchenko, a professor who specializes in human pain genetics, told the Times.

Back pain is the most common type of pain, according to the U.S. Centers for Disease Control and Prevention.

The research is “intriguing, but requires further study,” Dr. Steven Atlas, director of primary care practice-based research and quality improvement at Massachusetts General Hospital, told the Times.

That opinion was echoed by Dr. Bruce Vrooman, a pain specialist at Dartmouth Hitchcock Medical Center in New Hampshire. But Vrooman also told the Times that the study was “impressive in its scope” and added that if the findings hold up in a clinical trial, it could “force reconsideration of how we treat acute pain.”

The study represents a “paradigm shift,” Dr. Thomas Buchheit, director of the regenerative pain therapies program at Duke University, told the Times.

“There is this unspoken rule: If it hurts, take an anti-inflammatory, and if it still hurts, put a steroid on it,” he said. But this study shows that “we have to think of healing, and not suppression of inflammation.”

Current guidelines advise people with back pain to begin with exercise, physical therapy, heat or massage, which can be as effective as pain medications but don’t cause the same side effects.

If those approaches don’t work, patients can try NSAIDs like ibuprofen, the guidelines advise. Acetaminophen (best known as Tylenol) is not an anti-inflammatory.

More information

Visit the National Library of Medicine for more on back pain.

SOURCE: The New York Times
Copyright ©2022 HealthDay. All rights reserved.
Can a Standing Desk Reduce Back Pain?

Can a Standing Desk Reduce Back Pain?

Sitting at your desk all day can cause back pain. Will switching to a standing desk setup help? Read on to find out.

COVID-19 has changed many aspects of American life, and one of most pronounced is how and where we work. To stop the spread of the virus, companies allowed workers to work from home or split their hours between office and home using a hybrid work model. The result was a huge surge in employees who work from home.

As people began to work from home more regularly, they quickly realized they didn’t have a proper desk setup in their houses. Instead of an office desk and chair, they crouched on their sofa with a laptop or on a stool at their kitchen table, leading to back and neck pain. Even those who had dedicated office space in their residence with a desk and chair often suffered from lower back discomfort. To alleviate back stiffness, some workers considered purchasing a standing desk, which people frequently claim can reduce some of the health risks caused by sitting for long periods of time. But can these devices actually reduce your neck and back pain? Or might they even lead to more serious pains?

How Sitting All Day Affects Your Back

Sitting has been termed the “new smoking” due to the damage it can do to your health. While this may seem like an exaggeration, there’s no denying the health risks caused by extensive sitting. When you sit for eight hours a day at work and then more at home in front of the television, you’re not active and that can lead to serious health problems across the board.

When it comes to your back, sitting for long hours in a chair can strain the muscles in your back, neck, hips, and buttocks. Sitting can also compress the discs in your spine, leading to stiffness and pain. And if you slouch forward — as many of us do when seated — that pressure on your spine increases. In addition to simply sitting, the way you set up your desk and computer may also be causing problems. If the computer is too low or too high, you may be stressing your neck muscles in addition to your back.

How a Standing Desk Can Help

Now that you know how harmful sitting all day can be, you may want to try a standing desk or a sit-standing desk, which lets you switch between the two positions. One study found workers using a sit-standing desk reported less lower back pain. Other studies have reported standing at a desk burns more calories and results in better productivity. Generally speaking, standing may force you to improve your posture which in turn can take the pressure off your lower back.

However, a standing desk will not cure an underlying orthopedic issue, such as scoliosis or a herniated disc. And standing could exacerbate leg swelling or foot pain.

Staying Healthy When Using a Standing Desk

To avoid back pain with a standing desk, follow these tips:

Set Up Your Desk Correctly. Incorrectly setting up your standing desk or standing with poor posture could strain your back and neck more than sitting. Therefore, it’s important to rearrange your desk layout and positioning so you don’t end up with extra back pain. First, adjust your standing desk so your head, neck, and spine are aligned and your computer monitor is at eye level. As you stand, move your head slightly back and your spine in an “S” curve. Your elbows should be at a 90-degree angle, with your wrists resting flat on the desk.

Take the Pressure off Your Feet. It’s not just your back that will bear the strain of standing all day — your feet absorb most of your weight as you stand. To take the pressure off your feet, wear comfortable supportive shoes, or place a cushioned mat under your feet for extra support.

Don’t Make the Switch Overnight. Suddenly switching from a seated desk to a standing desk can be a shock to your body. Ease into your new setup by alternating between sitting and standing throughout the day until your body adapts and you find the most comfortable position.

Make a Homemade Standing Desk. Before you make a large investment in a standing desk, devise a homemade one at home. Prop up your computer on a pile of books or boxes and give it a try. You may find a standing desk isn’t helpful, or switching between standing and sitting is better for your back.

Get Moving. Whether you sit or stand all day, remember to get up and move frequently. Take a break to walk around or stretch your legs and back to unlock stiff muscles. At the end of the day, your back will feel much better if you’ve moved throughout the day.

Sit Properly. If you decide to stay seated or alternate between sitting and standing, sit properly with your lower back straight, shoulders relaxed, and feet on the floor. For more back support, insert a pillow along your lower spine.

Are You Suffering from Lower Back Pain?

For years the doctors at Comprehensive Orthopaedics have successfully treated back pain with conservative and surgical methods. We will diagnose your condition and recommend therapies so you can live pain-free.  Contact us today for a consultation.

Spring Cleaning and Orthopedic Injuries

Spring Cleaning and Orthopedic Injuries

Many orthopedic injuries happen in the home, and spring cleaning is a perfect time to strain your muscles and joints. Learn about the most common injuries and how to prevent them.

It’s spring, and it’s time to clear away the clutter and tackle those home-based projects you put off during the colder winter months. Spring cleaning offers the opportunity to start afresh as the temperatures warm up. Whether you’re trying to dust every nook and cranny or getting unused items ready for a yard sale, all that furious cleaning and lifting brings the risk of an orthopedic injury.

While people tend to think about orthopedic injuries occurring on the playing field, serious injuries can happen in the home too. The National Safety Council recorded 39.4 million home and community-related injuries requiring medical attention in 2019. If you want to stay safe and healthy this spring, make sure to take precautions before you dig into your spring cleaning tasks.

Common Spring Cleaning Orthopedic Injuries

Spring cleaning is a great way to start afresh with a decluttered, spotless home. Yet lifting, bending, hauling, and scrubbing can take a toll on your joints and muscles. Most of the injuries occur because of overuse or not using the proper technique. Here are some common spring cleaning injuries:

Tennis Elbow. You don’t need to swing a tennis racket to suffer from tennis elbow, an inflammation of the tendon in the outer elbow. Anytime you lift a heavy package you put extra stress on your elbow tendons, as well as your forearm and wrist muscles, leading to painful tendonitis.

Rotator Cuff Injury. Repeated lifting and reaching for heavy objects can result in either a tear or irritation of the rotator cuff muscles and tendons that support the shoulder joint. Pain and stiffness are typical symptoms of a rotator cuff injury.

Wrist/Ankle Injuries. A big part of spring cleaning is often tossing out unused items. But as you lift and move those objects, you can overextend the wrist and ankle joints, leading to a sprain or tear in the ligaments connecting those joints. Walking over piles of discarded items can also cause you to slip and fall, which can break a wrist or ankle bone.

Back Injuries. Spring cleaning inevitably involves a lot of lifting, bending, and unnatural twisting of the back. But those repetitive movements often lead to sore back muscles or worse back injuries.

How to Prevent Spring Cleaning Orthopedic Injuries

Spring cleaning may not be a welcome yearly chore, but it doesn’t have to be one that causes pain. You can avoid injuries and keep up with your spring cleaning tasks with some simple precautions.

Stretch. Just like you would if you were preparing for a run or other workout, warm up your muscles before setting out to clean and lift. Cold muscles are more vulnerable to injury, so do some light exercises before you dig into the jobs. A short walk and a gentle stretch of the calves and hamstrings gets your muscle loose and ready.

Lift Properly. When lifting heavy objects, use the proper technique. Hold the item close to your body, and bend from the knees instead of your back. As you lift, engage your leg muscles, not your lower back. And be realistic about what you can lift. If an object is too heavy, ask for help.

Switch Up Tasks. It’s easy to think you have to do all your tasks in one day. But if you perform the same job over and over again you could be setting yourself up for a repetitive injury. Change from one task to another as you go through the day so you don’t overtax one joint or muscle.

Take a Break. If you feel fatigued, immediately stop what you’re doing. Not all tasks have to be done in one day. If you feel tired or achy, take a break to allow your muscles and joints to recover. That way, you’ll accomplish your spring cleaning without any injuries.

Let Us Heal Your Muscles and Joints

Whether you get it doing your spring cleaning or some other activity, the specialists at CompOrtho can help you overcome any orthopedic injury you may suffer. If the pain doesn’t subside with rest or other home-based methods, you may need an orthopedic evaluation. Our specialists can work with you to determine the perfect treatment plan for your circumstances. Fortunately, most injuries can be healed with conservative methods rather than surgery. Contact us today for a consultation.

Tips for Preventing Ankle Sprains

Tips for Preventing Ankle Sprains

Ankle sprains are some of the most common and painful orthopedic injuries. But you can prevent ankle sprains if you’re careful! Learn how.

Ankle sprains make up some of the most common orthopedic injuries. In fact, one study estimated that 2 million people suffer severe ankle sprains each year. The injury frequently occurs during athletic workouts, such as basketball or tennis, but it isn’t limited to just that. You can easily sprain your ankle during everyday activities due to anything from a slip on a sidewalk to running up stairs where you wrench the joint into an unnatural position. Read on to learn more about ankle sprains and how to prevent them.

What Are Ankle Sprains?

While you may think that ankle sprains are related to the bones in your leg, they actually have to do with the ligaments that connect the bones in your ankle and give your joint stability. When you twist or jerk your ankle out of its normal position, the ligaments may slightly tear or completely rupture, leading to an ankle sprain and pain when you place your weight on your foot. Other common symptoms include swelling and bruising as well as a limited range of motion in the ankle.

While ankle sprains are typically not the most serious orthopedic injury, they can have serious consequences if you aren’t careful. At the very least, ankle sprains are painful and can severely restrict your mobility. The best way to deal with those symptoms is to take precautions to prevent a sprain in the first place.

6 Ways to Prevent Ankle Sprains

Improve Your Balance. Most ankle sprains occur because you lose balance. A simple way to improve your balance is by standing on one foot as you do routine activities, like brushing your teeth or when exercising your upper body. Make sure to do this on both legs!

Strengthen Your Ankles. As you concentrate on building up your leg muscles, it’s easy to neglect your ankle muscles. Tone your ankle muscles using a resistance band tied in a large loop. With the band, sit in a chair and place one end of the loop around the leg of a heavy, stable chair or table. Loop the other end around your foot. Move your ankle out and up, and then in and up, always keeping the band tight. Another exercise to try is to keep the band looped over your foot and press your foot down against the resistance of the rubble band, keeping your heel on the floor. The action is similar to pedaling the accelerator of your car.

Stretch Your Ankles. Make sure to stretch your ankles before you exercise. To give your ankles a good flex, lean your hands against a wall or table, keeping your back leg straight and your front leg bent. As you lean forward, keep your heel on the floor until you feel a stretch in your back leg. Hold for 15 to 30 seconds. Then, bend your back leg slightly and stretch for 15 to 30 seconds with both heels on the floor.

Tape Your Ankle. To give your ankle extra support, tape it with athletic tape if you’re at risk of a sprain. A physical therapist or trainer can show you the proper way to tape your ankle. Or, you can use an ankle brace. Today’s ankle braces allow for more mobility, so you can choose one that is comfortable and supportive. It’s particularly good to tape or brace your ankle if you’ve strained it to prevent the strain from becoming a full sprain.

Wear the Right Shoes. If you’re exercising or playing a sport, choose shoes that provide support while not being too restrictive. High-top shoes are often touted as a way to prevent ankle sprains — and they can be helpful — but some studies suggest they are not strong enough to support the ankle if the ligament is severely wrenched out of place. If you’re curious what shoes are best, talk to your orthopedist.

Watch Where You’re Walking. Most ankle sprains happen when you’re simply walking, especially when traversing uneven or slippery surfaces. Tread carefully and watch where you step so you don’t lose your balance.

Treating Ankle Sprains

Ankle sprains respond well to conservative methods. Treatments and the length of the treatment depend on the severity of the sprain. Mild sprains usually resolve in two weeks. More severe sprains may take longer to heal.

For ankle sprains, the first line of treatment is the RICE method: Rest, Icing, Compression, and Elevation. Working together, these actions should reduce pain and swelling. Over-the-counter pain medications can reduce the discomfort, as well.

If your ankle is painful, you should try to take as much weight off of it as possible. That may mean using crutches for a while. When the pain subsides, a physical therapy program designed to strengthen the ankle muscles, restore range of motion, and improve flexibility and stability is the recommended course of treatment.

Surgery is reserved only for cases of severe tears that don’t respond to conservative treatments. A surgeon can stabilize the ankle by reconstructing the ligament from other ligaments or tendons, but that is not typically recommended for ankle sprains.

Start Treating Your Ankle Sprains Today

At Comprehensive Orthopaedics, we treat a variety of orthopedic problems, including ankle sprains. We provide the latest in diagnostic techniques and will offer you several treatment options, from conservative methods like physical therapy to surgery, if necessary. Contact us today for a consultation.

Are Cortisone Injections Good or Bad for Arthritic Knees?

Are Cortisone Injections Good or Bad for Arthritic Knees?

Cortisone injections have gotten a bad rap in recent years as a treatment for arthritis pain, because steroids are known to damage cartilage and could potentially cause the joint to further deteriorate.

But a new study suggests that if used wisely, cortisone shots are as safe as another type of injection used to treat knee arthritis.

Occasional cortisone shots don’t appear to cause knees to deteriorate any faster than injections of hyaluronic acid, a substance injected to lubricate joints stiffened by arthritis, the researchers said.

“Knee replacement rates were, if anything, a little bit less in the group that got the cortisone injections,” said senior researcher Dr. David Felson, a professor of medicine and epidemiology at Boston University School of Medicine.

However, Felson added that the study only looked at people who’d gotten infrequent cortisone shots to their knee, and shouldn’t be interpreted as giving the green light to regular injections for years to come.

“What we know from the study that we can trust is that a few cortisone injections won’t really cause much trouble,” Felson said. “It’s conceivable that repeated injections every three months for years won’t cause any trouble, but you can’t say that.”

Steroids are known to be toxic to cartilage, the connective tissue that keeps your bones from rubbing against each other, explained Dr. Melissa Leber, director of the Emergency Department’s Division of Sports Medicine in the Icahn School of Medicine at Mount Sinai in New York City.

“If you use it enough, it will damage the cartilage,” said Leber, who had no role in the study.

A 2019 study reported a threefold increased risk of knee arthritis progression in people who’d received repeated cortisone injections, compared with people who’d never gotten the shot, Felson and his colleagues said in background notes.

Comparing two types of shots

However, no clinical trials had ever compared the two most common types of knee arthritis injections, cortisone jabs and hyaluronic acid shots, Felson said.

The two types of shots do different things in the joint, and are sometimes used in combination, Leber said.

Cortisone shots are anti-inflammatory and help reduce pain, while hyaluronic acid injections are like a gel that provides lubrication in the ailing joint.

“You’re injecting WD40 almost into the knee. That acts to allow smoother gliding in the joint,” Leber explained.

Unlike cortisone, hyaluronic acid gel isn’t harmful to cartilage.

The latest study looked at nearly 800 people with knee arthritis, of whom 4 out of 5 reported getting cortisone shots for their knee pain. The rest had reported receiving hyaluronic acid injections.

After seven years of follow-up, researchers found that those who got steroid injections had no greater cartilage loss than those treated with hyaluronic acid.

In fact, people who got cortisone shots were about 25% less likely to need a total knee replacement than those who got hyaluronic acid.

The message to knee arthritis patients regarding cortisone shots is simple, Felson said: “Don’t be scared.”

“There’s nothing bad that’s going to happen with one shot or even a few shots,” Felson said. “People should be reassured. They shouldn’t avoid getting an effective treatment.”

Wise use is crucial

The findings bolster the approach orthopedic specialists already take in handing out cortisone shots to treat knee arthritis, Leber said.

“If someone already has a ton of damage to the cartilage in their knee, a lot of arthritis, then we don’t worry as much about using a steroid to help with pain control because they already have a lot of arthritis in the knee,” Leber said. “Damaging it a touch more just to give them good pain control is a very minor thing. It’s not as risky.

“In someone who’s young, in their 20s to 40s, who has very little cartilage damage but has pain, we try to use it sparingly,” she continued. “Would you use them on occasion in a young person? Yes. That’s only as a one-time thing. You don’t want to use it repetitively.

“Steroid is bad for cartilage, but that doesn’t mean it’s bad for every patient,” Leber concluded. “It’s a case-by-case situation.”

Regardless, you wouldn’t expect any patient to receive frequent cortisone injections, whatever their condition, added Dr. Jeffrey Schildhorn, an orthopedic surgeon with Lenox Hill Hospital in New York City.

“If you give someone a shot in January and they come back in April saying they want another one, and they come back in August and want another one, how well are they working?” said Schildhorn, who was not part of the study. “They’re not working, if you’re only getting two or three months of relief.”

The new study was published recently in the journal Arthritis and Rheumatology.

More information

The Cleveland Clinic has more about knee arthritis.

SOURCES: David Felson, MD, professor, medicine and epidemiology, Boston University; Melissa Leber, MD, director, Emergency Department’s Division of Sports Medicine, Icahn School of Medicine at Mount Sinai, New York City; Jeffrey Schildhorn, MD, orthopedic surgeon, Lenox Hill Hospital, New York City; Arthritis and Rheumatology, Dec. 1, 2021

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