Corticosteroid injections, sometimes called Cortisone, are often employed to reduce inflammation and pain following an injury, or in the degenerative conditions of arthritis or carpal tunnel syndrome. It is best to consult with a doctor who specializes in the area needing treatment. In the case of the hands and arms, a hand specialist should perform the injection. For the foot, ankle and lower extremities, a podiatrist should be consulted.
In the case of injury or degeneration in the hands or wrists, corticosteroid injections are just one part of an overall plan to return the patient to full health and mobility. Hand exercises, hot and cold modalities and massage therapy may also be employed by the team of hand therapists at Midwest Hand Therapy.
Here is a step by step description of what you can expect from a corticosteroid injection procedure:
The patient will be placed in a comfortable position, so that the area requiring the injection is readily accessible to the doctor.
The injection site will be disinfected with alcohol or iodine.
The patient will be encouraged to relax. If the muscles around the joint are relaxed, the injection will glide more smoothly and with less resistance and discomfort.
If ultrasound is being used, a gel will be applied near the injection site, and a technician will gently press an ultrasound transducer against the skin to show an image of the joint space.
If the affected joint or bursa contains excess fluid, the doctor may gently draw off the fluid with a needle and syringe. This is known as joint aspiration or arthrocentisis.
The doctor will then inject a small amount of cortisone into the joint; the cortisone may be mixed with an anesthetic such as lidocaine or bupivacaine. The patient may notice a pinching or a burning sensation.
The injection area will then be cleaned and bandaged, and the patient may be asked to flex the joint several times to help distribute the medication.
Usually patients wait about 30 minutes in the doctor’s waiting room, following this procedure, just to insure they have no unusually severe pain or an allergic reaction to the medication.
These injections can be helpful in reducing inflammation and its associated pain over varying periods, depending on the individual. Frequently the pain is reduced for several weeks or even months, allowing the patient to participate in therapy to strengthen and elongate the muscles and tendons around the joint, to help resolve the issue.
If someone you know is struggling with pain, swelling, tenderness or tingling in the fingers, hands, wrists or elbows, contact Dr. Rehman today. She specializes in injuries and conditions of the upper extremities, and will perform an in-depth analysis of the cause of the condition. Utilizing state-of-the-art technology, she will design a comprehensive program of therapy to return the affected area to full strength and mobility.
Arthritis is inflammation in the joints. Most joints in the body have the potential to develop arthritis, which causes swelling, stiffness, pain, a reduction in mobility of the joint, and sometimes deformity.
There are generally two types of arthritis: osteoarthritis and rheumatoid arthritis. Osteoarthritis is the more common, and tends to worsen over time. It can be the result of a traumatic injury or a defect in the cartilage; the smooth white tissue that cushions bones in the joint where they come together. Osteoarthritis affects the large weight-bearing joints in the body, such as the knees, hips, shoulder and spine, but it can also affect the small joints of the hand, most commonly the thumb. Gripping, grasping or pinching objects may become painful with this condition.
Rheumatoid arthritis is a chronic disorder that can affect any part of the body, including large or small joints, the heart, circulatory system, the lungs, the muscles used for breathing and even the digestive system.
Oftentimes joint replacement surgery is recommended if the condition becomes too painful, and interferes with the activities of daily living or the patient’s occupation. But prior to that, there are steps you can take to make your daily life more comfortable if you have arthritis.
To reduce pressure in your hands when holding or gripping objects:
Wrap foam, cloth or tape around the handles of everyday objects like knives, pots and pans, to cushion the grip. Look for household or gardening tools with larger, ergonomically-designed handles. These are available in many retail stores. Keep a pair of gardening gloves with rubberized palms in the kitchen, to help grip and hold, and use common tools like jar openers to help with household tasks.
To reduce pain or pressure before or after activities, and while sleeping:
Apply either heat or cold to the affected joints before and after activities, and before bed. Elevate and support your arms and legs on pillows when sleeping.
Reduce pain and stress on your joints:
Use carts or carriers with wheels to move heavy items like garbage bags, laundry, or grocery bags, so you don’t need to lift them. Replace round doorknobs with lever-style handles.
An entire profession, known as Occupational Therapy, is devoted to helping people with disability issues perform their jobs and household tasks more easily. They can recommend personalized adaptive equipment that will put less weight on the joints. They can also instruct patients on how to use compression garments and thermal agents (heat and cold), and can make custom splints to support or properly position your joints during activities or while sleeping. These professionals can evaluate your home environment and suggest changes or modifications that will make it easier for you to perform your activities. They can also address both the physical and emotional effects of arthritis. They can recommend therapeutic exercises and activities designed to decrease stiffness and improve endurance and strength. And they can address the emotional stress that results from lack of sleep or being in constant chronic pain.
If someone you know is struggling with arthritis, or numbness, tingling or pain in the hands, wrists, elbows or shoulders, contact Dr. Rehman and her team of Occupational Therapists today for help! Dr. Rehman is a specially-trained orthopedic doctor who specializes in conditions and injuries affecting the upper body. She will conduct a thorough evaluation and design a comprehensive, individualized treatment program to correct the problem and return the affected area to health, strength and full range of mobility.
Call Dr. Rehman and her team today for more information: 586-532-0803
Pain in the thumb is no laughing matter, and anyone who is experiencing it will tell you that. The thumb is a crucial structure that is in use constantly in daily activities. When it is working properly, we don’t give it a thought. But when it is sore, it is a painful presence, affecting most of what we do with our hands.
The thumb is connected to the wrist via the basal or carpometacarpal (CMC) joint. This joint, and its attached appendage, the thumb, are susceptible to arthritis for a number of different reasons. One condition that contributes to the problem is obesity, but other conditions may play a part as well; injury, aging, stress, genetics and overuse may also be factors that contribute to the development of arthritis of the thumb. When arthritis is present in a joint, the cartilage that protects bones from rubbing together has deteriorated, and the bone rubbing against the bone generates the pain. Other signs of this disorder can also be swelling, stiffness, or a reduction in strength or range of motion.
Oftentimes, this condition can be managed by non-invasive methods such as:
Rest
Ice
Anti-inflammatory drugs
Corticosteroid injections
Hand splints
Occupational therapy techniques specifically designed to ameliorate the problem
But don’t try to go it alone. Seek out a Board Certified Osteopathic doctor like Dr. Rehman for a complete evaluation and a thorough, comprehensive treatment plan. Her specialized team of hand therapists will work with you to attain the best success, and if it is eventually concluded that surgery is required, Dr. Rehman is an experienced, skilled hand surgeon. The delicate structure of the hand requires specialists to treat it gently and properly. If you are experiencing pain in the thumb or any other joint or hand pain, contact Dr. Rehman today.
Pain that is localized to the base of the thumb may indicate the presence of this condition. Often, everyday activities such as opening a jar lid, grasping a large object or sometimes even turning a doorknob can become painful. As the condition progresses, pain may become constant. The individual may not be able to move their thumb away from the hand to grasp large objects; they may even lose the function of the hand.
Sometimes as we age, cartilage wears away from the ends of the bones that form the thumb joint. Cartilage functions as a cushion for joints, and when it is missing, pain is usually the result.
A thorough examination by an osteopathic specialist is required to make a firm diagnosis of Basal Thumb Arthritis. Following that, a variety of non-invasive approaches may be used to treat the condition. Activities may be modified, the hand may need periods of rest, nonsteroidal anti-inflammatory drugs can be useful, specialized exercises may be prescribed and even splinting may be used. Sometimes an injection of Corticosteroid may be required; pain relief may last from several days to several months with this treatment.
While most often the treatments discussed above are successful, occasionally surgery is required if these methods fail or if the condition is very advanced.
If you are experiencing pain in or around the thumb area, contact Dr. Rehman for a full and thorough evaluation. The correct diagnosis, followed by a treatment plan that includes multiple modalities will yield the most effective and successful outcome.
Pain, stiffness and swelling in the hands and fingers may be caused by arthritis.
Osteoparthritis
This is the most common form of arthritis, and is a chronic condition. It is the result of the cartilage deteriorating at the ends of bones where they meet to form joints in the fingers, hands or wrists. This breakdown of the cartilage results in bone rubbing against bone, with resultant stiffness, pain and loss of movement in the joint.
Rheumatoid Arthritis
The immune system is a double-edged sword. Designed to protect the body from foreign invaders, sometimes the system turns on itself. In the case of Rheumatoid Arthritis, the immune system incorrectly attacks the synovium, the thin membranes that line the joints in the body. The result can be swelling, inflammation, joint damage and loss of function. This condition can even result in deformities of the hand that make it virtually impossible to use the hand.
Gout
Gout is a form of arthritis that occurs when high levels of uric acid, a bodily waste product circulating in the blood, is deposited as sharp crystals in tissues of the body. Although commonly affecting the legs and toes, this condition can also result in problems with the hand and fingers.
A doctor who specializes in the hand, arm and wrist is the best professional for diagnosing the root cause of pain, inflammation and stiffness in the hands and fingers. During the examination, the doctor will review the history of the problem and do a thorough physical exam of the area of concern. Samples of blood or joint fluid may be collected to confirm a diagnosis. Imaging tests may be ordered that allow the doctor to ascertain exactly what is going on inside the hand. X-Rays, CT scans or MRI (Magnetic Resonance Imaging) may be ordered.
Early detection and intervention are always advisable and increase the chances of a successful outcome with the least invasive procedure possible. If you are experiencing pain in the hands or fingers, contact Dr. Rehman today.
Arthritis doesn’t mean that you can’t keep moving – in fact the opposite is true! According to the CDC, regular physical activity can help reduce pain, improve function and mobility as well as enhance the mood and quality of life of arthritis patients. Often arthritis comes with additional chronic conditions, like heart disease, obesity and diabetes, conditions which can also be improved by regular physical activity.
So what types of physical activity help patients with arthritis? It is recommended that individuals participate in moderate intensity, low impact physical activity. This includes a combination of both aerobic exercise and strength training. The most important part of an exercise regimen is to find something that the patient loves to do and will remain consistent with.
Aerobic exercises that are ideal for arthritis patients include vigorous walking, cycling swimming, group fitness classes, dancing and water aerobics. The selection should be based on a few things – the severity of the condition, the interests of the patient and the current physical state of the patient. Diving into an aggressive exercise regimen can be overwhelming and the most important factor is consistency.
In addition to 2-3 hours of aerobic exercise per week, you should also include 2-3 sessions of strength training. By strengthening the muscles around the joints, you are providing relief and stability. Strength training should be based on the individual’s current state and goals – for beginners working with resistance bands is a great option. If you have existing muscle, we recommend calisthenics and a weight training program.
Last but not least – balance exercises are great to ensure the safety of patients, particularly those who are at risk of falling. We recommend gentle yoga, walking backwards, single leg exercises and breathing exercises. These should be performed under the supervision of a therapist, coach or trainer.
Before starting any type of exercise program, patients should receive an evaluation and discuss a plan with their doctor. If you believe you may be suffering from arthritis, contact Dr. Rehman for an evaluation.
While few studies have been conducted on the correlation between the cold and arthritis, a general consensus amongst patients show that most feel that the effects are worse when the temperatures cool down. Because we enjoy listening to our patients we wanted to come up with a few ways for those who do suffer from this challenge to improve their symptoms in the chillier times.
Some people suggest that the drop in barometric pressure chambers result in the increased aches and pains – others that the moisture or lack thereof causes it. Regardless, we found a few ways to deal with the challenges the colder months bring!
Wear Layers – these will keep you warm outside and you’re able to shed them when you get inside. Keeping warm will help regulate your body’s temperature so as not to experience such drastic drops!
Exercise Indoors – you don’t want to become sedentary just because the weather has cooled down. Take your exercise indoors to maintain the healthy blood pumping activity all year round. Whether you enjoy workout DVDs, have a home gym or simply walk the mall, stay moving!
Stay Safe – wear the right shoes, avoid icy surfaces and don’t overdo the shoveling or other winter activities. One of the most important things patients with arthritis can do is prevent further damage.
If you are suffering from arthritis or think you may be developing the condition, contact us today to help you build a comprehensive plan for managing your condition! Got tips for keeping yourself safe in the winter? Share them with us!
Osteoarthritis is a form of arthritis that causes pain, swelling, and reduced motion in your joints. It can occur in any joint, but it usually affects the hands, knees, hips or spine.
Osteoarthritis breaks down the cartilage in the joints. Cartilage is the soft, slippery tissue that covers the ends of bones in a joint. Healthy cartilage absorbs the shock of movement. When you lose cartilage, your bones rub together. Over time, this rubbing can permanently damage the joint. Most doctors use several methods to diagnose osteoarthritis, including medical history, a physical exam, x-rays, or lab tests.
Risk factors for osteoarthritis include:
Being overweight
Getting older
Injuring a joint
Warning signs of osteoarthritis are:
Stiffness in a joint after getting out of bed or sitting for a long time
Swelling or tenderness in one or more joints
A crunching feeling or the sound of bone rubbing on bone
Other tests such as blood tests or exams of the fluid in the joints
Treatments include exercise, medicines, and sometimes surgery. Doctors often combine treatments to fit a patient’s needs, lifestyle, and health.
Basal Thumb Arthritis is a condition that is often times associated with other conditions such as carpal tunnel syndrome and scaphotrapezial arthritis. Typically, patients complain of pain localized to the base of the thumb. This pain is often activity-related, particularly after excessive use involving a forceful pinch.
Daily activities such as grasping large objects, unscrewing jar tops, turning doorknobs and writing can cause symptoms to flare up. As the condition progresses, pain may become constant. In addition to pain, weakness or loss of motion are also reported. In the later stages of the disease, patients may experience an inability to move the thumb away from the hand, weakness of pinched grip and loss of hand function. As a result, the thumb cannot be brought far enough away from the index finger to grasp large objects.
A detailed examination is normally all that is needed to make a diagnosis of Basal Thumb Arthritis. Initial treatment of Basal Thumb may include activity modification, rest, nonsteroidal anti‐inflammatory drugs, exercises and splinting. Corticosteroid injections can be useful when conservative measures have not worked; pain relief can be effective and last from a few days to several months.
While the above treatments are often successful, surgery may be needed when more conservative measures have failed, or in advanced cases.
If you are experiencing pain in or around the thumb, contact Dr. Rehman for a comprehensive evaluation – proper diagnosis is critical to proper treatment!
There are many types of corticosteroid injections, but in general, a corticosteroid injection is a formulation of two or more medications to reduce inflammation, relieve pain and improve function and mobility.
Corticosteroids are derived from cortisone, a steroid hormone released by the adrenal gland in response to stress. When combined with other pain-killing and anti-inflammatory medications in a corticosteroid injection, they work more effectively and efficiently to treat discomfort. Depending on the condition that is being treated, injections can providepain relief for several weeks up to several months.
At Midwest Hand Therapy, we sometimes administer corticosteroid injections as part of a comprehensive approach to hand and wrist rehabilitation. Depending upon the condition and the particular patient, a corticosteroid injection may accompany hand exercises, hot and cold modalities, and massage.
Many patients that have never had one of these injections express concern regarding the amount of pain they will experience. These injections are very similar to any other type of injection; the initial needle stick is similar to the pain caused by a quick bee sting. There is temporary discomfort while the medication is being injected, but nearly all corticosteroid injection patients agree that a short moment of discomfort is much better than ongoing pain of the wrist or hand!
Corticosteroid injections should only be administered by a licensed physician, and to ensure the best results, patients should visit a doctor that specializes in the specific area being treated. For example: a hand specialist for the hand, fingers, wrist or forearm, and a podiatrist for the foot, ankle or lower extremities.
For more information on corticosteroid injections, or if you are experiencing hand, wrist or finger pain, please contact us at Midwest Hand Therapy.
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