Raleigh Hand to Shoulder Center in Raleigh, NC

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Golfers Elbow Pain Treatment in Raleigh, NC

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Golfers Elbow Pain, or medial epicondylitis, is caused by trauma to the tendons that attach the forearm muscles to the inner side of the elbow.   This can be related to an acute injury but most often is related to overuse and repetitive stress to the tendon attachment.   Although it is often associated with golfers, medial epicondylitis is also prevalent in baseball, weight lifting and throwing sports.   Activities involving forceful, repetitive use of the elbow and forearm such as carpentry, painting and landscaping can be associated with the condition in some cases. 

Symptoms include pain on the inner side of the elbow often radiating down the forearm.  There can be a mild ache at rest worsened with use of the arm.  Wrist and elbow flexion with resistance such as lifting boxes, carrying groceries or moving furniture may cause increased pain.  The elbow may have a feeling of stiffness and there may be a loss of strength in the arm. Occasionally, irritation of a nerve close by can present with pain radiating into the hand and numbness or tingling in the small and ring fingers.  

What are treatments for Golfers elbow pain?

Golfers elbow pain symptoms may be mild requiring no treatment or simply limiting your activities, rest and icing.   If symptoms persist, splinting, non-steroidal anti-inflammatory medications orally or topically, and a home stretching program can be implemented.  Supervised occupational therapy (OT) or physical therapy (PT) can be added in cases that do not respond to a home exercise program.  Corticosteroid injections and rarely surgery are required in patients who are significantly symptomatic and fail to respond to less invasive treatments. 

Treatment of golfers elbow pain and tennis elbow pain is available at Raleigh Hand to Shoulder Center. Non-surgical options are available in our office. Surgery is offered at our surgery center, when needed. Our doctors are members of the American Society for Surgery of the Hand and our OTs are certified hand therapists.

If you have golfers elbow pain and cannot do the things you love, give our office a call to be evaluated by a hand and upper extremity specialist!

Update on Thumb Arthritis

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Thumb Carpometacarpal Arthritis

Arthritis at the base of the thumb (carpometacarpal joint) is a common location for arthritis in the hand. Similar to arthritis in other areas of the body, it develops from the normal wear process of our joints as we age. Typically arthritis at this joint occurs after 40-50 years of age, and is much more common in women than men.

Why does arthritis develop in this particular joint?

All joints are subject to pressure across them with normal use. Walking, for instance, causes pressure across the knee joint that over time can wear out the joint. Ligaments around the joint provide stability so there is more uniform pressure on the joint. The basilar thumb joint, or thumb carpometacarpal (CMC) joint, has significant pressure across it with normal hand use. The joint can become unstable from ligament stretching or weakening with normal aging. Over time, the combination of instability and high pressure across the joint, leads to arthritis of the thumb CMC joint.

thumb CMC joint

What are the common symptoms of arthritis of the Thumb CMC Joint?

Pain in the area of the joint is typical (see above diagram for location of joint). The pain can be mild, “achy” pain early on but can progress to severe pain that limits use of the hand. Activities that involve forceful grip or pinch often increase the pain. Patients with thumb CMC arthritis often have difficulty opening jars or bottles. Use of keys can be painful as well as pulling heavy items around the home. A deformity may occur over time making it difficult to hold objects that have a large diameter.

What treatment options are available?

The physician will usually get an x-ray of the hand to confirm the diagnosis. Treatment often depends on the severity of the symptoms. In patients with mild symptoms, activity modification to avoid forceful pinch activities and occasional use of anti-inflammatory medications may be all that is required. If symptoms are more severe, splinting and cortisone injections can be used. In severe cases which do not improve with conservative treatments, surgery may be indicated.

What is involved if surgery is recommended?

Surgery can be performed on an outpatient basis under regional anesthesia. Surgical techniques vary, but typically involve removal of the trapezium bone, placing a spacer where the bone was removed, and sometimes reconstructing the joint ligaments. The patient’s own tendons can be used for a cushion/spacer and to reconstruct the joint, if necessary. In some patients a fusion of the joint or joint replacement can be considered as an alternative to the above surgery.

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