Symptoms Of De Quervain’s Tendonitis
Tendons normally slide through a flexible tunnel, called a sheath, to connect and support the thumb. When the tendons swell or the sheath thickens because of pressure or inflammation, you may notice that your the inside of your wrist or your thumb hurts. This condition may happen because of repetitive activities like playing racket sports or golf, engaging in handicrafts, or lifting children.
How Do You Treat Compartment Syndrome
Acute compartment syndrome is a surgical emergency. Your doctor will make an incision and cut open the skin and fascia covering the affected compartment. This procedure is called a fasciotomy. Non-surgical treatment is the first option for chronic, exertional compartment syndrome. Physical therapy, braces or supports, and anti-inflammatory medicines are often suggested.
How Is Radial Tunnel Syndrome Diagnosed
There are no formal imaging tests that can diagnose radial tunnel syndrome, which makes diagnosing this condition somewhat difficult. Even so, your doctor may order an X-ray, MRI or electromyography test, just to rule out other potential injuries or conditions.
Before examining your elbow and forearm, your doctor will ask you about your specific pain, your medical history and your symptoms. Then theyll try to find the exact point where the nerve is being compressed inside your radial tunnel by feeling around the outside of your elbow and applying light pressure. There are also two specific tests that your doctor may use to diagnose this condition, which include:
- Physical exam: Your doctor will ask you to turn your palm from a palm down position to a palm up position against resistance. If you experience pain in your forearm, its likely a sign of radial tunnel syndrome. The second part of this test requires you to keep your middle finger straight against resistance. If its painful to do so, its also a sign of radial tunnel syndrome.
- Rule of nine test: During this test, with your arm facing up and your elbow slightly flexed, your doctor will separate your elbow into nine equally sized areas, in three rows. Then theyll lightly apply pressure to each spot, asking you whether you feel pain, discomfort, or nothing at all. If you feel pain on the outermost spots of the top two rows, its likely a sign of radial tunnel syndrome.
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Surgery For De Quervains Tenosynovitis
If noninvasive treatment doesnt improve your symptoms, or if the condition is severe, you may need thumb surgery to relieve De Quervains tenosynovitis.
Your surgeon will open the thumb compartment to give the irritated tendons more space to move. When the tunnel heals, it will leave more room for the tendons. The surgery is brief, but full recovery takes several months.
Well recommend hand therapy or occupational therapy after surgery to regain your thumb function and learn healthy ways of using your hand. Learn more about orthopedic physical therapy.
What Is Radial Tunnel Syndrome
The radial nerve is one of three nerves in your forearm, traveling from the side of your neck, down the back of your arm, through your forearm and into your hand. Your radial nerve is responsible for a lot of different arm movements, including forearm rotation, elbow extension, and wrist and finger movement. When the nerve reaches your elbow, it passes through the radial tunnel, which is a collection of muscles.
Radial tunnel syndrome occurs when the nerve is pinched or compressed as it enters the radial tunnel. This creates unwanted pressure on your radial nerve, often causing nagging pain.
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Who Is At Risk For Wrist Injuries And Disorders
Certain things can put you at higher risk of having a wrist problem, including:
- Doing sports, which can put you at risk for injuries and puts stress on your wrist. For example, you may fall on your outstretched hand when you are skating or snowboarding. Your wrist could be injured while doing contact sports. And other sports such as gymnastics and basketball can strain your wrists.
- Doing repetitive wrist motions, such as typing on a keyboard, working on an assembly line, or using power tools.
- Having certain diseases. For example, rheumatoid arthritis can cause wrist pain.
What Are The Causes Of Carpal Tunnel Syndrome
Carpal tunnel syndrome is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. Contributing factors include trauma or injury to the wrist that cause swelling, such as sprain or fracture an overactive pituitary gland an underactive thyroid gland and rheumatoid arthritis. Other factors that may contribute to the compression include mechanical problems in the wrist joint, repeated use of vibrating hand tools, fluid retention during pregnancy or menopause, or the development of a cyst or tumor in the canal. Often, no single cause can be identified.
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Forearm Strain From A Repetitive Injury
Repetitive strain injury of the forearm is caused by constantly using the wrist.
You do not need treatment, just rest from your overuse. Wearing a brace and physical therapy might be helpful.
Rarity: Uncommon
Top Symptoms: forearm numbness, forearm weakness, forearm pain from overuse
Symptoms that always occur with forearm strain from a repetitive injury: forearm pain from overuse
Symptoms that never occur with forearm strain from a repetitive injury: severe forearm pain, forearm injury
Urgency: Self-treatment
Diagnosing Tendonitis And Tenosynovitis
Your healthcare provider will ask about your health history and give you a physical exam. You may have tests to check for other problems that may be causing your symptoms. The tests may include:
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Joint aspiration. The healthcare provider uses a needle to take a small amount of fluid from the joint. The fluid is tested to check for gout or signs of an infection.
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X-ray. A small amount of radiation is used to make an image. Tendons cant be seen on an X-ray, but they can show bone. This test can check for arthritis.
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Less Common Symptoms Of Wrist Tendonitis
Some less common symptoms of wrist tendonitis may include:
- Pain at rest. In advanced stages of wrist tendonitis, a person may experience constant wrist pain, even at rest.5
- Numbness. In cases where the affected tendon pinches on or irritates an adjacent nerve, numbness in one or more fingers may occur. This may lead to the development of carpal tunnel syndrome.6
- Loss of motion. Although rare in the wrist joint, calcium deposits in the tendons may lead to tendon hardening. This condition, known as calcific tendonitis, may cause severe stiffness and pain. Sometimes, a low-grade fever may also occur in calcific tendonitis of the wrist.7
- Depression and anxiety. In some people with wrist tendon pain, decreased pain tolerance may cause depression. Avoiding physical work in anticipation of pain may further result in anxiety, irritability, and frustration.8
In tendonitis resulting from a sudden force such as an accident or acute trauma, fracture of bones, nerve damage, and/or ligament injury may also occur. A medical professional can help diagnose and treat wrist tendonitis and other wrist injuries.
How Do You Treat Carpal Tunnel Syndrome
Carpal tunnel syndrome is a gradual process that usually worsens over time without some form of treatment. There are nonsurgical and surgical treatment options for carpal tunnel syndrome depending on the stage of the disease. For example, early stages can be treated with pain medication, bracing/splinting, and activity changes. However, if the condition has progressed significantly, surgical treatment may be necessary.
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What Is Forearm Pain
What Can Cause Forearm Pain
The causes of forearm pain can be classified as follows:1
- Injuries, such as a fall or direct blow to the arm, can lead to damage to the muscles, tendons, and ligaments. Injuries can also cause a fracture of the forearm bones.
- Repetitive strain, such as from working for long hours on a computer. Also, strain from performing repetitive movements in the workplace, for example, assembly-line factory workers.
- Overuse during sports and physical activities, such as tennis or weightlifting. This can cause strain in the forearm muscles.
- Nerve entrapment can cause a sharp, shooting pain.
- Arthritis in the elbow or wrist joints can lead to dull pain in the forearm.
- Medical conditions such as angina can cause referred forearm pain.
Now, lets take a look at some of the common causes of forearm pain in more detail.
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What Causes Forearm Pain
Forearm pain can result from a number of causes. These range from degenerative conditions to injuries to underlying medical conditions that damage nerves, bones, or joints:
- arthritis, which causes the protective cartilage in your joints to wear down, resulting in bone rubbing against bone
- carpal tunnel syndrome, where the nerve canal in your wrist leading to your fingers starts to narrow, pressing on the nerves and resulting in pain
- falls, which can lead to injuries such as bone fractures, sprains, or damage to ligaments
- issues with veins and circulation
- muscle strain, often from playing a sport such as tennis or golf
- overuse injuries, such as injury from excess computer use
- poor posture, such as poor neck posture or your shoulders curving slightly forward, which can compress the nerves in your forearm
- problems with nerves, which can be the result of medical conditions such as diabetes or thyroid disorders
Learn more: Tips for treating diabetic nerve pain »
You may be able to pinpoint the exact underlying cause of your forearm pain. Other times, you may not be sure how the symptoms occurred. Your doctor can help you identify if there is any underlying damage to the bones, joints, or nerves, or if another condition could be causing your symptoms.
You should seek immediate medical attention if you have a visible bone fracture or hear distinctive popping, clicking, or crunching related to a forearm injury.
Treatments for forearm pain can vary based on the underlying cause.
Contusion Of The Wrist
A bruise is the damage of the blood vessels that return blood to the heart , which causes pooling of the blood. This explains the blue/purple color of most bruises. Bruises of the wrist are common, often due to minor injuries.
You can treat this at home with R.I.C.E – rest , ice , compression , and elevation.
Rarity: Rare
Top Symptoms: wrist injury, pain in one wrist, wrist pain from an injury, swelling of one wrist, wrist bruise
Symptoms that always occur with contusion of the wrist: wrist injury
Urgency: Self-treatment
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Avoid Tasks That Make The Pain Worse
Try to avoid tasks that are causing the pain or making it worse. This may be anything that has a repetitive nature, such as using a screwdriver, painting or lifting heavy objects. You might be able to change the way you do some tasks to take the strain off your hands and wrists. Some conditions affecting the hand and wrist wont get better until you stop doing certain tasks.
Who Is At Risk Of Developing Carpal Tunnel Syndrome
Women are three times more likely than men to develop carpal tunnel syndrome. People with diabetes or other metabolic disorders that directly affect the bodys nerves and make them more susceptible to compression are also at high risk. CTS usually occurs only in adults.
Workplace factors may contribute to existing pressure on or damage to the median nerve. The risk of developing CTS is not confined to people in a single industry or job, but may be more reported in those performing assembly line worksuch as manufacturing, sewing, finishing, cleaning, and meatpackingthan it is among data-entry personnel.
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Desk Stretching Exercise Videos
Prolonged periods of sitting at a desk, combined with long commutes, can cause loss of flexibility in the muscles in your legs, hips, back, shoulders and neck. The downloads on this page are designed to help increase your flexibility and combat the stress of everyday life. Select the muscle group you wish to address and follow along with your on-line stretching coach. To prevent injury while sitting at your desk, try these desk-stretches throughout your day.
What Research Is Being Done
The mission of the National Institute of Neurological Disorders and Stroke is to seek fundamental knowledge of the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. The NINDS is a component of the National Institutes of Health , the leading supporter of biomedical research in the world.
Scientists supported by the NINDS are studying the factors that lead to long-lasting neuropathies, and how the affected nerves are related to symptoms of pain, numbness, and functional loss. Researchers also are examining biomechanical stresses that contribute to the nerve damage responsible for symptoms of carpal tunnel syndrome in order to better understand, treat, and prevent this ailment. By quantifying the distinct biomechanical pressures from fluid and anatomical structures, researchers are finding ways to limit or prevent CTS in the workplace and decrease other costly and disabling occupational illnesses.
Scientists funded through NIHs National Center for Complementary and Integrative Health are investigating the effects of acupuncture on pain, loss of median nerve function, and changes in the brain associated with CTS. In addition, a randomized clinical trial designed to evaluate the effectiveness of osteopathic manipulative treatment in conjunction with standard medical care is underway. Evaluations of these therapies and other therapies will help to tailor individual treatment programs.
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When To See A Doctor
Hand and wrist pain often gets better with things you can do at home.
However, youll need to visit your GP surgery if:
- your pain isnt getting better after treatment at home for two weeks
- the pain is getting worse
- the pain keeps returning
- the pain is stopping you from doing your everyday activities
- your hands are stiff and swollen, particularly in the mornings and these feelings dont get better after half an hour
- as well as being swollen and stiff, your hands are warm and red
- you also feel generally unwell, especially if you have a high temperature
- you have ongoing tingling, numbness or weakness in the hands or fingers.
Its important to get urgent medical attention, if:
- you think youve broken a bone
- you have extreme pain
- any part of your hand, wrist or fingers is a funny shape or colour
- you have lost the feeling of part or all of your hand
- there was a snap, grinding or popping noise when you injured your hand or wrist
- you cant move your hand, wrist or fingers properly.
If you have ongoing hand and wrist pain or a specific condition affecting the hand and wrist it could be helpful to see a hand therapist. These are healthcare professionals with expertise in treating conditions affecting the hand and wrist. Your GP, rheumatology department or orthopaedic department could refer you to one.
Can Surgery Treat Radial Tunnel Syndrome
There is a surgical treatment for this condition, but your doctor will likely only recommend it when rest and non-operative therapy fails.
The goal of the surgical decompression is to take the unwanted pressure off your radial nerve as it passes through the radial tunnel. Your surgeon will begin this procedure by making a cut right below the outside of your elbow and into your forearm. After moving around muscle tissues in the radial tunnel, theyll be able to see where exactly the nerve is being pinched or compressed. Once they find the exact spot, your surgeon will simply cut the parts of the radial tunnel that are compressing the nerve, expanding the tunnel in the process. Once the procedure is done, theyll stitch the cut back together.
This surgery is uncommon, and it can be performed as an outpatient surgery, meaning you wont stay in the hospital overnight. This procedure can be performed with general anesthesia or local anesthesia, which will only numb the arm that is being operated on. Youll remain awake on local anesthesia.
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Who Is Most At Risk Of Developing Radial Tunnel Syndrome
Radial tunnel syndrome is most common in people between the ages of 30 and 50. Women are also much more likely to develop this condition than men. There are also certain factors that may put you at a greater risk of developing radial tunnel syndrome, including:
- Poor arm and wrist strength and flexibility.
- Failing to adequately warm-up before playing sports.
- Tumors or ganglion cysts in your arm.
- Swelling or fluid in your arm.
- Radial nerve inflammation.