Posts Tagged ‘Upper extremity’

Takeaways from the Hand, Wrist & Elbow Live Chat

hand-wrist-elbow-emailThanks to everyone who joined us Tuesday, April 26, for our live online chat on “Hand, Wrist & Elbow Pain and Treatment” hosted by Emory orthopaedic surgeon, Dr. Michael Gottschalk.

We had an awesome turnout for the chat, and we were able to answer a lot of really great questions that were submitted prior to and during the chat. Below you can find some of the highlights. You can view the full chat transcript here.

Question:I have carpal tunnel and arthritis in my hands and my wrist is very painful I can’t use my hands. What can I do for this?

Dr. Gottschalk: Currently there are several suggestions and recommendations for carpal tunnel syndrome. I always like to first make sure that this is indeed what you have. Carpal tunnel syndrome is a pinching of the median nerve at the wrist. It can cause pain, numbness and tingling to the hand and especially the thumb, index, middle, and half of the ring finger. If your carpal tunnel is severe or has been going on for a long time it can also cause weakness or wasting of the muscles to the thumb. Often times we might order an electrical test to confirm you have carpal tunnel syndrome or perform certain physical maneuvers to confirm this in the office. Once we have confirmed you have carpal tunnel syndrome I will normally make the following suggestions.

1) Wear a wrist brace at night that keeps the wrist straight (the brace does not need to be tight)

2) Try anti-inflammatory medications such as Ibuprofen or Aleve, make sure to check with your primary care doctor first as these medications can have side effects and cause kidney/stomach issues

3) Injections: I normally reserve injections for patients I am either confirming the diagnosis or for a patient that has a temporary reason for carpal tunnel (e.g. pregnant women)

4) Surgery: This is normally a last resort and I often recommend this for patients who have failed 1 and 2.

 

Question: My wrist hurts when I bend it backwards (as if I were telling someone to stop) and if it bears any weight (like shifting my weight in a chair). If I make a fist and keep my wrist straight it doesn’t hurt at all to bear weight on it. There’s also a slightly tender knot on the ulna side of my wrist). This has been happening for approximately 3 weeks. Any thoughts?

Dr. Gottschalk: This can be a common problem. Hyperextension or bending the wrist backwards (e.g. like for pushups) can cause significant stress on the wrist joint. There are several possibilities as to why this may be painful. One possibility is a wrist sprain where the ligaments are injured but not torn. Other possibilities include inflammation within the wrist joint (synovitis), ligament tears (more severe than a sprain), and possibly even a broken bone.

If these symptoms do not subside I would recommend seeing a physician for x-rays. It is possible that they may recommend NSAIDs, bracing, or an injection. I would also recommend cessation of activities that make it worse at least until it improves.

 

Question: Tell me a bit about golfers elbow.

Dr. Gottschalk: Golfer’s and Tennis elbow are very similarly related. They’re often repetitive overuse injuries. They normally occur where the tendon attaches to the bone near the elbow. Treatments often start with stretching exercises, inflammatory medication and sometimes bracing. If these are ineffective, I would normally recommend injection or other advanced therapies. Surgery would be the last resort option.


If you missed out on this live chat, be sure to check out the full list of questions and answers on the chat transcript. You can also visit Emory Sports Medicine Center for more information.

Also, if you have additional questions for Dr. Gottschalk, please feel free to leave a comment in our comments area below.

About Dr. Gottschalk

gottschalk-michaelDr. Gottschalk grew up in Dallas, Texas as the youngest of three boys. He went on to graduate from JJ Pierce High School in the top 10% of his class and as an AP Scholar with Distinction. Dr. Gottschalk received an academic scholarship to attend the Business Honors Program at the University of Texas at Austin. After graduating from UT Austin, he then went to complete medical school at the University of Texas Health Science at San Antonio. Upon completion of medical school, Dr. Gottschalk completed his Orthopaedic Surgery Internship and Residency at Emory University. While in his training, Dr. Gottschalk received multiple accolades and awards for his outstanding research and was elected as a resident leader to the esteemed American Orthopaedic Association.