Shoulder, Arm and Hand

the bones and muscles (shoulder, arm and hand)

the bones and muscles (shoulder,arm and hand)

A friend complins that her shoulder `comes out of its socket` nearly every time she raises her arm. Is she exaggerating?

She may not be. Recurrent spontaneous dislocation of the shoulder is a condition that isn`t fully understood, but it often seems to follow an earlier and more severe injury to the area. Any extension of the arm-even for such unstrenuous activities as dressing or combing the hair-would seem then to cause dislocation. In some people, the condition is manageable; they find it possible to reposition the shoulder by themselves or with help. For others, surgery may be required.

After a recent painful shoulder injury, a friend of mine was told he was in danger of developing a frozen shoulder. What is that?

A so-called frozen shoulder can result from any painful condition, such as an injury,arthritis, bursitis or tendinitis, that brings about temporary inactivity of the shoulder joint. Failure to mive the joint leads to more stiffness, which sets in motion a hard-to-break spiral of further lack of activity, pain and stiffness.The main goal of treatment is to restore and maintain mobility in the joint. If pain is the chief problem, your friend may be given analgesic medications that will make it easier for him to move his shoulder regularly. His doctor may also prescribe oral anti-inflammatory agents or inject cortisone into the joint. Physiotherapy mat be recommended as well. Although an isidious and self-perpertuating condition, frozen shoulder can be rexersed with early and persisternt treatment. If left untreat, however, it can lead to permanent impairment.

Why do so many people who never play tennis complain of tennis elbow?

The term tennis elbow, or more correctly lateral epicondylitis, is used rather loosely to refer to any pain along the outside of the elbow joint; more specifically, it refers to a partial tearing and inflammation of the tendons that link the forearm muscles to the elbow. The pain is caused by the combination of tight gripping and rotary movement used in tennis. The same symptoms-radiating forearm aching and tenderness along the outside of the elbow-can also be brought on by prolonged use of a screw-driver or excessive handshaking. Playing golf may cause similar painful problems on the inside of the elbow.

My wife wants to take up tennis. How can she avoid getting tennis elbow? And if the problem develops, how is it treated?

The best prevention is probably to be professionally coached and learn how to grip the racket and perform the basic strokes correctly-especially the backhand and serve. Tennis elbow is rere among players who use the two-handed backhand and thus avoid racket arm stress. As for trearment, rest is the standard recommendation, followed by simple stretching and strengthening exercises once the pain subsides. Aspirin or ibuprofen, or cortisome shots may relieve the pain and imflammation. Elastic support bandages may also help. Surgery may be needed if movement is badly impaired, but this is rare. To avoid a recurrence of the injury, allow enough time for the elbow to heal before resuming the sport.

A schoolboy I know developed a locked elbow while playing football. What is this condition?

Both the elbow and the knee are prone to this problem, in which sudden or repeated stress on the joint causes a fragment of bone and cartilage to break loose. Eventually, this chip lodge in the joint, producing pain and restricted movement. Youthful sportsmen seem to be particularly vulnerable to the condition. With rest, the problem may heal on its own, but if pain persists for several months, surgery may be necessary to extract the fragment.

Is it true that there is an occupational disease that typists tend to develop?

Yes, it is. The condition, called De Quervain`s disease, is a form of tendinitis in which the coverings of the tendons that lead from the wrist to the thumb become irritated and cause tenderness and pain in the area. The repetitive action of typing can bring it on, as can activities that involve the gripping of tools- even playing golf. Treatment usually consists of rest, icing the area, and taking aspirin. If the thumb is still tender after a week or so, stronger anti-inflammatory drugs or cortisone injections may be prescribed. Surgery is rarely needed.

My mother complains of pain in her hand at night, and sometimes frops objects she i s carrying. What could cause this?

Your mother could be suffering from carpal tunnel syndrome, in which the median nerve that tuns from the forearm through the hand is squeezed by swelling and inflammation of the bone (carplas) and ligaments in the wrist. Arthritis can contribute to this condition, as can sudden weight gain or a wrist fracture, which is fairly common in older people. Women are more susceptible than man, and the conditionoccasionally flares up in pregnant women, and then subsides after they have given birth.For mild cases, resting-perhaps with the help of a wrist splint, especially at night-will often provide relief. If arthritis is the underlying problem in your mother`s case, her doctor may prescribe anti-inflammatory medications or cortisone. In severe cases, surgery may be required to cut through the carpal ligament and create more room for the nerve.

RSI has had a lot press coverage in the past few years. What exactly is this condition?

It is true that there has been an upsurge in a syndrome or group of conditions known collectively as repetition strain injury (RSI), or more recently as occupational overuse syndrome. It is characterised by tenosynovitis (inflammation of the tendon and its synovial sheath) of the fingers, wrists, elbows and/or shoulders, resulting in pain, weakness and loss of function.The condition has been known for many years to occur in people, such as musicians and knitters, who perform repetitive fine hand movements, but the incidence has increased with the introduction of new high-speed keyboard technology. The exact pathology is not known, and this has led some critics to suggest that there may be a psychological element to the syndrome. Management of the condition consists of pain-relieving drugs, physiotherapy and, above all, rest of the affected part; attention must be paid also to the patient`s general health and lifestyle. If the condition remains untreated, serious crippling deformity can result. There is now far more emphasis given to prevention in the workplace, including ergonomically sound work practices, attention to equipment so that posture is improved, and adequate rest breaks.

Member of my husband`s family all have a tendency towards a curving, or clawing, of the hand. Does this condition have a name, and is it inherited?

A number of disorders can result in clawing deformaties, but the only one known to run in families is Dupuytren`s contracture, in which a slow thickening and tightening of the tissue in the palm cause the hand to contract in a claw-like manner. It can be acquired also as a complication of certain chronic illnesses such as diabetes and liver disease. Severe cases can be disabling, and corrective surgery may be needed to restore the ability open the hand fully.

What is meant by the term mallet finger?

In mallet finger, the tendon that extends to the tip of a finger is ruptured, usually as a result of injury-often from a hard ball when failing to catch it-or possibly as a result of underlying arthritis, so that the tip of the finger cannot be straightened. The finger should be splinted while the tendon heals, or else the mallet position will persist. Surgery is occasionally needed to repair the tendon or, if this is not possible, to hold the joint in the straight position.

the bones and muscles (shoulder,arm and hand)