Ask a Doctor: Steroid Injections

Nov 27,2017 / By The Hand Society / 16 Comments

Hand surgeon Steven Goldberg, MD, answers your questions about steroid injections.

Steroid injections are a common non-operative treatment for multiple musculoskeletal conditions. The following are a list of some conditions where steroid injections may be recommended:

Carpal tunnel syndrome
Trigger finger
DeQuervain’s tendonitis (pain at the wrist near the base of thumb)
Joint synovitis or arthritis
Tennis elbow (lateral epicondylitis)
Golfer’s elbow (medial epicondylitis)
Shoulder bursitis

How do steroids work?

There are different types of steroids. Glucocorticoid steroids are the ones used to treat the musculoskeletal problems listed above. There are many different types of steroids that have different onsets of action, duration, solubility, and reasons for use. Any single medication may be used at different doses and volumes depending on the clinical problem. There is no single steroid regimen that is “best”. They have different effects on many different types of tissue, but they may work to reduce inflammation and change the array of proteins that cells make.

Advice from a Certified Hand Therapist: Surgery for Thumb Arthritis Pain

Nov 21,2017 / By the American Society of Hand Therapists / 1 Comment

Thumb arthritis pain can be debilitating, making everyday self-care tasks intolerable. There is a surgical option when other treatments, such as injections and therapy, fail to adequately reduce pain. A carpometacarpal arthroplasty or CMC arthroplasty is a joint replacement procedure for the base of your thumb. It eliminates the grinding and pain felt from the rubbing of bone on bone after the protective cartilage has worn away, usually caused by arthritis.

Below are some commonly asked questions regarding this procedure:

Will I be in a cast?

Yes. You will likely be in a cast for 2-4 weeks. You will also use either a removable orthosis a hand therapist will custom make for you or an off-the-shelf thumb and wrist splint for a month after the cast has been removed. This will help maintain the optimum position of your thumb as you are healing and protect your new thumb joint.

What happens after my thumb has been immobilized?

Any time a joint has been immobilized, it takes time to regain your flexibility. For this surgery, the wrist and thumb are usually quite stiff. Your doctor will likely recommend you see a hand therapist to assist you with regaining the range of motion and strength safely.

Hand Hand Surgery Replantation

What is Replantation?

Nov 17,2017 / By The Hand Society / No Comment

Replantation is a procedure during which a surgeon will reattach a finger, hand or arm that has been completely cut from a person’s body. Replantation, however, isn’t always an option. A surgeon will only perform this procedure if the limb is still expected to function without pain. Sometimes, the body part is too damaged to perform a replant.

This procedure takes a number of hours to complete. The steps include:

Step 1: Damaged tissue is carefully removed.
Step 2: Bone ends are shortened and rejoined with pins, wires, or plates and screws. This holds the part in place to allow the rest of the tissues to be restored.
Step 3: Muscles, tendons, arteries, nerves and veins are then repaired. Sometimes grafts or artificial spacers of bone, skin, tendons and blood vessels may be needed, too. The grafts can be from your own body or from a tissue bank.

Hand Hand Pain Overuse

Smartphone-Related Hand Injuries and How to Reduce Them

Nov 17,2017 / By The Hand Society / 1 Comment

from WRVO Public Media

Repeated use of anything can cause wear and tear including your smartphone. Continued scrolling and tapping can wear down the tendons in your hand and wrist causing injury. Repetitive use injuries are common in older adults but health professionals are seeing injury in younger patients as the age smartphone use decreases.

Dr. Daniel Polatsch, an orthopedic hand surgeon and co-director of the New York Hand and Wrist Center of Lenox Hill, joins us this week to discuss how extended use of smartphones can cause injury and how to reduce the risk of it.

Trigger finger and tendonitis are two of the more common injuries related to overusing your hands. This is usually common in people who spend long hours typing at the computer all day but Polatsch is seeing more patients come in with these injuries due to smartphone use.

“It can develop into something called a trigger finger or trigger thumb which is actually the proper name,” said Polatsch.

Read the full story.