Posts

Symptoms of Trigger Finger

The complex anatomy of the hand consists of 27 bones, along with muscles, joints, tendons, nerves, and ligaments. If any of these structures become injured, pain and loss of function can put a damper on almost all activities. In other words, you rely on the use of your hands for almost everything you do on a daily basis. However, when you have constant pain and discomfort in your hands or wrists, these simple tasks become more difficult and uncomfortable. Some conditions, such as trigger finger, are not only painful, but also affect your appearance and function.

Any hand or wrist problem causing pain, swelling, discoloration, numbness or a tingling sensation, or abnormal shape, that persists for more than two or three days should be evaluated by your orthopedist to establish the cause, and allow treatment as early as possible. Early diagnosis and early treatment generally give the best results.

So, you notice that one day when making a fist, you try to straighten your fingers afterwards, when one catches when attempting to bring it back into a straight position, causing pain. After you go to a doctor to check it out, they diagnose you with a condition called trigger finger, caused by overuse.

Trigger finger, known medically as stenosing tenosynovitis, is a condition that causes pain, locking, popping or clicking of the fingers or thumb when the hand is opened or closed. Muscles in your forearm attach to tendons that run all the way down to the bones at the ends of your fingers. These muscles are what help you bend your fingers into a fist. 

The reason why we are able to open and close our hand is due to our tendons being pulled close to the bones of the fingers by pulleys. If these pulleys become too thick, stiff, tight or swollen, commonly due to inflammation, this causes the finger to “trigger” or get stuck when trying to straighten your fingers after being in a fist. Therefore, if the tendon cannot glide freely, trigger finger occurs.

Symptoms of trigger finger can occur differently for people, which is why it is not always easy to identify the cause. In its early stages, trigger finger can cause pain on the palm of your hand, or on the back side of a finger. Trigger finger causes inflammation, creating symptoms of stiffness and swelling. As the muscles and tendons in our fingers give us the ability to move, when someone is diagnosed with trigger finger, there can be a painful snapping sensation when opening and closing the hand. Often one of our fingers can get stuck in a certain position, making it painful and impossible to straighten or bend it.

To learn more about trigger finger and its symptoms, call Colorado Center of Orthopaedic Excellence in Colorado Springs at (719) 623-1050 or request an appointment online.

What is Swan Neck?

The fingers are made up of bones called phalanges. The phalanges in each joint are separated by two joints called interphalangeal joints (IP joint). The two joints are the distal IP joint (DIP joint), meaning further away, and the proximal IP joint (PIP joint), meaning the middle or closer in. These IP joints of the fingers are like hinge joints, allowing us to have mobility with our hands, including straightening and bending. 

The tendons allow each of our finger joints to be able to flex and straighten completely. These are called extensor tendons. The extensor tendons come from the muscles that arise from the backside of the bones located in the forearm. These muscles travel toward the hand, where they eventually connect to the extensor tendons before crossing over the back of the wrist joint.

Then, the extensor tendons become what is called the extensor hood. The extensor hood becomes flat in order to cover the top of the finger. The extensor hood sends out branches of ligaments (tough bands of tissue) to connect the bones in the middle and end of the finger. When the extensor muscles contract, they tug on the extensor tendon, allowing the joints to work together, so that the finger can straighten and bend.

Finger position and movement of the hand occur from the balanced actions of many important structures, that work cohesively when everything is normal. Ligaments support the finger joints, muscles hold and give our fingers the ability to move, while tendons help control the motion of each finger. Any injury or condition can disturb the balance and inner workings of all these parts, altering functionality and the alignment and structure of the hand and fingers. The result may be a condition call swan neck.

What is Swan Neck?

Swan neck is a deformity, in simple terms, a crooked finger. The PIP joint (the joint in the middle of the main knuckle and DIP joint), includes the strongest ligament called the volar plate. These ligaments connect on the palm side of the joint. As the ligament tightens when the finger is straight, the PIP joint is protected from bending back too far, or hyperextending. Swan neck deformity occurs when the PIP joint in the finger becomes hyperextended and the DIP joint at the end of the finger is flexed, causing a crooked finger.

Swan neck symptoms include inflammation from injury, or conditions such as Rheumatoid arthritis (RA), causing pain and swelling of the PIP joint. This imbalance causes the finger to look like a swan’s neck, bent and abnormally crooked.

Your doctor will physically examine your finger, and sometimes order an X-ray to check your joints and look at the alignment, to fully diagnosis the problem. Treatment for swan neck deformity can be nonsurgical or surgical, depending upon the severity of the deformity. The approach your doctor chooses will also depend on whether the proximal IP joint is flexible or stiff.

 While the term deformity connotes a visual disturbance, remember that it can also affect mobility and day-to-day function, so getting treatment is important! To learn more about swan neck deformity and how to treat it, call the orthopedic surgeons at Colorado Center of Orthopaedic Excellence in Colorado Springs at (719) 623-1050 or request an appointment online.

The 411 on Gout

Gout is a painful form of arthritis, characterized by inflammation that occurs when uric acid builds up and crystalizes in your joints. Symptoms include painful inflammation, tenderness and redness around the affected joint. Some people experience gout in different joints of the body, such as the knees or elbows, but it most commonly effects the big toe.

If you have high levels of uric acid in your blood, you may have a condition called hyperuricemia. Your liver normally metabolizes uric acid, and the kidneys get rid of it when you go to the bathroom. The levels of uric acid build up when not enough uric acid is eliminated, or too much uric acid is being produced. The purines in our food which increases the uric acid levels in our blood, are known to bring on gout attacks.

The uric acid buildup takes a crystalline form, and often finds a home in the joints. Since our joints need to stay lubricated and run very smoothly, a buildup of crystals will cause inflammation and pain, known as gout. When you are experiencing a gout attack, the affected joint will feel hot, swollen, turn red and will become very sensitive to the touch. The onset of pain during a gout attack will increase for 24-48 hours if left untreated.

Blood and urine tests are always recommended by your doctor in order to measure the level of uric acid in your blood. Taking in fluids dilutes the levels of uric acid, so drinking at least 64 ounces of water a day is ideal for breaking down uric acid levels, and as a result gout pain may decrease.

If you are experiencing gout flare-ups, it could be one of a few reasons and risk factors: males over 40 years old, family members with a history of gout, obesity, aspirin medications, a diet consisting of high purine foods or high-fructose drinks. Heavy drinking also contributes to elevated uric acid levels.

More often than not, gout has to do with our diet and what we are eating. It’s best to stay clear of certain foods when you have high uric acid, have had gout attacks in the past or family members that have had it as well. Certain medications can help control uric acid levels, and your orthopedic doctor can recommend the best treatment option for you.

While gout may seem like something that you can manage, it’s best to get it treated right away before inflammation and pain turn into more serious injury or disease. To learn more about gout and how to avoid it, call Colorado Center of Orthopaedic Excellence in Colorado Springs at (719) 623-1050 or request an appointment online.

ACL Tears vs PCL Tears

Our knee is important, as it provides us with a foundation to stand on. The knee provides stability and mobility, and is vital to all types of movement, especially for athletes. If you ever had any sort of injury, especially a knee injury, you probably appreciate how your knees power you through various activities. To avoid knee injuries, it helps to understand how your knees work and what you can do to protect them.

The ACL (anterior cruciate ligament) and the PCL (posterior cruciate ligament) are the two major ligaments in the knee that work together to provide stability in the knee. They cross each other and form an ‘X’ which allows the knee to flex and extend without side to side movement. ACL and PCL tears are two of the most common and most serious knee injuries that happen to athletes. When you get an injury to the anterior cruciate ligaments or the posterior cruciate ligament, there are slightly different symptoms. 

What is an ACL Tear?

The ACL is one of the four main ligaments within the knee that connect the femur to the tibia. The knee is essentially a hinged joint that is held together by the medial collateral (MCL), lateral collateral (LCL), anterior cruciate (ACL) and posterior cruciate (PCL) ligaments.

The anterior cruciate ligament (ACL) is a tough band of tissue joining the thigh bone to the shin bone at the knee joint, providing much needed stability. It runs diagonally through the inside of the knee, and when there is too much stress on the ligaments, it can result in a sprain or worse, the ligaments can be stretched too far or snap, causing the ACL to tear. 

ACL Tear Symptoms:

  • Pain in the knee
  • Swelling, which builds up over twenty-four hours
  • Loss of complete range of motion of the knee
  • Tenderness to palpation of the joint line
  • Pain and inability to walk on the affected leg
  • Unstable knee

The most common treatment for a torn ACL is arthroscopic surgery and ACL reconstruction.

 What is a PCL Tear?

The posterior cruciate ligament (PCL) is located in the middle of the knee, next to the anterior cruciate ligament. While the ACL helps prevent your thigh bone (femur) from moving too far forward, the PCL helps prevent your shin bone (tibia) from moving too far backward. 

The PCL is lesser known because it is not injured as frequently as the ACL. However, injuries to the PCL should be taken seriously, as this ligament significantly affects the stability of the knee. Injuries to the PCL typically occur when the tibia is hit by an outside force while the leg is bent. One big difference between PCL and ACL tears is that most PCL tears are only partial tears, whereas the ACL usually completely tears.

PCL Tear Symptoms:

  • Pain in the knee
  • Immediate swelling of the knee
  • Difficulty or impossibility of walking on the affected leg
  • The knee feels like it is going to “give out”

To diagnose and treat tears to the ACL and PCL, your doctor will evaluate your injury by checking the severity of your knee instability. An MRI will most likely be done to get a closer look at the knee joint. If the diagnosis is an ACL or PCL tear, arthroscopic surgery can be done to repair the torn ligaments. Recovery can be lengthy for this injury, and will most likely require extensive rehabilitation, such as physical therapy.

The doctors at Colorado Center of Orthopaedic Excellence will do their best to get you back to optimal function as quickly as possible. To learn more about ACL and PCL tears, and how we can help, call our office at (719) 623-1050 to request an appointment. You can also schedule an appointment online.

The Overlap Between an Orthopedic Specialist and a Rheumatologist

If you are one of the 100 million Americans in the United States suffering from joint pain, and the unpleasant effects associated with it, you know how difficult carrying out or completing everyday tasks can be. Getting healthcare is a privilege and a right, however, not everyone is fortunate enough to receive good healthcare. Good healthcare depends largely on the specialist you see, and for joint pain it can get tricky. Doing research, and talking to others can help you choose the right doctor.

In getting an accurate diagnosis, a visit to your primary care doctor is usually the first step. They can give you a basic diagnosis, and refer you to a specialist such as an orthopedist or rheumatologist for a closer look and second opinion. Both a rheumatologist and orthopedist treat joint pain as part of their specialty, whether the pain is chronic or acute.

The main difference and overlap between an orthopedist and a rheumatologist is that an orthopedist is a surgical specialist and a rheumatologist is a medical specialist. Usually, first, a rheumatologist will give you a diagnosis, and monitor your condition/progression following the use of medications and other non-surgical treatments. If symptoms continue to persist, the rheumatologist will often refer you to an orthopedic surgeon to see if you are a candidate for surgery, usually as a last resort, if no other treatments could alleviate the problem. 

Visit an orthopedist if you have experienced:

  • Joint or musculoskeletal pain following an injury
  • Hip or knee pain that gradually increases when bearing weight
  • Severe joint pain interfering with typical functioning
  • Moderate or advanced arthritis in the hips or knees
  • Previous unsuccessful treatment of joint pain
  • Need surgery – Joint Replacement

See a rheumatologist if you have experienced:

  • Pain involving multiple joints
  • New joint pain not associated with an injury
  • Joint or musculoskeletal pain associated with fever, fatigue, rash, morning stiffness or chest pain
  • Joint pain coinciding with back pain
  • Joint pain with psoriasis
  • Muscular pain with or without any other symptoms
  • Recurring headaches or muscle aches
  • Back pain with or without leg pain
  • Ongoing symptoms, such as unexplained fever, sweating or weight loss

At Colorado Center of Orthopaedic Excellence, we understand how chronic pain, or pain in general can disrupt your life. At our practice, you will find a multi-disciplinary team of specialists that will diagnose and treat your joint pain. Whether your pain is caused by disease or an injury, our orthopaedic surgeons, podiatric surgeon, and physical therapists will provide the relief you need to get you back to doing the things you love. If further care is needed, we will refer you to the right specialist, to receive the best care possible.

To request an appointment with one of our orthopedic surgeons, call Colorado Center of Orthopaedic Excellence at (719) 623-1050. You can also request an appointment online today.

Sports Medicine: Keeping You in the Game

People with active lifestyles are often at increased risk for sports-related injuries. Our board-certified orthopedic surgeons and sports medicine specialists can properly diagnose all athletic injuries and provide treatments that restore a more pain-free condition. The Sports Medicine “team” is made up of individuals from a variety of fields such as orthopedic surgery, primary care medicine, athletic training, physical therapy, and nutrition.

Sports medicine doctors have special training to restore function to injured patients so they can get moving again as soon as possible. They are also knowledgeable about preventing illness and injury in active people. Although sports medicine doctors do work with professional athletes, they also treat children and teens involved in sports, and adults who exercise for personal fitness, as well as people who have physically demanding jobs.

Reasons to see a sports medicine specialist:

  • Ankle sprains
  • Fractures
  • Knee and shoulder injuries
  • Tendonitis
  • Exercise-induced asthma
  • Heat illness
  • Concussions
  • Eating disorders
  • Cartilage injuries
  • Proper injury recovery
In addition, sports medicine doctors can provide advice on nutrition, supplements, exercise and strength training, and injury prevention.

Our experts at the Colorado Center of Orthopaedic Excellence strive to prevent and treat injuries in physically active individuals. If your child sustains an injury during exercise, sports participation, or any type of physical activity, you may be advised to see a sports medicine doctor for treatment.

Our goal is to return you to play as quickly as possible while preventing re-injury and improving your body’s response to stress. We utilize cutting-edge diagnostic and treatment methods to eliminate pain and improve range of motion, so the next time you throw the ball, dunk a basket, or run toward the finish line, you will feel just as good or better than you did before your injury occurred.

Whether you are an amateur or professional athlete, our Colorado Springs orthopedic doctors give the best care possible. Request an appointment today with one of our specialists today by calling (719) 623-1050 or you can request one online.