Shoulder replacement

What is shoulder replacement surgery? Shoulder replacement surgery involves removing and replacing the damaged parts of the shoulder (usually the head of the humerus and scapula) with artificial implants. These are either made out of plastic or metal, or sometimes both. These implants are usually held in place using a special cement, or if they allow new bone growth, then cement is not required permanently. Although shoulder replacement surgery is less common than knee or hip replacement surgery, it can be just as effective in relieving shoulder joint pain. Why would you need shoulder replacement surgery? Shoulder replacement surgery will usually be recommended if non-surgical treatments, such as medication or changes in physical activity have not been successful in relieving pain. You can experience shoulder pain for a number of reasons, including: Age-related wear and tear shoulder arthritis Rheumatoid arthritis Injury-related arthritis Rotator cuff tear Severe shoulder fractures Failed previous shoulder replacement surgery. This is known as revision shoulder replacement. What does shoulder replacement surgery involve? There are several types of shoulder replacement surgery: Total shoulder replacement – the arthritic joint surfaces are replaced with a metal ball (on the head of the humerus) and a plastic socket is attached to the shoulder joint. Stemmed hemiarthroplasty – just the ball of the shoulder joint is replaced. Resurfacing hemiarthroplasty – the head of the humerus is surfaced with a cap implant. Reverse total shoulder replacement – a metal ball is attached to the shoulder bone and a plastic socket is attached to the upper arm bone. How to prepare for shoulder replacement surgery Before surgery, certain medications will need to be stopped. It is also important to prepare your home prior to surgery, to make recovery easier. This includes, moving essential things to low-level shelves and having everything easily available. Before surgery you should wear loose-fitting clothes, with a button down shirt that allows easy removal after surgery. Surgery is performed with either general anaesthetic or regional anaesthetic. Post-operative care After surgery, you will be given antibiotics to lower the risk of infection. Your arm will be in a sling and will have minimal movement. Patients generally return home after 2-3 days following surgery. Pain medication will be prescribed for the short-term, but will be carefully monitored. Physical therapy is also crucial to a good recvoery, and soon after surgery movement will be possible. Driving is not permitted for two to four weeks following surgery. ...

Shoulder surgery

What is shoulder surgery? Shoulder surgery treats injured shoulders by repairing the muscles, connective tissue, or damaged joints that occur from traumatic injury, or from where the shoulder has been overused. The shoulder is the most flexible joint in the body, allowing the arm to be placed and rotated in many positions in front, above, to the side and behind the body. This degree of movement makes the shoulder susceptible to injury. Shoulder problems that require surgery Bursitis or tendinitis The rotator cuff can cause pain in many different ways, which includes tendonitis, bursitis or mechanical impingement. These are due to repetitive activities such as swimming or weightlifting. The repetition causes rubbing or squeezing of the rotator cuff under the acromion and in the acromioclavicular joint. Impingement This occurs when the top of the shoulder blade puts pressure on the underlying soft tissues when lifting the arm away from the body. Symptoms of impingement include difficulty reaching up behind the back, pain when using the arm over the head and weakness in shoulder muscles. Full-thickness rotator cuff tears Full-thickness rotator cuff tears are often the result of shoulder impingement, partial thickness rotator cuff tears or they can occur from heavy lifting and falls. Rotator cuff tears may involve the entire thickness of the tendon or they may be incomplete, which is known as partial thickness. Rotator cuff surgery and rehabilitation allows patients to regain the lost function in shoulders with cuff disease. Instability One of the shoulder joints is forced out of its normal position. This condition can result in a dislocated shoulder. Patients will experience pain when they raise an arm and it may also feel like their shoulder is out of place. Diagnosis of a shoulder injury The doctor will discuss the medical history of the patient and then examine the shoulder. They will check to see whether it is tender in any area and whether there is a deformity. The strength of the arm will also be tested and the arm will be moved in different directions. Other tests that help with diagnosis include imaging tests, X-rays and MRI scans. Non-surgical treatment of shoulder injuries An orthopaedic surgeon will explain certain exercises that are aimed to strengthen the shoulder muscles, which will include wall push-ups and shoulder press-ups. They may also prescribe anti-inflammatory medication. Surgical treatment for shoulder injuries All-arthroscopy repair – this allows the surgeon to insert a thin device with a small lens into tiny incisions to look inside the joint. The images are relayed onto a television screen, allowing the doctor to be guided and make a diagnosis. Open repair – in some cases, open repair surgery is necessary. It is done through small incisions, which are only a few inches and required if the tear is large. It is a good option if the tear is complex or if additional reconstruction, such as tendon transfer, is required. ...

AC joint surgery

What is AC joint surgery? AC joint surgery, also known as acromioclavicular joint surgery, is a type of shoulder operation to treat acromioclavicular joint separation, also known as a separated shoulder. An acromioclavicular joint separation occurs when the clavicle (collarbone) separates from the scapula (shoulder blade). It is not to be confused with a shoulder dislocation as the injury is different. Surgery can involve the use of a screw or suture loop and on some occasions an artificial ligament. Why is it done? AC joint surgery aims to reconstruct the acromioclavicular joint when non-surgical treatments, such as physiotherapy or medication, have failed. Surgery aims to restore the alignment of the shoulder blade and the collarbone, improving function, mobility and reducing pain. Surgery is usually required for the most severe cases of AC joint injuries as milder injuries can successfully be treated with conservative means. What does it involve? AC joint surgery can either be carried out arthroscopically or as traditional, open surgery. How it is performed will depend on the severity of the injury. There are various versions of AC joint surgery: Repairing the joint – the joint is repositioned and held in place with pins called k-wires. Holding down the clavicle – the collarbone may be held down in place using metal implants, screws or tight sutures. Reconstructing the ligaments – using either the patient’s own tissue or donor tissue, the damaged ligaments can be replaced and repaired to ensure the clavicle and scapula are held in place correctly. How do you prepare for AC joint surgery? AC joint surgery requires general anaesthesia so you will need to fast for a duration before surgery. It is also important to stop smoking for a period before surgery to aid a better recovery. It is advised that you make arrangements to have someone to take you home from surgery and to have home-support for at least the first few days. Aftercare: Following surgery, it may be necessary to wear a sling to provide support for a few days. You will need to have physiotherapist to ensure a thorough recovery, however, you may have a few weeks between the operation and the start of physiotherapy. Physiotherapy will involve range-of-movement exercises, passive exercises and when your ligaments have healed, you will be given active exercises. Recovery can take a matter of months and requires patience and commitment to physiotherapy. Alternatives to this treatment: If the injury is not very severe, surgery should be avoided, and the following measures should help: Rest Physiotherapy Applying ice to the injury Anti-inflammatory medications ...

Arthritis

What is arthritis? Arthritis is a disease that causes inflammation of the membrane that covers the joints. There are more than 100 different types of arthritis, but the most common are: Osteoarthritis: the most common type of arthritis. It usually starts with age and affects the fingers, knees and hips. In some cases, it develops in areas where there was a previous hit or injury. Inflammatory arthritis: There are many types of inflammatory arthritis, the most common of which is rheumatoid arthritis, which occurs when the body's defenses do not work properly. It affects both joints and bones, often in the hands and feet. What are the symptoms of arthritis? The symptoms of arthritis can be: Joint pain Joint inflammation Redness and heat of the skin around the joint Decreased ability to move the joint Joint stiffness, especially in the morning What are the causes of arthritis? This pathology can be a consequence of: Bone fracture Autoimmune disease Infection by bacteria or viruses Joint wear Crystals (such as uric acid or calcium pyrophosphate dihydrate) Can arthritis be prevented? Joint damage can be prevented with timely and adequate diagnosis and treatment. Also, if someone has a family history it is important to talk with the doctor, even if s/he does not have any symptoms. It is also recommended to avoid repetitive and excessive movements to prevent osteoarthritis. What is the treatment for arthritis? The treatment aims to alleviate the symptoms and prevent the disease from getting worse. The treatment can be covered by several aspects: Lifestyle changes: this is the preferred treatment, since exercises help to reduce pain and fatigue, relieve stiffness and improve muscle and bone strength. The doctor can also recommend physiotherapy. Other measures may include sleeping 8-10 hours a day, not staying in the same position for a long time, eating a healthy diet, avoiding alcohol and tobacco, among others. Medicine: can be added to the changes in lifestyle. Surgery: is performed if the other treatment methods have not worked. The main intervention is arthroplasty, which consists of replacing the affected joint with an artificial one. ...

Arthroplasty

What is arthroplasty? The term “arthroplasty” refers to any surgical procedure to restore the function of a damaged joint, often by replacing them with artificial joints made of chromium, cobalt and titanium, along with high density plastics. The ultimate aim of arthroplasty is to correct deformities, reduce or eliminate pain in the affected areas, and restore mobility. Arthroplasty is commonly performed on the hip, knee, elbow, shoulder, and ankle, among others. Different types of arthroplasty include: Joint replacement – the damaged joint is removed and replaced with a prosthesis. Hip replacements and knee replacements are the most common. Interpositional arthroplasty – tissue, such as skin or muscle is interposed to keep inflammatory surfaces from rubbing together. Excisional arthroplasty – bone is removed from the surface of the joint to stop the bones making contact. Scar tissue is left to fill the gap. Resurfacing arthroplasty – the surfaces of the bones at the joint are replaced with a smooth, protective metal coating. Why is arthroplasty done? Arthroplasty is carried out to replace the damaged joint with a healthy one, allowing the patient to live a full and active life with adequate mobility. Arthoplasty may become necessary due to: Rheumatoid arthritis Osteoarthritis Osteoporosis Osteonecrosis Misaligned joints (often due to traumatic injury) What does arthroplasty consist of? Arthroplasty procedures are carried out under general anaesthetic. The patient’s heart rate, blood pressure, breathing, and blood oxygen are monitored, while the surgeon makes an incision and removes and/or repairs the damaged parts of the joint, before closing the incision with stitches. The process of placement of the prosthesis will be different depending on the type of joint replacement. Preparation for arthroplasty No special preparation is required for arthroplasty, other than notifying the specialist of the possibility of being pregnant and the medication the patient is taking, which may be strong in cases of rheumatic diseases and may need to be stopped or changed prior to the operation. Care after the intervention After the intervention, the patient may feel pain, which is normal in any intervention. In case of pain, the specialist will recommend the best treatment. During the hospitalisation, specialists will soon begin to move the joint, so that recovery is as effective as possible and the patient regains mobility as soon as possible. After being discharged from the hospital, the patient must go for rehabilitation for a few months to fully recover the mobility of the joint and also to check that make sure that the prosthesis is functioning properly. ...

Arthroscopic subacromial decompression

What is arthroscopic subacromial decompression? Arthroscopic subacromial decompression is a type of shoulder operation that aims to treat shoulder impingement. Shoulder impingement is a very common cause of shoulder pain and results from when tendons and bones in the shoulder rub against each other on raising your arm. Subacromial decompression is a day case procedure, so you won't have to stay overnight in hospital, and the procedure takes about an hour. It is usually performed as keyhole surgery (minimally-invasive) and uses general anaesthesia. Why is it done? The operation aims to increase the space between your shoulder blade and the rotator cuff. Not having enough space can cause pain and restrict your movement when you try to raise your arm. Impingement also causes shoulder pain. What does it involve? This procedure is mostly done using minimally-invasive techniques, and as such it can be done as a day-case. General anaesthesia is required and the surgery usually takes about an hour. You might also have local anaesthesia in the shoulder nerves to ensure you do not feel pain during the procedure. Once anaesthetised, a number of small incisions are made around the shoulder. These are usually no bigger than 5mm in size and normally 2-3 are sufficient. Through these incisions, the surgeon inserts a thin, flexible tube called an arthroscope into the subacromial space of the shoulder joint. The camera on the end of the arthroscope shows its images on a monitor which the surgeon uses to guide their surgical instruments which are inserted through the other incisions. Using these instruments, the surgeon repairs any damaged tendons and reshapes the shoulder blade. Once complete, the instruments are removed and the incisions are closed with stitches. How do you prepare for arthroscopic subacromial decompression? One of the most important preparatory measures to take is to prepare your home for your recovery, as well as arrangements for getting you home after surgery. This is nearly always a day case procedure meaning you return home the same day, therefore, you will need a friend or family member to pick you up and take you home. It is also wise to have someone stay with you for the first day following surgery. As the procedure uses general anaesthesia, you will have to fast for a duration before the operation. Aftercare: Pain relief can be given whilst the anaesthesia wears off immediately following surgery and you can return home the same day. You may have to keep your arm in a sling for a few days. A full recovery takes up to four months. During this time you may need over-the-counter painkillers to manage pain. You should also have physiotherapy during this time to help improve shoulder mobility and stability. Patients who do not do manual labour for work can return to work within a few days following surgery. Alternatives to this treatment: Some people suffering from shoulder impingement and pain won’t require this form of intervention as they will see improvements from the following treatment options: Physiotherapy Rest Steroid joint injections Non-steroidal anti-inflammatory medication ...

Biological therapy

Biological therapy involves using living organisms, or substances derived from living organisms, in the treatment of diseases.

Broken collarbone

What is a clavicle fracture? The clavicle is the long, thin bone located in the upper chest, between the sternum and the shoulder. Its function is to join the upper limbs with the thorax and keep the shoulders aligned. Clavicle fracture, or broken collarbone, occurs when the bone is broken. An injury that causes the clavicle to be broken can also cause the clavicle to be dislocated or the neighbouring acromioclavicular joint to dislocate. What are the symptoms of a clavicle fracture? If the fracture is mild, the main symptoms are: pain in the fractured bone area a feeling that the shoulder could be dislocated difficulty and pain when moving the shoulder or arm bruising, swelling or a bulge in the clavicle crunching or creaking noise when lifting the arm If the fracture is more severe you may notice: significant irregularity in the clavicle area lack of sensitivity or tingling sensation in the arm or the fingers of the hand What causes a clavicle fracture? A clavicle fracture is almost always caused by a violent impact on the arm extended in a fall or by a fall directly on the shoulder itself. It is more frequent in children, since these bones do not harden until adulthood. How is a clavicle fracture diagnosed? A clavicle fracture requires a physical examination and imaging tests. In the examination, the doctor will ask you how the injury occurred and will examine your shoulder to see if there are any irregularities. An X-ray can determine whether the clavicle has fractured and whether any other damage has taken place. What is the treatment for a clavicle fracture? In many cases, the clavicle can heal with surgical intervention. Treatment involves: medication to reduce pain and swelling keeping your arm supported in a sling exercises to gradually build up the mobility in your shoulder as it heals It is important to see the doctor regularly for follow-up scans to check the clavicle is healing in the right way. If the bone does not heal correctly, a large bump can form over the clavicle, and this may take many years to subside. Surgery is indicated in fractures that involve a displacement of the fractured bone. There are several surgical techniques, including the use of needles that are placed through the skin, the placement of plates screwed to the bone or the placement of a long screw inside the fractured bone. After the procedure, the arm must be placed in a sling for at least a few days, and no daily activities or weight lifting can be carried out for four to six weeks. ...

Carpal tunnel surgery

What is carpal tunnel surgery? Carpal tunnel syndrome is a condition which causes numbness, tingling, or pain in the hand. It is a common condition which occurs due to compression of the median nerve in the wrist, which runs down the carpal tunnel, a narrow passage on the side of the wrist. The nerve controls movement in the thumb, and fingers except the little finger. Carpal tunnel surgery is indicated in some cases to correct long-lasting cases of carpal tunnel syndrome. Why is carpal tunnel surgery performed? Carpal tunnel syndrome often clears up by itself or with therapy, but in some cases symptoms can go on for a long time, and the condition may get worse. Muscles in the hand and wrist can weaken, and everyday movements such as grasping or gripping may become more difficult to perform. Surgery is indicated in cases of long-lasting carpal tunnel syndrome, when other treatment methods have been explored and been unsuccessful. What does it involve? Carpal tunnel surgery is usually performed either as open or endoscopic surgery. In open surgery, a larger cut is made, and recovery time is generally longer. In endoscopic surgery, smaller cuts are made and a tiny camera is inserted which helps guide the surgeon as they cut inside the joint and ligament. However, in both cases the ligament around the carpal tunnel is cut, which relieves pressure around the median nerve. After surgery the ligament is brought back together, but the median nerve has more space to pass through, which permanently relieves the compression. How to prepare for it Before surgery, the surgeon will explain exactly what type of procedure they will be performing, and what to expect. Before surgery, medication will be discussed and blood thinning medications must be avoided, as they can increase bleeding during surgery. The patient should arrange for someone to escort them from the hospital, as they will not be able to drive after the surgery has been performed. Post-operative care After the operation, the wrist and surrounding area will be sore and painful, with some swelling and stiffness. A bandage is put in place and this will be kept on for 1-2 weeks. Some over-the-counter medications may help with pain relief. During the recovery period, exercises can be done which will be advised by the surgeon. This helps to prevent the fingers from getting stiff, but it is important to avoid straining them. In the period directly after surgery (2 weeks afterwards), care should be taken, making sure to only perform light tasks and light movements. Return to normal movement can be made slowly, over a period of time. It usually takes around 10-12 weeks for strength to fully return. ...

Carpal tunnel syndrome

What is carpal tunnel syndrome? Carpal tunnel syndrome is a condition which causes numbness, tingling, or pain in the hand. It is a common condition which occurs due to compression of the median nerve in the wrist, which runs down the carpal tunnel, a narrow passage on the side of the wrist. The nerve controls movement in the thumb, and fingers except the little finger. What are the symptoms? Carpal tunnel symptoms normally progress over time, and do not come on suddenly. Usually symptoms start with numbness or tingling in the fingers (except the little finger, controlled by a different nerve) or thumb, which comes and goes. Symptoms can also include pain in the fingers, or even pain in the arm occurring between the hand and elbow. Sometimes symptoms become more apparent at night. What causes carpal tunnel? Carpal tunnel syndrome occurs when the carpal tunnel inside the wrist swells and compresses, or squeezes the median nerve. There are certain risk factors, including being overweight, having another illness such as diabetes or arthritis, and doing a job or having a hobby which involves repeatedly bending the wrist or gripping objects hard. Some women also develop carpal tunnel syndrome during pregnancy. How can it be prevented? Some measures can be taken to help prevent carpal tunnel syndrome from developing. Firstly, you can take care of your health in general, by maintaining a healthy weight, not smoking, and regularly exercising. You should also exercise your arm, hand, and finger muscles to keep them strong. Try to avoid activities which place repeated pressure in the same area, and move your hand and wrist in a way that spreads the pressure over a larger area. Regularly switch hands and take breaks if performing tasks which involve a repetitive motion. Treatment of carpal tunnel syndrome Carpal tunnel syndrome can often be treated at home, as it clears up naturally in a few months, especially if you have it while pregnant. Some recommendations include: Wearing a wrist splint, which can help to keep your wrist straight, especially at night Cut down on repetitive movements which cause strain Try alternative treatments such as yoga, acupuncture, and hand exercises Try not to take painkillers as there is not much evidence that they help If your symptoms get worse or do not go away, make an appointment to see your doctor. They may prescribe medication, usually in the form of steroid injections, or in more serious cases where carpal tunnel does not go away, they may refer you on to a specialist for surgery. Surgery usually cures carpal tunnel syndrome, and is done as a day case procedure. After surgery, the hand and wrist will recover after about a period of a month. ...

Chondrocalcinosis

Chondrocalcinosis is the excessive accumulation of calcium crystals in the bones. The condition affects mostly the knees, although it is also common in other joints and bones. Normally it does not cause any symptoms or discomfort in the patients, therefore it is discovered when the patient has an x-ray. The main evidence of chondrocalcinosis is the existence of a white line in the cavities at the ends of the bone....

Elbow

What is the elbow? The elbow is the joint that joins the arm to the forearm, connecting the humerus with the proximal ends of the ulna and radius. It is formed of bone, cartilage, ligaments, and fluid. The muscles and tendons help stabilise the elbow when we move it. Trauma to any of these structures will cause problems in the elbow. Function of the elbow The elbow enables a series of movements for straightening and bending the arm. These include: Extension, using the triceps brachii muscles. Flexion, using the biceps brachii, brachialis and brachioradialis. Supination, using the short supinator muscle and biceps brachii. Pronation, using the round and the square pronator muscles. Pathologies of the elbow Many factors can cause pain in the elbow, whether injured or not. The most common of these are: Osteoarthritis. This a degenerative process that rarely affects the elbow. When it does occur, it is mainly caused by intense, continuous exercise or repetitive trauma. Arthritis. An inflammatory process that affects a joint, causing pain and an increase in temperature. Its causes are varied. In the elbow, the most common causes are: rheumatoid arthritis, psoriatic arthritis, infectious arthritis, gout and chondrocalcinosis. Epicondylitis, or tennis elbow, which causes pain on the outside of the elbow. Medial epicondylitis, or golfer’s elbow, which causes pain on the inside of the elbow. Olecranon bursitis, or student’s elbow. This is a rheumatic disease that affects the soft parts (not the bone) of the joint. Elbow luxation. Though this is less common than shoulder luxation because the surfaces of the bones fit together perfectly. The main cause is a fall onto an outstretched hand, and is usually associated with fracture. Painful pronation (babysitter's elbow or radial head subluxation). The head of the radius moves from its normal position, without completely dislocating, and is therefore referred to as subluxation. It is common in children under 5 years of age due to sudden traction on the forearm (e.g. when taking a child’s hand and pulling them to help them up steps, during physical contact sports such as judo, etc.). Fractures: Most fractures are of the lower or distal extremity of the humerus, the head of the radius and the olecranon of the ulna. Monteggia fracture. This is a complex and rare injury where luxation of the radial head at elbow level is associated with a fracture in the proximal third of the ulna. Terrible triad of the elbow. This is a severe injury that is usually caused by a fall onto an outstretched hand. This type of injury is usually accompanied by luxation, with a fracture of the radial dome and the coronoid process of the ulna. Treatment involves surgery. Treatments for elbow pathologies Treatment will depend on the cause of the problem. To diagnose any elbow injury, various tests need to be performed: direct arthrography, radiography and nuclear magnetic resonance imaging, among others. Once the diagnosis has been made, the specialist will decide how best to treat the elbow pathology in each case. Normally, the main measure taken to treat the injured structure is to reduce inflammation, restrict mobility and alleviate pain, weakness and functional disability. This is why it is important, first of all, to administer NSAIDs (anti-inflammatory drugs), to put the arm in a sling, or similar, to limit mobility and to have physiotherapy. Physiotherapy will generally involve cryotherapy (application of cold), electrostimulation (TENS), a passive stretching programme for the pronation and supination muscles (those involved in twisting the forearm), wrist extensions and flexions, together with postural recommendations. Once the pain has subsided, exercises can be carried out to strengthen the muscles of the affected arm. If the injury is more severe, the specialist may recommend other procedures. These may include elbow arthroplasty, surgery for tennis elbow or, if surgery is not recommended, injections into the joints and soft tissues. Which specialist treats elbow pathologies? Elbow pathologies are treated by an orthopaedic specialist. There are also orthopaedic surgeons who specialise in elbow problems and therapeutic treatments. ...

Elbow Pain

What can cause elbow pain? The elbow is a complex joint formed by bones, cartilage, ligaments and fluids. The muscles and tendons help to move the joint and if any of these parts suffers any damage, the pains and problems appear. Elbow pain can occur as a result of: Muscle strain or sprain – the muscles or ligaments in your elbow can be strained from overexertion. However, with rest and proper support, they should heal over time sand your symptoms should improve. Bone fracture – this usually occurs as a result of playing sport or a fall, and is a sudden injury. You may still be able to move the elbow but it will be painful to do so. It’s important to seek medical help if you suspect you’ve had a fracture, as leaving the elbow untreated can lead to the bones not healing properly Dislocation – this occurs when one of the bones in the elbow moves out of place, causing significant pain. You should get medical help for a dislocated elbow immediately. Tendinitis – certain movement, such as arm movements involved in playing golf or tennis, can result in the tendons in your elbow becoming inflamed from overuse. These injuries are not limited to sports players – they can happen to anyone who frequently carries out a similar arm movement, such as at work. Bursitis – another injury from repetitive arm movement, where sacs containing fluid become swollen and cause pain in the elbow. Arthritis – both osteoarthritis (wear and tear of the cartilage in your elbow) and rheumatoid arthritis (a condition causing inflammation in your joints) can result in joint pain in the elbow. In this situation a rheumatologist will recommend the best treatment. Trapped nerve – everyone has a number of nerves travelling down the arm, through the elbow and the hand. Sometimes a nerve can get trapped in the elbow, causing constant pain and some tingling. This can also cause similar symptoms in the hand and fingers. Who should I see about elbow pain? You should see your GP in the first instance, who is likely to refer you for imaging tests (such as an X-ray or MRI), and possibly to a specialist orthopaedic surgeon for further investigation. The orthopaedic surgeon will coordinate your care, which can involve: splints and other support for the elbow anti-inflammatory injections and medication physiotherapy in severe cases, elbow surgery In the case of arthritis, your care will be coordinated by a rheumatologist. ...

Elbow replacement

What is elbow replacement surgery? Elbow replacement surgery involves replacing and repairing the damaged parts of the elbow joint. This surgery aims to relive pain caused by conditions such as arthritis. The damaged joint is replaced with an artificial joint made from two implants that are attached to the bones. The implants are joined by a metal and plastic hinge. The procedure is similar to hip and knee replacement surgery. Why would you need elbow replacement surgery? Elbow replacement surgery will be recommended if non-surgical treatments have failed to relieve pain. Pain in the elbow can be caused by: Rheumatoid arthritis Wear and tear arthritis (osteoarthritis) Injury-related arthritis or instability Severe elbow fractures Failed previous elbow replacement surgery. This is known as revision elbow replacement. What does elbow replacement surgery involve? An incision is made at the back of the elbow, through which the muscles are gently moved to allow access to the joint. Once any scar tissue around the joint has been removed, the implants will be installed. The stems of the implant are placed into the humerus and ulna bones, and kept in place with special cement. Both stems are connected by a hinge. Sometimes a temporary draining tube is placed in the wound where the incision was made, which is removed after the first few days following surgery. How to prepare for elbow replacement surgery Before surgery certain medications will have to be stopped. It is also important to make sure your home is prepared to allow a smooth recovery, such as placing objects you need on lower level shelves. Surgery is carried out under either general anaesthetic or regional anaesthetic. Post-operative care After surgery, antibiotics are given to reduce any chances of infection. Pain management medication will be prescribed for the short-term as well as a level of pain is expected during the healing process. During recovery certain exercises that help with mobility and strength need to be carried out. Physcial therapy sessions will help show you how these exercises work. ...

Epicondylitis (tennis elbow)

What is lateral epicondylitis? Lateral epicondylitis, also known as tennis elbow, is an injury that causes pain on the outside of the elbow. It is due to repeated wrist extension and forearm supination movements. Repeated use of these muscles causes microinjuries to the tendon. If this persists over time, irritation and pain develops on the outside of the elbow. Although commonly known as tennis elbow, this condition is suffered not only by tennis players but also by anyone who performs work that involves repetitive stretching and flexing movements of the forearm and wrist; for example, professional painters, mechanics, labourers or those who work long hours in front of a computer using a mouse. Prognosis of the disease Lateral epicondylitis is not a very serious injury, though it can significantly affect your life. Most people improve with non-surgical treatments and the condition can even be cured. Symptoms often persist for several months before the condition is completely cured. Symptoms of lateral epicondylitis Lateral epicondylitis is characterised by the following symptoms: pain and movement difficulties when extending the wrist pain on the outside of the elbow pain with some basic movements, like lifting a cup of coffee This pain does not go away with rest or by applying local cold or taking anti-inflammatories. Medical tests for lateral epicondylitis Every trauma specialist should perform a thorough evaluation in order to diagnose lateral epicondylitis. Among other procedures, this will include: a visual exam to check the appearance of the skin, possible swelling of the area, and to make sure the joint is aligned properly using the hands to feel the area and evaluate pain a "chair test", which entails lifting a chair with the palm of the hand facing downwards and the elbow in extension. Pain usually prevents this action from being performed Pain assessment, by extending the fingers and wrist against resistance, and extending the middle finger against resistance with the elbow extended other assessments of pain and mobility such as the Mill’s manoeuvre Can it be prevented? Lateral epicondylitis can only be prevented with careful “postural hygiene”. Proper movements during sport and work will ensure that the tendons are not subjected to excessive stress. Resting your elbow well after a busy session can also help prevent epicondylitis. Stretching and preventive massages, as well as elbow pads, are helpful. Treatment for lateral epicondylitis Treatment for an injury of this nature should be gradual and depend on the severity of the injury. Initial recommendations include: nonsteroidal anti-inflammatory drugs, oral or topical. resting the elbow, reducing activities that cause pain and reducing the duration and intensity of exercise. physiotherapy and application of local heat, massages, shock waves, ultrasound, as well as exercises and techniques. If these measures are not effective, the following will be recommended: Local corticosteroid infiltrations or injections (with or without anaesthetic). These can improve pain for a period of time and stimulate healing when injected near the affected area. In some cases, three infiltrations are performed at 1-2-week intervals. However, infiltrations are usually limited to three, as there is a slight risk of rupture of the tendon and tendon insertion. At present, platelet-rich plasma infiltrations are also used. Limiting movements or activities that cause epicondylitis. In this respect, a study of your workplace should be carried out, which will be key to a successful cure. You should also reduce the practice or play intensity of racquet sports. If the above treatments also prove ineffective and you still suffer from the symptoms and pain of epicondylitis, surgery will be the next option. Surgery can be performed with an open incision, or using arthroscopy. Arthroscopy is currently the most commonly-used technique as it gives access to the lesion, with a miniature camera, through two or three small incisions. This technique is minimally-invasive, so recovery is faster and less painful. Which specialist treats it? Epicondylitis is treated by a trauma specialist, who usually has specific training in the treatment of elbow pathologies. Other professionals may be involved during recovery from an epicondylitis injury, such as physiotherapists, who will provide practical exercises to restore movement, and orthopaedic surgeons, to repair the tendons in the elbow when other treatment approaches have failed. ...

Fractured elbow

What is a fractured elbow? An elbow fracture is when there is a break in one or more of the three bones that make up the elbow joint. It normally happens after an injury, like a blow to the elbow, a fall, or a twist. The fracture may also be sprained, strained, or dislocated. Fractures can be: Bone fissure: it is a clean break, but there could be complications. Displaced: where two ends of the bone separate. Non-displaced: the bone is broken but stays in place. Open: when the bone goes through the skin. Comminuted: when the bone breaks in many pieces. The most common types of fracture are: Radial head and neck fracture: the patient is in more pain when rotating the palm of the hand upwards or downwards. Treatment will depend on what kind of break it is and how many fragments there are. If it is a complex fracture, the joint may need surgery to be repaired, or to remove or replace the radius (if there are multiple fragments). Olecranon fracture: these are usually displaced and require surgery to realign the bones with nails, wires, plates, or screws. Distal humerus fracture: these are more common in children and the elderly. They are often associated with nerve or artery damage and should be examined. Treatment is normally surgical and plates or screws are used. Prognosis Elbow, ulna, and radius fractures are quite common, especially in backward or hand supported falls, or when there is elbow hyperextension. Although it is not a very serious injury, rehabilitation can take time to recover mobility, especially joint movement. What are the symptoms? The most common symptoms are: Joint pain and sensitivity. Swelling and bruising. Elbow, arm, and hand numbness as well as weakness. Inability or difficulty to move the arm. Arm Deformity or swelling. A snap may be heard at when the fracture happens. If there is a visible change, it may mean that the bones are out of place or the joint is dislocated. Medical tests An orthopaedic surgeon will evaluate the injury. They will first check for skin injuries, then see if the patient has less sensitivity. They will also check if there are any mobility issues. The following tests may be carried out: X-rays: to check the bone fracture. If a fracture can’t be seen, it may be a displaced fat pad. More X-rays should be taken from different angles. CT scan or MRI scan: this is used to see the fractured bone and to check if surrounding tissues are affected. The contrast dye enables the bones to be seen clearer. What causes it? The most common causes for an elbow, radius, and ulna fracture are a fall, a direct blow to the joint, or a twist. Osteoporosis also increases the risk of an elbow fracture. How can it be prevented? Elbow fractures are difficult to prevent. However, it is easy to improve symptoms and pain by following the recommendations given by the specialist. Examples of these tend to include: Raise the elbow above the heart to reduce inflammation and pain. Propping the elbow up with pillows, moving the fingers, and opening and closing them can help prevent hand stiffness. Apply ice to the elbow to help relieve swelling and pain, as well as potential tissue damage. Remember to apply ice through a towel. It should be applied for 15-20 minutes every hour more or less. Take painkillers, according to the specialist’s instructions. The patient shouldn’t wait until the pain is unbearable. The specialist will recommend how often they should be taken, and prescribe them. Physiotherapy and rehabilitation exercises. The physiotherapist will recommend exercises to improve joint movement as well as to regain muscle strength. What is the treatment? Elbow fractures don’t tend to need surgery and are treated with a sling, a cast, or a splint (when there is little risk of the bones moving out of place). Treatment will depend on the patient's age and their daily activities. It is quite common to put a plaster cast on children, as it is unlikely that they’ll have elbow stiffness which is more common in adults. To avoid this, rehabilitation exercises are recommended, along with applying heat, ice, or having massages. In more serious fractures that are out of place or unstable, surgery may be necessary. The procedure involves replacing and stabilising the bone fragments or removing them. If there is an open fracture and the skin is broken, the wound and bone should quickly be cleaned to avoid the risk of infection. What specialist should I see? The specialist who treats elbow fractures is an orthopaedic surgeon, of which there are those who specialise in treating elbows. ...

Fractured humerus

What is it? The humerus is the longest bone in the arm. It is articulated with the scapula by the shoulder, ulna, and the radius in the elbow joint. The most common injury of this bone is a humerus fracture. This mainly affects the elderly and young people. Humerus fractures can be classified by the area affected: the upper, centre, or lower section. Prognosis Recovery will depend on the following criteria: Patient age: if over 45 years old, the risk of abduction limitation increases. Level of muscle contusion (bruising), especially the deltoid muscle. Shoulder muscle strength. Obesity Level of patient cooperation and understanding. There are other factors that can slow down recovery: Inadequate rehabilitation. Being over 45 or 50 years old makes recovery more difficult. Insufficient muscle development Obesity Bone tearing with fragment displacement Taking too long to get the correct diagnosis. What are the symptoms? Humerus fracture symptoms tend to be immediately noticeable, as there is often a loud snap or crack which is often an indication that the arm is fractured. There are other symptoms, including: Severe pain that increases with arm movement. Swelling. Haematomas. Deformity of the arm or wrist. Inability to rotate the arm. If the patient is in a lot of pain and cannot use their arm, medical help should be sought as soon as possible. Delaying diagnosis and treatment can lead to poor healing. Medical tests X-rays are used to diagnose humerus fractures. This can help determine the extent of the injury, locate the exact location of the fracture, and see if it has affected a nearby joint. The doctor may order a CT scan in order to get a more detailed image. How can it be prevented? There are certain sports and conditions that can increase the risk of fracturing the humerus. These include; basketball, rugby, wrestling, football, hockey, snowboarding, or skiing. Osteoporosis, a condition that weakens the bones, or a fall, even from a short distance, can also cause a humerus fracture. What is the treatment? There are different treatments for a humerus fracture, the one used will depend on the type of fracture. Treatments include: Bone adjustment: if the patient has a displaced fracture, the specialist will have to manipulate different parts of the humerus to ensure it is in the right place. The patient may need a muscle relaxant, a sedative, or even general anaesthetic if the pain and swelling become unbearable. Immobilisation: the patient may need to use a sling, splint, brace, or plaster cast to immobilise the broken bone and ensure it is healing. Immobilisation time may vary, but it tends to be between 3 to 20 weeks. Medications: the specialist may prescribe painkillers to help with the pain and swelling. Physical therapy: it is important to start movement rehabilitation to minimise arm, hand, and shoulder stiffness while the arm is still in a cast or sling. Once these have been taken off, the specialist will recommend exercises to regain muscle strength, joint movement, and flexibility. Surgery: in some cases surgery is needed to stabilise fractures. Fixation devices such as; wires, plates, nails, or screws, may be needed to maintain proper bone position during healing. The risk for complications is low, but there could be an infection and lack of bone healing. Which specialist should I see? A traumatologist, or orthopaedic specialist treats humerus fractures. ...

Fractured shoulder

The shoulder fracture is a break or a crack in the collarbone, in the scapula or the proximal humerus. In the latter case, it would be called fracture of the humerus. Shoulder fractures often result from a sudden force applied on the arm (a serious fall, a lesion when doing sports or a car accident). The most common symptoms of this injury are pain, swelling, tenderness, deformity under the skin, violet colour or skin discoloration, cracking and inability to move the arm. In general, the treatment of a fractured shoulder involves surgery, but we must also take into account the conservative options and minimally invasive surgical options such as arthroscopy. ...

Frozen shoulder

What is a frozen shoulder? A frozen shoulder is a condition that causes pain and stiffness in the shoulder and hence a loss of mobility. The shoulder joint capsule has ligaments that hold the shoulder bones together; when this capsule becomes inflamed, the bones are not able to move freely in the joint, causing a stiffened, frozen shoulder. Prognosis: Typically, frozen shoulder treatments help to restore mobility and the functioning of the shoulder after one year; even without treatment, it may improve after two years. In cases that are treated by surgery, this should be followed with physical therapy for a few weeks or months to prevent the frozen shoulder from returning. Frozen shoulder symptoms: The main symptoms of frozen shoulder are pain, stiffness, and decreased joint mobility. Medical tests for frozen shoulders: To make a diagnosis of frozen shoulder, the specialist will ask the patient about their symptoms, examine the shoulder, and they may also require x-rays or, less often, an MRI scan. What causes a frozen shoulder? There are no specific causes of a frozen shoulder, although there are some risk factors: Shoulder injury and/or surgery Diabetes Thyroid problems Parkinson’s disease Hormone changes Can a frozen shoulder be prevented? Generally, a frozen shoulder cannot be prevented, however, if you have suffered a shoulder injury or have recently had shoulder surgery, you should practise certain exercises to keep the joint mobile and avoid stiffening. If your shoulder does become stiff, you should see a specialist as soon as possible. Frozen shoulder treatments: Frozen shoulders can be treated with NSAIDs and steroid injections, in addition to physical therapy. It may take a few weeks to see progress, and a few months to achieve a full recovery. Frozen shoulder surgery is recommended when non-surgical treatment is not effective. In these cases, it is performed by a shoulder arthroscopy, which is done under anaesthesia. Which specialist treats frozen shoulder? Orthopaedic surgeons treat cases of frozen shoulder. ...

Hand

What are hand pathologies? The most common hand problems include: Carpal tunnel syndrome: compression of the nerve that passes through the wrist, causing frequent numbness of the fingers, tingling and pain Injuries: including fractures, torn ligaments, and dislocations Osteoarthritis: a degenerative disease that affects joints and cartilage. The cartilage that cushions the joints breaks down, causing bones to rub against each other, pain sets in and this can lead to hand deformity and weakness Tendonitis: severe irritation of the tendons that connect muscles in the body to the bones. Symptoms include swelling, inflammation and pain when using the hands Injuries and diseases of the fingers: fractures, breaks and specific deformities of the fingers Symptoms of hand pathologies Where there is a condition of the hand, the most common symptoms are: Pain in different areas of the hand, from the wrist to the fingers Tingling or numbness in the hand and fingers Swelling that is painful to touch Weakness of the hand Stiffness of the hand and fingers Change in colour or temperature of the hand or fingers What are the causes of hand pathologies? The hands suffer, to a large extent, from wear and tear, which happens earlier in men than in women. Other causes of hand pathologies include: Lack of calcium; calcium is essential for strong and healthy bones. A lack of calcium, which can be obtained from dairy sources, broccoli, some leafy green vegetables and beans can lead to weaker bones, increasing the risk of bone-related diseases like osteoporosis Hormonal changes; for example, as menopause approaches. A drop in oestrogen levels during menopause can affect the hydration of the joints and tendons, causing cracking fingers, stiffness and inflammation Injuries Bone-related diseases such as osteoporosis and osteoarthritis Pregnancy Auto-immune diseases Can they be prevented? Hand pathologies can be prevented by regular exercises that relax the joints at times of constant work. These exercises are based on the movement of the wrist and the stretching of the fingers, all of them with the purpose of relaxing the hand, getting rid of the stiffness and making the hands more flexible. By following a diet rich in calcium, vitamin D and omega 3, you can also help to keep the bones and joints healthy. What does the treatment involve? The treatment for the hand will depend on the ailment, but all treatments are aimed at restoring functionality. Some injuries can be treated with rest and cessation of activity, but some fractures and diseases that cause limb deformities will require surgery. ...

Hand fracture

What is a hand fracture? A hand fracture, or broken hand, affects one or more of the bones found in the hand. It occurs when the bone(s) break or crack, often as the result of a fall or through sporting activity. A fracture can be simple, involving only a few fragments of bone, or it can be more complex, involving multiple fragments. Fractures can also be closed, meaning there is no break in the skin, or compound (open), where the skin breaks over the fracture. What causes fractures? A blow to the wrist or hand, or an injury crushing the hand can result in fractures and breaks in the bones. Fractures are commonly caused by falls, particularly onto an outstretched hand when trying to break the fall. Contact sports can be a cause of such falls, along with sports like skiing, skating, or snowboarding. Fractures can also be caused by trauma to the hand in high-impact situations like a car crash. What are the symptoms of a fracture? A broken wrist or hand can cause the following symptoms, which are usually immediate, and require urgent medical attention: Swelling Tenderness to the touch Severe pain which gets worse when gripping an object or when moving the wrist/hand Deformity in the wrist or fingers Stiffness or complete inability to move fingers Bruising Numbness Risk factors for fractures Playing contact sports or engaging in high-impact activities can increase your risk of breaking a bone. Some particularly high-risk sports include hockey, rugby, football, skating, trampolining, horseback riding, skiing, and skateboarding. It is impossible to prevent fractures, but you can try to protect your bones as best as you can by doing strengthening exercises, wearing a wrist guard, and avoiding situations which might cause a fall, such as walking on slippery surfaces. What is the treatment? To diagnose a broken or fractured hand, X-rays are usually taken, along with a physical exam done by a healthcare professional. There are various methods of treating a broken hand, and the treatment depends on the severity of the fracture. Often the doctor first moves and manipulates the pieces of bone and fragments back into their correct position, frequently done under anaesthetic. Treatment can then consist of: Medications: in order to help reduce pain or, in the case of an open fracture, help the wound to heal, pain medication or antibiotics may be prescribed Restricting movement: in order to help the bones heal, the affected area must have movement restricted, usually meaning a cast or splint is placed Surgery: some patients may need to have their bones held in place by screws, rods, and plates, which will help them to heal. Surgery may be necessary if bones move after being immobilised Physical therapy: rehabilitation exercises may be utilised which can help restore the movement in your hand, fingers, and wrist Fractures can take several months to heal, and over this time your progress will be monitored, in case a different course of treatment is deemed necessary. ...

Hand injury

What are hand injuries? There are many different types of hand injuries, most of which occur due to trauma, but some also occur due to over-exertion or compression. Injuries can occur to the bones, muscles, nerves, ligaments, and skin of the hand, wrist and fingers, and different treatments are needed for different injuries. Some common types of sudden hand injury include: Breaks and fractures – blunt trauma to the hand, wrist, or fingers can fracture or even break the bones in these parts of the body. Dislocations – when a bone is pushed or pulled out of its normal place. Lacerations – cutting the skin on a sharp object is one of the most common hand injuries. Burns – damage is mainly done to the skin and soft tissue. Sprains (joint injuries) Strains (pulled muscles) Crushing injuries – these can lead to compartment syndrome, where an area of tissue becomes enclosed and swells, leaving the muscles, nerves, and blood vessels no room to expand. This is incredibly painful and can cause tissue death if left untreated. Tendon injuries, e.g. mallet finger Ligament injuries, e.g. skier’s thumb Some common types of overuse injury are: Carpal tunnel syndrome – the median nerve in the wrist becomes trapped, leading to pain, tingling, numbness, and weakness in the hand and fingers. Tendonitis – a series of tiny tears in a tendon due to overuse. De Quervain’s disease – the tendons on the part of the wrist nearest the thumb become inflamed and swell up. What are the symptoms of a hand injury? Different injuries cause different symptoms. Most traumatic injuries will cause pain, bruising, and often swelling. Fractures and breaks often limit the hand’s range of movement, and cause weakness. They may also be accompanied by bleeding or numbness, and severe cases can cause deformity. Lacerations are characterised by bleeding, which in turn can cause weakness and pallor, while burns can cause redness, blistering, black areas of tissue, discolouration, and alterations or deformities of the skin, depending on the severity. Overuse injuries typically result in pain and soreness, and may also lead to numbness, tingling, and weakness. What causes hand injuries? Hand injuries can either be caused by some sort of trauma or by overuse. The most common cause is blunt trauma, resulting in injuries like breaks, fractures, sprains, and dislocations. Overuse injuries are caused by repetitive tasks or by over-exertion. Contact sports, falls, fights, and strenuous tasks all carry the risk of injuring your hands. Sports that involve using the hands for weight-bearing (such as gymnastics) or for holding equipment (such as ski poles) can also cause injury. Nerve injuries, such as carpal tunnel can be caused by repetitive motions, such as typing on your computer. Lacerations are also very common, and are usually caused by contact with a sharp object, while burns are caused by excessive heat or fire. What is the treatment for hand injuries? The treatment depends on the type, location and severity of the injury. Some injuries may heal on their own, while others may need help in the form of a cast, splint, bandage, or physical therapy. If more conservative treatments don’t work, your doctor may recommend surgery. If the injury is severe, surgery may be required immediately. Serious breaks, fractures, laceration and burns require immediate medical attention, and if a crushing injury causes compartment syndrome, this too is an emergency. ...

Hand nerves surgery

Hand nerves surgery includes various surgical procedures to restore hand function without altering their aesthetic appeal. It can be done due to many reasons, including injuries in the hand, rheumatic changes in the structures of the hand, congenital deformities (present at birth) and infections. These include carpal tunnel syndrome and Dupuytren’s contracture. Therefore, depending on the cause of the problem, you can perform skin grafts, immobilisation of a fractured bone, tendon repair, joint replacement, relocation, surgical drainage, fasciotomy and repair of nerves in the hand (ulnar, median and radial). Damage to these nerves can cause decreased ability to move the hand and sensitivity. ...

Hand surgery

What is hand surgery? Hand surgery may be performed for various reasons, including infection to the hand, injury to the hand, or to correct long-term conditions affecting the hand. Surgery may be done on different areas of the hand, and it can be advised to correct either the bones or soft tissues in the hand. Hand surgery is usually performed by either a general surgeon, an orthopaedic surgeon, or a plastic surgeon. Why is hand surgery performed? Hand surgery is often performed to correct the following conditions: Carpal tunnel syndrome Trigger finger Hand injuries and trauma Tendon repair Joint replacement Congenital defects Inflammatory arthritis Dupuytren’s contracture A bone deformity or extra growth (such as metacarpal bossing) What does hand surgery involve? Surgery on the hand varies depending on the type of condition it is attempting to correct. Many surgeries are performed as minor day case operations, meaning the patient can leave the hospital on the same day the operation is performed. Some operations are performed under local anaesthetic, meaning the patient is awake. Day-case operations are usually preferred as they allow for quicker healing time. What is the aftercare for surgery? Surgery may also be accompanied with physiotherapy or visits to a specialist who will show the patient how to strengthen their hand and monitor movement and function. Depending on the surgery, a splint may also be advised to help along the healing process. Healthcare providers will schedule follow-up appointments to check progress. In some cases stitches may need removing. Depending on the surgery, it can take around a month or longer to fully heal and be back to normal. How to prepare for hand surgery Before any type of surgery, discuss the procedure and its potential risks with your surgeon. Any type of surgery, even minimally invasive, carries risks, and it is important to be aware of what could happen. Ask your doctor, surgeon or healthcare provider to explain anything that you do not understand before surgery. Your general health will also be checked to make sure you will not have any problems going under a general anaesthetic, should this be used during the procedure. Before going for surgery, plan your visit to the hospital, as you will have to do things one-handed afterwards. Think about the clothing you will wear, the route you will take, and if you need a friend to come help you with transport. Talk to your surgeon to be clear on the procedure and understand what is expected of you on the day. ...

Hand tendonitis

What is wrist tendonitis? Tendonitis is a common condition which happens when a tendon swells and becomes painful after an injury. Wrist tendonitis affects the tendons around the wrist joints, causing them to become inflamed and irritated. It usually affects one tendon in the wrist, but it may involve more. Tendons connect muscles in the body to the bones, and tendons which are found in the wrist connect the muscles found in the forearm to the bones in the hand, and finger bones. There are various tendons surrounding the wrist, and any one of them can become inflamed and irritated, causing pain or discomfort when moving the wrist. What are the symptoms? Usually patients complain that they feel pain in the wrist. They may also notice swelling, and the tendons may feel warmer than they usually do. Some redness may be apparent. Sometimes patients report that they feel a ‘grinding’ sensation from the affected tendons. What causes tendonitis? Hand and wrist problems usually occur through injury, general wear and tear, or overuse. Tendonitis can be caused by an injury, but more often it is caused through repetition of the same movement over a period of time. These movements can lead to overuse, which in turn can cause tendonitis. What is the treatment? Many cases of tendonitis heal over time with self-care and the proper home treatment, which aim to relieve pain and reduce inflammation. Resting the wrist, supporting it with a bandage, and applying ice on the injury can help swelling to go down and help reduce pain. Taking painkillers can help with mild pain. However, not all cases can be treated through lifestyle modifications and home treatments. In some circumstances, doctors may recommend specific medications, like anti-inflammatories or corticosteroids. Muscles and tendons also may need strengthening, and physiotherapy can help with this. In more long-term or severe cases, surgery may be recommended to repair the tendon and remove the damaged tissue. How can it be prevented? Like many wrist and hand injuries, tendonitis cannot really be prevented, but risks can be minimised by taking care of your body and avoiding movements or activities which can put strain on it. To prevent tendonitis as far as is possible, make sure to warm up correctly when doing exercise, and stretch properly when cooling down. Avoid repetitive movements, and take breaks to minimise strain or overuse. ...

Inflammatory arthritis

What is inflammatory arthritis? Inflammatory arthritis is one of the two major sub-categories of arthritis (the other being osteoarthritis), and, as its name suggests, it is characterised by the inflammation it causes in the joints and surrounding tissue. Most forms of inflammatory arthritis are thought to be autoimmune diseases. There are many different types of inflammatory arthritis, including the following: Rheumatoid arthritis – one of the most common types of arthritis, this autoimmune disease is thought to be caused by the body’s immune system attacking the joints. Psoriatic arthritis – a type of arthritis that may develop alongside the skin condition psoriasis. Ankylosing spondylitis – inflammatory arthritis primarily affecting the spine and back, AS can cause pain anywhere between the buttocks and the neck. The vertebrae may fuse together, robbing the spine of its flexibility. Juvenile idiopathic arthritis – the most common type of arthritis that affects children. Lupus can also have arthritic effects on the joints. What are the symptoms of inflammatory arthritis? The main symptoms of inflammatory arthritis are: Pain in the joints and surrounding tissue Swelling and tenderness Warmth in the affected areas Joint stiffness, particularly in the morning. These bouts of stiffness typically last longer than in osteoarthritis. Depending on the type of inflammatory arthritis, other parts of the body might be affected, causing additional symptoms, such as: Skin rashes Inflammation of the eyes Hair loss Fever Dry mouth What causes inflammatory arthritis? The causes of inflammatory arthritis are not fully understood, but most forms are thought to autoimmune. This means that the body’s own immune system mistakenly attacks healthy cells in the body’s tissues, wrongly identifying them as a threat. It is not understood why the immune system turns on the body it should be protecting in this way, but it is believed that genetics are a factor, along with other triggers, which may differ depending on the disease. What is the treatment for inflammatory arthritis? While the condition cannot be cured, inflammatory arthritis can be managed and its symptoms relieved. The aim is to improve physical function, reduce long-term complications, prevent further damage to the joints and organs, and send the pain and inflammation into remission. Inflammatory arthritis treatment depends greatly on the type, the severity, the symptoms that manifest, and the patient involved. Always consult your doctor to discuss the right treatment for your case. Some common treatments for the various forms of inflammatory arthritis include: NSAIDs (non-steroidal anti-inflammatory drugs) – these may be prescribed to relieve pain and inflammation, and have proven effective in managing the symptoms of rheumatoid and psoriatic arthritis. DMARDs (disease-modifying anti-rheumatic drugs) – medicines that work to change the course of the disease. One subset of these are biologic drugs, which work quickly, and may be prescribed to patients with rheumatoid arthritis. Another new variety of DMARDs are JAK inhibitors. Corticosteroids – these can quickly stop inflammation that threatens to cause significant damage to the joints or internal organs, but are used less commonly than other medications. Topical treatments – a variety of creams, gels, lotions, and shampoos are available to deal with the skin symptoms brought on by psoriatic arthritis. Surgery is an option for severe cases, when the patient’s daily activities, movement, and independence are threatened by their arthritis. Joint replacement can help to restore mobility in the joints and improve quality of life. ...

Joint injections

Joint injections are a treatment against joint pain that involves the injection of anti-inflammatory drugs and analgesics to improve joint mobility. It is a quick and simple technique, is minimally invasive, and produces longer-lasting effects compared to those obtained through a drug administered orally or intramuscularly. ...

Joint preservation surgery

What is joint preservation surgery? Joint preservation surgery covers a number of treatments that are an alternative option to joint replacement surgery. The aim of joint preservation surgery is to restore functionality to a joint so that it does not have to be replaced, or to delay the need to replace a joint. Joint preservation can be achieved through osteotomies (cuts to the bone) to allow the realignment of the joint. Why would you need joint preservation surgery? Joint preservation is usually required to address the problems caused by osteoarthritis. Although joint preservation cannot cure arthritis, it can help to relieve pain and discomfort. This form of treatment would be offered to those where non-surgical options have failed. Joint preservation is also more successful in patients who only experience joint pain in certain areas of the joint and the joint as a whole. What does joint preservation surgery involve? During the osteotomy procedure, two small incisions are made, through which a camera is passed to allow the surgeon to assess the damage. An incision is made above the tibia so that the bone can be cut, to allow the realignment of the knee so that the patient’s weight is transferred to the healthier side of the knee joint. The procedure takes up to two hours. Post-operative care After joint preservation surgery, patients usually stay in hospital for 2-4 days. Afterwards, crutches are needed for up to 6 weeks. After two weeks, certain movements can be carried out to restore range of movement and muscle strength. Intense, physical activities can be resumed 4-6 months after surgery. ...

Joint replacement

What is joint replacement? Joint replacement refers to one of a number of surgical procedures in which damaged or diseased parts of a joint are removed and artificial replacements are fitted. Joint replacement surgery can be performed on a number of joints in the body, most commonly the hip and knee, but joints in the shoulders, elbows, fingers, and ankles can also be replaced. Why would you have a joint replacement? Joint replacement surgery may be necessary if one of the patient’s joints has become damaged due to arthritis, disease, or simply wear and tear from age, and this damage is causing the patient pain and affecting their quality of life. The doctor will probably suggest more conservative treatments, such as physical therapy or medications, before recommending surgery. Joint replacements can help to relieve pain and help the joint to regain some of its function, facilitating movement. However, the surface of the replacement can also wear away with time, and after 15-20 years another replacement may be necessary. What does joint replacement involve? The surgery is performed in a hospital or outpatient centre. The patient is anaesthetised so that they can’t feel pain during the operation. The surgeon will then remove damaged bone and cartilage from the joint and replace them with prosthetic parts, which may be made from metal, plastic, or ceramic. How to prepare for joint replacement In the weeks before the surgery, your doctor will run a series of tests, such as blood tests and a cardiogram to check your general health and plan the surgery. Your doctor will advise you on any preparation you will need to do for your particular operation. For many joint replacements, recovery can be a long process and may make movement difficult for a while – especially hip and knee replacements. For this reason, it is a good idea to plan ahead and make sure you have help and any assistive items, such as handrails or a shower bench after the surgery. Post-operative care Each patient and each operation is different, but in the vast majority of cases, physical rehabilitation is needed to aid recovery. Your doctor will usually advise you to start using the new joint soon after the surgery is complete, which should help to get your body used to it and speed up the recovery process. There is often some pain afterwards, which can last for a few months, as the tissues heal and the muscles become strong again. Exercise can be challenging, but it is crucial to recovery, and your doctor will advise you on how to exercise the muscles around the joint. In the long term, joint replacement generally improves motion, reduces the pain felt previously, and improves the patient’s quality of life. ...

Median nerve

What is the median nerve? The median nerve is one of the nerves in your arm, extending into the hand. It is the only nerve which passes through the carpal tunnel, one of the passageways that connects the hand to the forearm. The median nerve controls the function and feeling in most of the fingers in your hand as well as part of your palm. The only fingers the median does not control is the little finger, and part of the ring finger, which are controlled by the ulnar nerve. The radial nerve is also responsible for some sensation in the hand. How can the median nerve become injured? The two most common places for the median nerve to become damaged or compressed are at the elbow and at the wrist. A number of elbow injuries can affect the median nerve, including a fracture, or dislocation. When the median nerve is compressed at the elbow this is known as Pronator teres syndrome. This is often caused by repetitive turning grasping and twisting of the hand and wrist, often involved in jobs work heavy manual labour, weightlifting, or racket sports. Pronator teres syndrome can also be caused by body abnormalities, a tumour, or scar tissue. At the wrist, compression is known as carpal tunnel syndrome. This is a common condition which tends to affect women more than men, but the exact cause is unknown. What are the symptoms of a median nerve injury? Symptoms can vary depending on the injury. Compression on the nerve can cause pain, particularly at night, a tingling sensation in your fingers, numbness and weakness in the hand. Fracture, trauma or dislocation that has caused damage to the nerve can also cause numbness or weakness. You might find it difficult to turn the hand over, grip things, or move the thumb across the palm. If the nerve has been severely damaged this can lead to muscle wastage. How is an injury to the median nerve treated? When the median has been damaged by an acute injury at the elbow or wrist (such as a fracture or dislocation), the first line of treatment is to address the initial injury. Soft tissue injury can be treated with compression, applying ice, and keeping the arm elevated. A bone fracture which is unlikely to heal in the correct way, or which is putting pressure on the nerve, may require surgery. Carpal tunnel syndrome can be treated very easily with carpal tunnel surgery. This is a quick procedure which releases space in the carpal tunnel for the median nerve, and provides immediate relief of symptoms. Most treatment aims to prevent any further damage. Existing damage to nerves is likely to be permanent and you cannot always regain lost function or strength. Therefore it’s important to see an orthopaedic surgeon as soon as possible if you experience the symptoms above. ...

Orthopaedic surgery

What is orthopaedic surgery? Orthopaedic surgery is the field of surgery responsible for diagnosing and treating a wide range of conditions of the musculoskeletal system, as well as for reducing the symptoms of any conditions affecting it. These conditions can affect the bones, cartilaginous structures or the joints. What conditions does orthopaedic surgery treat? Some of the conditions treated by orthopaedic surgery include: Foot injuries: metatarsalgia, bunions, cavus foot, flat foot, hammer toe; Hand injuries: scaphoid bone fracture, carpal tunnel syndrome, De Quervain syndrome, thumb arthrosis (trapeziometacarpal osteoarthritis), stenosing tenosynovitis (trigger finger); Knee, kneecap and ligaments injuries, as well as knee osteoarthritis; Shoulder injuries (shoulder impingement syndrome or swimmer's shoulder); Hip injuries (hip osteoarthritis). What are the sub-specialisations of orthopaedic surgery? Emergency or trauma surgery can be regarded as a sub-specialisation of orthopaedic surgery. This type of surgery treats people who’ve suffered a traumatic injury (thus, an acute trauma). A few examples of traumatic injuries include: Incision or laceration wounds; Gunshot wounds; Car accidents; Several types of domestic accidents; Work-related accidents. When do I need to see an orthopaedic surgeon? If you have one of the above-mentioned conditions, you should see an orthopaedic specialist, who will determine whether or not you need surgery. Should the orthopaedic specialist also be a surgeon, he or she will be the one performing the surgery (if needed). ...

Osteoarthritis

What is osteoarthritis? Osteoarthritis is a degenerative conditions that affects the joints, causing them to become stiff and causing pain. Any of the joints in the body can be affected, but it more commonly affects the hips, knees, and small joints in the hands. It affects women more commonly than it does men, and is the commonest form of arthritis in the UK. What are the symptoms of osteoarthritis? The most common symptoms of osteoarthritis are joint pain, difficulty in mobility, and stiffness or deformity in the joints. These symptoms vary depending on the patient and intensify in a progressive manner. Joint pain, the most common symptom, appears first with movement and ceases with rest, but as osteoarthritis progresses, the pain may also be present while resting. What are the causes of osteoarthritis? The causes of the onset of osteoarthritis are not currently known but there are a number of risk factors associated with it: Genetics: In more than 60% of cases, genetic inheritance influences the appearance of osteoarthritis. Physical activity: athletes and people who maintain high physical activity have a higher risk of suffering from osteoarthritis. Working day: those who perform repetitive joint movements in their working day can wear down the joints and overload them, which can trigger osteoarthritis. Menopause: osteoarthritis more commonly affects women who have reached menopause due to the decrease in oestrogen that occurs during this stage of life. Injuries: fractures and traumas in the joints can influence osteoarthritis. Obesity: although it does not directly cause the onset of osteoarthritis, obesity influences wear and tear of the joints and therefore the progression of the condition. Prevention of osteoarthritis To avoid risk factors and therefore prevent osteoarthritis, it is very important to eat a balanced diet, such as the Mediterranean diet, and perform regular moderate exercise, thus avoiding wear and tear of the joints. Avoiding obesity is important as carrying too much weight can be detrimental. Treatment of osteoarthritis The objective of the treatment is to avoid or reduce pain and improve mobility. To treat osteoarthritis, the medical specialist will recommend the patient a series of exercises to be performed which are adapted to their situation and abilities, often with the help of a physiotherapist. Pharmacological treatment: In most cases anti-inflammatories or analgesics are prescribed to reduce swelling and therefore pain. Chondroprotective medications may also be prescribed which may slow the progression of the disease. Surgical treatment: osteoarthritis in very advanced stages may require prosthetic surgery. ...

Osteoarthritis of the elbow

What is osteoarthritis of the elbow? Osteoarthritis is a degenerative disease that causes the loss of cartilage that lines the joint surfaces, which leads to the joint space to disappear. The elbow is one of the least affected joints as osteoarthritis generally affects weight-bearing joints, like the knee. What are the symptoms? Osteoarthritis in the elbow can cause a variety of symptoms, which can vary from one person to the next. Some symptoms may be stronger than others, but largely, the most common symptoms include: Pain in the joint Stiffness in the joint A feeling of ‘scraping’ or ‘grating’ in the joint Locking or instability in the joint Swelling Difficulty when moving the joint Why does osteoarthritis occur? In the majority of cases osteoarthritis in the elbow is due to simple wear and tear, as the protective cartilage which covers the joints wears down. Injuries that involve a progressive deterioration of the joint can also speed up this process, and the corresponding loss of cartilage. Such wear and tear generates changes in the structure of the elbow. Can it be prevented? You can help to prevent osteoarthritis of the elbow by protecting your joints and avoiding repetitive actions wherever possible. Sports, hobbies and jobs which involve repetitive actions or continuous use of the elbow can mean osteoarthritis is more likely to develop. What is the treatment? Osteoarthritis cannot be cured, but it can improve with treatment. In the initial phase, treatment of osteoarthritis seeks to alleviate the symptoms by means of rest, physical therapy, and the administration of drugs for the pain, but if this fails it is possible to opt for a surgical intervention. If patients are overweight, losing weight can also help to alleviate the symptoms and pain. Certain special orthopaedic devices may also be used in order to help reduce any strain on the joints. If treatment is largely unsuccessful, surgery may become an option, but this is generally only offered in a small amount of cases. Surgical procedures performed include arthroplasty, which replaces the affected joint with an artificial joint, or joint resurfacing, where small wears and tears are filled with metallic inserts. Other procedures include arthrodesis, fusing the joint in a permanent position, and osteotomy, in which the orthopaedic surgeon adds or removes a small section of bone. New, non-surgical procedures are becoming more widely available and popular in the treatment of joint problems, such as PRP (platement-rich plasma) injections. PRP injections consist of blood plasma which has a high concentration of platelets, which speeds along the healing process. As this is a new treatment, it has been shown effective in the short term, but in the long term, its efficacy has not been demonstrated. ...

Osteoporosis

What is osteoporosis? Osteoporosis, meaning “porous bone”, is a disease in which the bones become weak and brittle due to the body either losing too much bone or making too little. On a microscopic level, the structure of healthy bone resembles a honeycomb, with hollows and spaces. In bones affected by osteoporosis, these hollows and spaces are much wider, meaning the bones are less dense, and therefore weaker than they should be. This makes them susceptible to breaks and fractures. Symptoms of osteoporosis Most of the time, a person will not realise they have osteoporosis until they break or fracture a bone. The hip and wrist are the most common places that fractures occur, while spinal fractures are also relatively common. Stooped posture (in older people) and particularly significant loss of height (>2 inches) should always prompt investigation for osteoporosis. Medical tests to diagnose osteoporosis The DEXA or DXA scan is a reliable method to measure bone mineral density using a low-intensity X-ray. It is painless, straight-forward, and involves minimal radiation – in fact, the operator sits in the same room as the patient. After the scan is done, the results are compared to that of a young, healthy individual, and based on accepted criteria a diagnosis of osteoporosis may be made. What are the causes of osteoporosis? Losing bone is a natural part of getting older, but some people will lose bone density faster than others. In general, women have a higher risk of getting osteoporosis than men, especially in the years following the onset of the menopause, when bone density is lost more rapidly. Things that can increase the risk of osteoporosis include: A family history of osteoporosis Certain other medical conditions, e.g. inflammatory conditions, malabsorption problems, some hormone-related conditions, etc. Certain medications (corticosteroids in particular). Heavy drinking and/or smoking Low BMI (body mass index) Can osteoporosis be prevented? While it is impossible to prevent a condition like osteoporosis with 100% certainty, you can lower the risk of getting the disease by taking steps in your lifestyle to keep your bones healthy: Regular exercise Diet - a healthy, calcium-rich diet, and vitamin D supplementation Give up smoking and reduce alcohol intake. Treatments for osteoporosis Treating osteoporosis revolves around treating fractures caused by the condition and trying to improve bone strength, which may involve medication. Your doctor will advise you on treatment depending on the results of your DXA scan and the cause of your osteoporosis. Most of the therapies available slow down the rate of bone loss and decrease fracture risk except for parathyroid hormone analogues which effectively stimulate bone formation. Possible treatments include: Biphosphonates to slow the rate of bone loss HRT – in menopausal women Testosterone treatment – if osteoporosis is a result of hypogonadism in men. Selective oestrogen receptor modulators (SERMs) Denosumab (Prolia) – subcutaneous injections at six monthly intervals Parathyroid hormone analogues – delivered via subcutaneous injection, this hormone can actually increase bone density Which type of specialist treats osteoporosis? Endocrinologists and rheumatologists treat osteoporosis. ...

Osteosynthesis

What is osteosynthesis? Osteosynthesis is a type of reconstructive surgery aimed at stabilising and joining the ends of a broken bone after a fracture, an osteotomy, or a non-union from a previous fracture. Bone fragments are stabilised by using mechanical devices. This allows for a complete or partial healing of the muscles and joint function. Once the bone fragments are stable, the mechanical device can either be removed or left in (if the procedure consisted of an internal fixation). What is osteosynthesis for? Osteosynthesis is mainly done after a bone fracture. One of the fractures most commonly treated by osteosynthesis is the femoral fracture, although osteosynthesis can be used for many others as well. In the case of lateral fractures (a type of ankle fracture), this procedure can heal quickly the affected bone. It is particularly suitable for young people. Osteosynthesis can also be used to treat bone non-union. This is when a broken bone fails to heal following a fracture. Several factors can increase the risk of this happening, such as increasing age, a diet lacking in calcium, vitamins and proteins, smoking, diabetes, anaemia, an ongoing infection and taking painkillers or corticosteroids. What does it involve? There are two types of osteosynthesis: External osteosynthesis – that is, by using an external fixator. This method can be used if you have a compound fracture, which has a high risk of infection. Internal osteosynthesis – there are two kinds of internal osteosynthesis: open reduction internal fixation (ORIF) and closed reduction internal fixation (CRIF). ORIF consists of open surgery to set the bones, while CRIF involves reduction without open surgery to achieve the same ends. Next, mechanical devices like pins, plates, or screws are used to fix the bones together. Another procedure consists of intramedullary osteosynthesis, which allows for better adherence and faster healing, since the mechanical device (usually a nail) passes through the medullary cavity. Post-operative progress It is fundamental that you undergo physical therapy after the surgery. This is also true for every type of bone fracture. Physical therapy can include muscle strengthening exercises, stretching and functional recovery exercises. ...

Osteotomy

What is an osteotomy? An osteotomy is a surgical procedure, carried out using general anaesthesia, that repairs damaged joints by cutting and reshaping the bones. An osteotomy can be performed on the following joints: Knee Hip Spine Jaw Chin Big toe Why is an osteotomy done? An osteotomy will fix problems experienced in different bones and joints. Knee – if the kneecap is misaligned or damaged from arthritis then a knee osteotomy cuts either the tibia or femur to take pressure of the damaged knee joint. Hip – the hip socket is reshaped so that the socket aligns better with the ball of the joint. Spine – a wedge of spinal bone can be removed to improve a hunched back. Jaw – in misaligned jaws, a lower jaw osteotomy can reposition the jaw. Chin – an osteotomy can narrow a very square chin. Most often this is performed by plastic surgeons. Big toes – a wedge of bone is removed to prevent the big toe obstructing your other toes. What does an osteotomy involve? Due to the complexity of an osteotomy, a hospital stay will be required. General anaesthesia is used, meaning you are asleep during the operation. The surgeons makes an incision over the area of bone that is being remodelled. Using a special surgical saw, a section of bone will be removed. The cut edges of bone are then secured together with metal hardware or special bone grafts. For a bone graft, a wedge of bone is usually taken from the pelvis, and it is secured with metal hardware. How do you prepare for an osteotomy? Before surgery you won’t be able to eat or drink and certain medications will have to be stopped. You will receive special instructions from your specialist. Aftercare following an osteotomy You can expect to stay in hospital for a couple of nights. Depending on the type of osteotomy performed, crutches are likely to be needed for a couple of months. Full rehabilitation can take up to 6 months. In most cases, physical therapy exercises will be needed to help restore strength, stability and movement to the bones. Alternatives to an osteotomy An osteotomy is often an alternative to larger surgical procedures, such as hip and knee replacements which are serious operations with very lengthy recovery times, and often revision surgeries too. Discussing your treatment options with your specialist is essential in making a treatment decision. ...

Platelet-rich plasma

What is platelet-rich plasma? Platelet-rich plasma is a blood derivative that stimulates the production of collagen, elastin and epidermal tissue. It is used to achieve firmer, brighter and better-quality skin. Why is the treatment performed? Platelet-rich plasma is a cosmetic treatment aimed at rejuvenating the skin of the face, particularly the area between the eyebrows, the crow’s feet and between the nose and lips. Platelet biostimulation is also used for other treatments such as improving stretch marks, joint degeneration, burns, skin loss after surgery and wounds caused by ulcers. Since the patient’s own plasma is used, there is no risk of the substance being rejected, encouraging a better result. What does it involve? This treatment consists of taking a small amount of blood from the patient, extracting the plasma from it and then injecting it into the desired area to stimulate cell regeneration in the tissues and to combat the signs of ageing. Treatment with platelet-rich plasma helps the skin to recover its firmness and smoothness, whilst also reducing the expression lines of the face. The main advantages of this technique are safety and effectiveness. How to prepare for platelet-rich plasma treatment Bioestimulation with platelet-rich plasma is performed at the surgery. After cleaning and preparing the area for treatment, an anaesthetic cream is applied and blood is taken from the patient. Once the plasma has been extracted, it is then applied to the patient via multiple injections in the form of mesotherapy, using a very fine needle. Post-treatment care Following PRP treatment, the patient should apply arnica cream to prevent small papules appearing in the areas injected on the neck and neckline area, and to lightly massage with the fingertips the areas where the skin is more delicate. On the day of treatment, it is advised not to sunbathe or to apply creams to the skin. It is also not advisable to go to a sauna or gym directly after treatment. ...

Rotator cuff injury

What is a rotator cuff injury? Rotator cuff injuries include inflammation, or partial or complete damage of the tendons of the shoulder. The rotator cuff is a group of four tendons that converge and surround the front, back, and top of the head of the humerus. These tendons are individually connected to very important muscles that cover the shoulder blade (scapula). When these muscles contract, they stimulate the rotator cuff tendons, causing the movements of elevation, separation, and internal and external rotation, hence the name "rotator cuff”. The main injuries to the rotator cuff are tendonitis and tears: Tendonitis of the rotator cuff : occurs when the tendons of the joint become inflamed. Tears of the rotator cuff : when one of the tendons detaches from the bone. The tear may be partial or complete, and may occur suddenly or slowly over time. Prognosis: Rotator cuff injuries are painful and can impede mobility, which has an impact on the patient's quality of life. If the injured rotator cuff is not treated properly, it can cause chronic stiffness and weakness, and can progressively wear away the shoulder joint. Symptoms of rotator cuff injuries: The main symptoms of rotator cuff injuries are: Pain and tenderness in the shoulder, which may extend to the arm. Severe pain when lifting the arm sideways, lifting weight, or trying to reach behind oneself. Pain when sleeping on the affected shoulder. Mobility problems in the shoulder. Medical tests for rotator cuff injuries: The orthopaedic surgeon will begin with a physical examination in which he or she will press on different points of the shoulder and move the patient's arm, as well as examining the strength of the arms. If the physical examination is not conclusive, imaging tests such as an ultrasound, X-ray or MRI may be used. Can rotator cuff injuries be prevented? Rotator cuff injuries can be prevented by avoiding activities that cause them, such as certain sports that involve arm movements (e.g. tennis or cricket). Also, certain jobs that require use of the arms for several hours, such as carpentry or painting. Exercising and strengthening the shoulders and arms is also a good way to prevent injuries. Treatments for rotator cuff injuries: In some cases, conservative treatment with rest, physical therapy exercises, and the application of ice is enough to treat a rotator cuff injury. In cases where conservative treatment is not enough, pain injections, physical therapy sessions, or surgery to repair the tendon or even a tendon transplant may be prescribed. This intervention can be done either by open surgery or laparoscopy. Which specialist treats rotator cuff injuries? An orthopaedic surgeon is the ideal specialist to diagnose and treat rotator cuff injuries. A physiotherapist will also be involved in the treatment and rehabilitation of the injury. ...

Scaphoid bone

The scaphoid is one of the hand bones that forms the thumb, one of those most often injured. A fall or sudden stretching can cause a fracture in the scaphoid of the hand. The recognisable symptoms of this injury are pain and swelling of the wrist. Likewise, any pressure on the bone causes intense pain to the patient. In some cases, the scaphoid fracture causes only mild discomfort and some pain in the area. But sometimes scaphoid fracture is difficult to detect because it can be mistaken for a simple sprained wrist. The treatment involves placing a cast on hand to hold steady wrist, although it is also possible to use surgery, depending on the case. ...

Second medical opinion

What is a second medical opinion? A second medical opinion is when you consult with a doctor that is not your regular doctor about a potential diagnosis and/or treatment plan. There is no legal right to a second opinion, however, it is rare for a doctor to refuse. Why would you get a second medical opinion? Patients may consider a second medical opinion if they are facing a new diagnosis or recommended treatment because sometimes this can feel confusing and a second opinion can put their mind at ease. In addition, there are certain situations where a second medical opinion is sought after: Potential treatment is risky and could be life-changing or the diagnosis is possibly life-threatening The diagnosis is not clear-cut If you are considering a new treatment approach that is experimental The aims of obtaining a second medical opinion are: To confirm whether a diagnosis is correct and/or appropriate. To confirm whether a suggested treatment is correct and/or appropriate. To compare information received from each doctor so that you can make an informed decision – sometimes a second medical opinion can rule out the need for a potentially unnecessary invasive procedure. Possible disadvantages of seeking a second medical opinion include: The process can delay the start of treatment. Logistically, seeing another specialist might be difficult and possibly time-consuming. It might be stressful to hear the same diagnosis again. How would you seek a second medical opinion? You can request a second medical opinion from your GP or consultant, but before doing so it is recommended that you ask for as much clarification and explanation about the initial diagnosis and treatment, before seeking a second opinion. Obtaining a second medical opinion does not mean that the second doctor will then take over – if that is what the patient decides, then this needs to be agreed formally between doctors and hospitals. ...

Shoulder

What is the shoulder? The shoulder is the part that serves as the link between the arm and the body. It is formed by the union of the ends of three bones: the clavicle, the scapula (shoulder blade) and the humerus, as well as muscles, ligaments and tendons. The main shoulder joint connects the head of the humerus and the scapula, or shoulder blade, and is called the scapulohumeral joint. It has two joint surfaces (one corresponding to the head of the humerus and the other to the glenoid cavity of the shoulder blade). The head of the arm bone fits into a rounded cavity in the shoulder blade. Both surfaces are covered with cartilage to allow smooth, painless movement. In addition, a set of muscles and tendons attach to the surfaces of the bones, allowing joint mobility. These include the rotator cuff, formed by four muscles that give mobility and stability to the shoulder. The shoulder joint has a greater range of motion than all other joints in the body. Shoulder function The shoulder enables a wide range of movements in the arm, allowing us to write, use cutlery, scratch our back, swim, and play certain sports that require the use of our arms (including basketball, handball, and tennis). Shoulder pathologies Shoulder pathologies generally fall into 4 categories: Inflammation of the tendon (bursitis or tendonitis), or tearing of the tendon Joint dislocation Osteoarthritis Bone fracture Less frequent are tumours, infection, and nerve-related problems. The main shoulder pathologies are: Bursitis: there are a number of small fluid-filled sacs located in the shoulder and in joints throughout the body. Overuse of the shoulder can sometimes lead to inflammation or swelling of the sac between the rotator cuff and the shoulder blade. Tendonitis: the tendon is a kind of cord that connects muscle and bone. Most tendonitis is due to tendon wear. It can be acute, or chronic when caused by a degenerative disease. The most commonly affected tendons are the four rotator cuff tendons and one of the bicep tendons. Tendon tears: these may result from acute injuries or degenerative changes due to ageing or prolonged overuse. They may be partial or complete. Rotator cuff and biceps tendon tears are the most common. Compression: this occurs when the upper part of the shoulder blade presses on the underlying soft tissues when lifting the arm away from the body. As the arm is lifted, the part of the shoulder blade compresses the rotator cuff tendons and sac. This causes pain and may lead to tendonitis or bursitis. If left untreated, compression could lead to a torn rotator cuff. Dislocation: this occurs when the head of the arm bone is forced out of the shoulder socket. It can be caused by sudden injury or overuse. A shoulder dislocation can be partial or complete. Which specialist treats shoulder pathologies? Shoulder pathologies are usually treated by an orthopaedic surgeon, and depending on the injury, a physiotherapist. If the cause of your shoulder problem was osteoarthritis, it is also likely that you will be treated by a rheumatologist. ...

Shoulder dislocation

What is a shoulder dislocation? The shoulder consists of the clavicle (collarbone), the scapula (shoulder blade) and the humerus (upper arm bone). The humerus inserts inside the glenoid cavity (socket) of the scapula. It is the joint with the highest range of movement, due to the high number of surrounding muscles. Shoulder dislocations are a common injury in sports and occur when the head of the humerus comes out of the glenoid cavity. This causes a lot of pain and hinders movement of the arm. After first occurrence of a shoulder dislocation, the probability of a second occurrence decreases with age: it is greater than 80% in people aged under 20 years and below 20% in people aged over 40 years. There are different types of shoulder dislocation: Subcoracoid dislocation: the most common anterior dislocation of the shoulder. In this type, the humeral head moves to below the coracoid process of the scapula. The most common causes are falls onto a hand or onto an elbow while it is extended, slightly separated from the trunk and pointing backwards. Subglenoid dislocation or extracoracoid dislocation: The humeral head is positioned on the glenoid cavity rim. Usually occurs with falls, when the arm is in a forced internal rotation position, which is why it is not very common. Subclavicular or intracoracoid dislocation: The humeral head is positioned on the ribs. It occurs with falls with flexion, adduction and internal rotation. Prognosis Although shoulder dislocations are not very serious injuries, one of the major considerations, apart from pain, is the potential for damage to the ligaments, blood vessels and nerves of the shoulder capsule. An orthopaedic specialist and a physiotherapist evaluate whether these structures have been compromised and also whether the nerves that innervate the various structures have been damaged, given that capsule retractions are very common if not managed early. Symptoms Shoulder dislocations are very painful, to the extent that the patient cannot move their arm. Due to the fact that many nerves insert in the shoulder joint, the injury may be complicated by neurological damage that makes the arm numb and prevents movement. However, the main damage occurs in the cartilaginous ring located at the end of the joint. Its function is to ensure that the humeral head inserts into the glenoid cavity. Normally, the glenoid cavity and ligaments are damaged. With recurrences of shoulder dislocation, the ligaments gradually become more lax. Testing for shoulder dislocation First, the specialist takes a full medical history to diagnose every type of injury or dislocation. These data are used to determine the appropriate treatment and the prognosis. In addition, X-ray and CT scans must be done to better observe the injury and any possible effects on vessels or nerves. In parallel, the specialist must analyse and evaluate the shoulder’s instability. To this end, an orthopaedic assessment may be done. The more orthopaedic tests give a positive result, the lower the probability of a wrong diagnosis. What are the causes of shoulder dislocations? The usual cause of shoulder dislocations is a traumatic injury, i.e. a forceful impact on the joint that forces it beyond its limits. Recurrence of shoulder dislocation does not require a forceful impact; rather, a minor movement of the joint may cause muscles holding the joint in place to become more lax. Can it be prevented? Shoulder dislocations cannot be prevented. Patients who suffer from repeated shoulder dislocations can however take preventive measures, by being more careful with movements they make and following the specialist’s advice. Treatments for shoulder dislocation Shoulder dislocations are extremely painful, and therefore require prompt attention to reposition the humeral head in its correct position. This requires specific mechanical manipulations that can only be performed by an orthopaedic specialist or a physiotherapist. In parallel, the patient will receive medication to relieve pain. The specialist places the shoulder in its correct position - as this procedure may be painful, it is sometimes performed in the operating theatre under anaesthesia. Next, the arm is immobilized with a sling. An X-ray and MRI scan must be done to evaluate possible damage to other structures and ligaments. People who do intense physical activities are more likely to suffer from repeated dislocations. In such cases, surgery with arthroscopy may be recommended to repair the ligaments. This is a minimally invasive intervention, so postoperative recovery will be shorter. Rehabilitation is necessary to restore mobility and strengthen muscles. Which specialist treats it? Shoulder dislocations are primarily managed by two types of specialists. An orthopaedic specialist determines the diagnosis and the most appropriate treatment for the shoulder dislocation. He determines the injury type and which structures have been damaged, and decides whether an orthopaedic or surgical approach should be used. A physiotherapist provides non-pharmacological therapy. They contribute to symptom relief via a series of manual exercises and techniques, and the application of hot, cold, light or water. ...

Shoulder prosthesis

The shoulder prosthesis is the replacement of the joint with a piece of synthetic material by surgical intervention. This operation is performed in cases where the shoulder joint is severely damaged by osteoarthritis. This technique achieves a reduction of pain and a restoration of mobility. In the shoulder prosthesis a metal piece is attached to the humerus head and a piece of polyethylene to the shoulder blade, both sealed with cement or embedded. There is also the inverted shoulder prosthesis for patients over 60 years old, to recover mobility of the shoulder. In the inverted prosthesis, the receiver is placed in the place of the humeral head, and where the receiver should be located, the humeral head is placed. These prostheses are indicated in cases of massive rupture of tendons, with no possibility of repair, to which certain joint osteoarthritis is associated. ...

Shoulder tendonitis

What is shoulder tendonitis? Tendonitis means the inflammation of a tendon, in which micro tears and areas of necrosis occur. Tendonitis in the shoulder can mainly affect the long portion of the brachial biceps and the muscles of the rotator cuff. Prognosis: Physical therapy and exercise are usually effective to improve the symptoms and reduce shoulder pain. If these exercises do not work, surgery may be needed, otherwise the tendon may rupture completely. Symptoms of shoulder tendonitis: The symptoms of shoulder tendonitis are: Inflammatory pain Pain from pressure on the tendon Lack of strength Difficulty to perform daily activities Pain when performing active shoulder movements and pain when stretching the muscle tendon. Medical tests for shoulder tendonitis: Tests to diagnose shoulder tendonitis are as follows: Ultrasound scan X-ray MRI scan Computed tomography scan (CT) These tests and the detailed study of the patient's medical history usually provide an accurate diagnosis. What causes shoulder tendonitis? The main causes of shoulder tendonitis include: Older age (wear and tear) Repetitive movement in certain work activities or sports. Poor blood supply to the tendons of the supraspinatus and infraspinatus muscles. Sudden movements. An imbalance of muscle groups closest to the humerus head. Can shoulder tendonitis be prevented? Shoulder tendinitis can be prevented by following basic exercise guidelines: Warming up the muscles before exercising Perform muscle strengthening exercises Stretching after sports activities Treatments for shoulder tendonitis: Physical therapy is the appropriate treatment for tendonitis of the shoulder. The goal of this is to eliminate shoulder pain and improve joint stability and muscle strength. For this purpose, a series of exercises are performed that consist of mobilising the joint to avoid the loss of movement, deep massage of the affected tendon and stretching. In addition, other techniques can be performed, such as: Steroid injections Shockwave therapy Painkillers Surgery Which specialist treats you? Orthopaedic surgeons and physiotherapists are the two types of specialists that treat this condition. ...

SLAP tear

What is a SLAP tear? A SLAP tear is a type of shoulder injury. Your shoulder is surrounded by a band of tissue called the labrum to keep the joint stable. The labrum in your shoulder can tear in many ways. A SLAP tear involves the labrum being torn where it connects to your biceps tendon, both at the front or back. What are the symptoms? Symptoms of a SLAP tear include: a clicking or popping sensation when moving the shoulder pain when lifting and lowering your arm pain when lying on the affected shoulder instability in the shoulder limited range of movement loss of strength in your arm It’s important to seek medical advice if you are experiencing the symptoms above. Injuries in the shoulder can lead to loss of motion or weakness without treatment. How is it diagnosed? It can be difficult to diagnose a SLAP tear because there are many other conditions with similar symptoms, including other types of shoulder tear in the rotator cuff such as a supraspinatus tear, or a dislocation. A clinical diagnosis of your shoulder will include questions about how long you have had the pain for, whether there are certain movements that make the pain worse, and whether you have had similar problems in the past. In addition to an examination, the GP may recommend: an X-ray, to rule out a different cause such as fracture an MRI scan, to see the shoulder joint in detail. A SLAP tear is quite difficult to detect, so you might be given a contrast dye to reveal it. Causes The most common cause of a SLAP tear is falling on your arm, but other common causes of a tear include shoulder dislocation or something pulling hard on your arm. Some people will experience a SLAP tear due to repeating the same actions, such as lifting weights or throwing a ball. You’re also more likely to experience a SLAP tear the older you get, as the labrum becomes less attached. Treatment for SLAP tear A SLAP tear can be treated with medication, physical therapy, steroid injections, or surgery: medication may include pain-relief and anti-inflammatory drugs to reduce swelling in the shoulder physical therapy involves advice on exercises to carry out which restore flexibility and strength to your shoulder. This is a common form of treatment, both for minor shoulder injuries and for patients recovering from shoulder surgery. surgery may be considered if medication and exercise haven’t worked. The most common form of surgery for a SLAP tear an arthroscopy, which involves trimming the torn part of your labrum, then reattaching it. A full recovery can take a couple of months after the procedure. ...

Sport Medicine

What is sports medicine? Sports medicine is a speciality that deals with injuries sustained during exercise, sports participation and other types of physical activity. Sports medicine specialists help injured patients regain strength and movement after injury and also focus on the prevention of injuries that derive from practising sports. Their various roles include care, nutritional advice, diagnosis, treatment and prevention in relation to all sports injuries. Why is sports medicine practised? Sports medicine is responsible for treating sports injuries in professional athletes and adults and children who exercise and partake in sports. The most common sports injuries treated by sports medicine specialists include: Concussions Muscle cramps Fractures Knee and shoulder injuries Cartilage injuries Tendonitis Ankle sprains Shin cramps What does sports medicine involve? Sports medicine is based on several disciplines: Prevention and treatment of sports-related injuries, for example; with physical therapy. Control and monitoring of sports performance to avoid injuries and illness. Prevention and treatment of diseases (hypertension, diabetes, obesity, heart disease) with physical exercise. Many specialists are qualified in internal medicine, so can help patients lower blood pressure, balance glucose levels and prevent other illnesses. Nutritional advice and lifestyle. Many sports medicine healthcare providers assist patients with weight loss, muscle gain and sports nutrition to help them perform at their optimum level. Aftercare After treatment relating to a sports injury, rehabilitation is often required for the healing process. This is needed for injuries such as the following: Bone, musculotendinous and joint injuries Problems of the spine and/or extremities Trauma-related injuries and orthopaedic surgery Rehabilitation is based on physical exercise programs to improve the health and performance of the patient, always under strict medical supervision. Dietary advice can also be given to the patient and their injuries and sports performance monitored to avoid further injury in the future. ...

Sport surgery

What is sports surgery? If a person sustains an injury during exercise, sports participation or any type of physical activity, depending on the severity of the injury, they may be advised by a sports medicine specialist to see an orthopaedic surgeon for treatment. Surgery is normally the last resort for amateur sportsmen and is more common amongst professional athletes. Surgery is likely if a person has sustained a serious injury or as a result of persistent symptoms that were not successful following the use of other treatments prior to the operation. What are the common sports injuries treated? Sports surgery can repair damaged soft tissue, realign bones and joints. However, not all injuries require surgery. A sports medicine doctor may treat the following injuries sustained through physical activity: Sprained ankles Hip Bursitis Fractures Knee and shoulder injuries Tendonitis Low back pain Pulled muscles Concussion Cartilage injuries The most common sports injuries are strains and sprains, which is when the ligaments have been stretched past their limits and have resulted in a tear. What are the different types of surgical procedures in sports surgery? Many sports injuries are treated using keyhole surgery. This involves the surgeon making a small incision and using a tiny camera to guide them during the procedure. This type of surgery is most common with knee injuries and is known as arthroscopy. How can sports injuries be prevented to avoid sports surgery? Even though it is recommended to exercise regularly as an important part of maintaining overall health, precautions should be taken to minimise the risk of injuries. Sports injuries occur from overtraining, lack of conditioning and poor technique. The following tips can be used as a preventative for sports injuries: Use the correct equipment Always warm-up before Wear the right protective gear Rest in between workouts to allow the body time to rest and repair Start exercising slowly and gradually increase strength, flexibility and endurance Listen to the body if it shows any signs of pain or distress What happens after a sports surgery procedure? Recovery from an operation for a sports injury depends on the severity and the individual case. Most injuries require a long rest period following surgery on an affected joint, muscle or soft tissue. Physiotherapy is used to rebuild strength and to increase the range of movement around the joint or muscle. It will also help to condition the injury to make it more resistant to any future complications. ...

Sports injuries

What are sports injuries? Competitive and non-competitive sports injuries are injuries that occur in athletic activities or whilst exercising. Whilst some of these happen by chance, others are facilitated by inadequate practice or poor execution in terms of technique, as well as by not using sports equipment correctly. Sports injuries mainly consist of muscle injuries or joint and ligament injuries: Dislocations; Muscle injuries (sprains, pulled muscle, cramps); Knee or ankle sprain; Back injuries Bone fractures; Tendon injuries. Prognosis: The outlook of a sports injury greatly depends on what caused it and its severity. Imaging tests (ultrasound, MRI scan) can rule out structural injuries and help to assess the severity of the injury itself. Furthermore, based on the results, the specialist can estimate how long it will take for you to recover and get back to sports, as well as your risk of getting injured again. What are the symptoms? The symptoms of a sports injury depend on how big and how severe the injury is. They usually are: Immediate onset of pain; Stiffness of the affected muscle; Swelling; Bruising; Increased sensitivity of the affected area; A feeling of heat emanating from the affected area; Decrease in range of motion. How are they diagnosed? Sports injuries, especially muscular ones, can be diagnosed with a physical examination. The following tests may be prescribed to get further insight on where the injury is and how severe it is: X-ray scan; Computed tomography (CT) scan; Magnetic resonance imaging (MRI) scan; Ultrasound scan; Bone density scans. What causes them? As an example, the main risk factors for a football injury are: Not having exercised enough; Muscle fatigue; Age; Cold or wet weather; Poorly maintained training field; Quicker execution and overall rhythm of the game; Doing a movement too fast; A different or new training technique; Stumbling upon another player; Playing too fast or too slowly, without having warmed up adequately; Inadequate training program; Poor execution; Eating an unhealthy diet; Not resting enough. How can they be prevented? The main preventive measures are: Ensure you warm-up adequately; Eat a healthy diet; Stay hydrated; Use proper equipment; Wear good sportswear and shoes. How are they treated? Treatment largely depends on how severe the injury is. It usually consists of physical therapy, surgery, applying ice packs, taking painkillers or anti-inflammatory medications and bed rest. Which doctor should I talk to? You should see a specialist in sports medicine, but you may also be treated by physiotherapists and orthopaedic surgeons, depending on your treatment plan and injury. ...

Sports traumatology

What is sports medicine? Sports medicine is a branch of medicine that focuses on the prevention, diagnosis, and treatment of sports-related injuries. Sports injuries can happen suddenly, due to overtraining, not training properly, poor technique, wearing inappropriate clothing, and a lack of fitness, among other causes. The treatments used allow the person to go back to their normal training routine as soon as possible and in the best conditions. What’s the difference between traditional orthopaedics and sports traumatology? Sports traumatology focuses on athletes specifically and injuries arising in sport, considering the athlete's needs, whereas traditional traumatology treats general locomotive system injuries. This kind of specialist has in depth knowledge of different types of sports and understands the different situations that the athlete may have. They not only have physical, medical, physiological knowledge of the human body, but they are also able to treat different sports injuries (due to training, seasonal changes, competition expectations, among others), as well as other reasons for injuries. The most common injuries in sports medicine The most common injuries are: Sprained ankle. Muscle tears. Tendonitis and tendinopathies (tennis elbow, golfers elbow, Achilles tendon rupture). Knee injuries (meniscus fracture or damage to the anterior cruciate or posterior cruciate ligament) and cartilage injuries. Shoulder injuries (dislocation and tendinopathy), among others. Sports medicine treatments The right treatment in sports medicine will always be based on each player’s medical history, which should include family and personal history, injury history, surgical history, and orthopaedic issues. The information gathered in a sports admission exam will be included, this will assess postural information, the skeletal muscle, joints, ligaments, and physical fitness, risk factors will also be included for any potential injuries according to the sport. Some of the treatments within this speciality include: Ultrasound-guided galvanic electrolysis technique, commonly known as USGET, is an innovative medical and physiotherapy technique that enables accurate treatment of injured tendons, muscles, or ligaments, successfully treating sports injuries such as: Achilles tendonitis Patellar tendonitis Pubalgia Epicondylitis (tennis and golfers elbow) Rotator cuff tendonitis (supraspinatus) Plantar fasciitis Trochanteritis Iliotibial band syndrome Muscle tears (hamstrings, femoral biceps, calf, and soleus among others) Platelet Rich Plasma (PRP) is a highly effective treatment to stimulate scarring, regeneration, and healing damaged tissues, such as: Tendon ruptures Chronic tendinopathies Ligament injuries Muscle injuries Focal cartilage injury Osteoarthritis Hyaluronic acid: Hyaluronic acid injections can reduce pain and revive joint function thanks to the treatment’s lubricant, mechanical, and biochemical effect. The most common areas to treat are: Knees (joint that most often receives this treatment) Ankles Hips Shoulders Hands ...

Stem Cells

What is it? Stem cells are cells that can differentiate, that is, they can transform into other tissues and organs cells. Stem cells can be found in any grown human body. Stem cells can divide into: Totipotent stem cells , which can become any kind of organic tissue; Pluripotent stem cells , a cell type that can transform into nearly all types of cells for tissues and organs; Unipotent stem cells , which can only produce one cell type; Multipotent stem cells , that is, cells which can only differentiate into a limited number of cells; Oligopotent stem cells , which can differentiate into only a few cell types. Stem cells can be found in the bone marrow, in the brain, in the dermis (skin) and in the dental pulp. In newborns, the umbilical cord and amniotic fluid are also rich in stem cells. What are stem cells for? Stem cell therapy is currently used in the UK as part of treatment for certain types of blood cancer. Stem cells enable significant blood transfusions after aggressive cancer treatment for conditions such as non-Hodgkin lymphoma . Because stem cells can regenerate old or damaged cells, there is significant interest in its use for a much wider range of conditions. Stem cell therapy is currently being researched for the treatment of conditions as varied as muscular dystrophy, jaw pain, Alzheimer’s disease. Treatment would consist in a procedure by which the damaged tissues or organs are healed by using stem cells. ...

Stiff hands

What is hand stiffness? Hand stiffness can involve a reduction in the overall range of movement in your hands, or greater difficulty within that range of movement. Stiffness might be constant or it might be worse at certain times of day. Depending on the cause of the stiffness, symptoms may worsen over time, stay the same, or improve. What causes hand stiffness? Some of the main causes of hand stiffness include injuries, arthritis, and nerve conditions such as carpal tunnel. Rarer causes include Dupuytren’s contracture and scleroderma. Injuries Sprains, bruises, fractures, and wounds are all injuries that can result in pain or stiffness in the hands. Tendonitis (inflammation of the tendons) is a common reaction to injury, and usually the stiffness should improve as the hand heals. In other cases, such as a rupture to a tendon, or a significant burn injury, there could be permanent damage to mobility. One class of injury, known as repetitive strain injury, can cause pain and stiffness in the hands due to overuse. In this situation, it’s important to identify the activity that is causing the pain and try to reduce that activity. There are also a number of treatments a GP might offer, such as anti-inflammatory medication, a heat pack, or physiotherapy. Finally, it is possible for the soft tissue in your hands to be damaged by infection. Many infections can be treated with antibiotics, so see a doctor if you’ve noticed a discolouration or swelling in your hands that isn’t going away. Arthritis Rheumatoid arthritis and osteoarthritis are common causes of hand stiffness in older people. As well as stiffness you might experience join pain and swelling, and in the case of rheumatoid arthritis symptoms are often worse in the morning. There are a number of treatments for arthritis. The exact treatment that is right for you will depend on what type of arthritis you have. Carpal tunnel Carpal tunnel is a nerve condition which affects the hands and arms. The main symptoms are a tingling sensation and numbness but sometimes weakness and stiffness can occur. Symptoms often go away on their own or with treatment (e.g. wearing a wrist splint) but if they persist it is important to see a doctor. Rarer causes Dupuytren’s Contracture is a progressive condition which usually occurs after the age of 50. It gradually pulls the fingers into a bent position, and mainly affects the ring finger and little finger. Treatment can slow the progression of the condition. Scleroderma is a skin condition which results in the thickening of the skin in various parts of the body. It can result in joint inflammation and swelling, especially in the mornings. Schleroderma is a rare condition with only 3-4 new cases a year. ...

Supraspinatus tendon tear

A supraspinatus tear is a tear or rupture of the tendon of the supraspinatus muscle, which is located at the back of the shoulder. What are the symptoms? Symptoms of a supraspinatus tear include: pain when lifting and lowering your arm pain when you lie on the injured shoulder stiffness in the shoulder limited range of movement Usually a tear due to an injury will produce immediate intense pain and weakness in the arm. In cases of a degenerated tear, pain is mild at first and increases gradually over time. It’s important to seek medical advice if you are experiencing the symptoms above. Injuries in the rotator cuff can lead to loss of motion or weakness without treatment. How is it diagnosed? A clinical diagnosis of your shoulder will include questions about how long you have had the pain for, whether there are certain movements that make the pain worse, and whether you have had similar problems in the past. It can be difficult to diagnose a supraspinatus tear because there are many other conditions with similar symptoms, including other types of shoulder tear in the rotator cuff, SLAP tear, or inflammatory conditions such as arthritis. In addition to an examination, the GP may recommend: X-rays – to exclude conditions such as sclerosis Ultrasound – to quickly view the tendons in your shoulder and compare them to your other shoulder MRI – to show the tendon and detect any tears or inflammation. Causes Supraspinatus tear can be caused by lifting something too heavy, falling on your arm, or dislocating your shoulder. However host cases are the result of the tendon wearing down over time, which is known as a degenerative tear. You’re more likely to be at risk of a supraspinatus tear if: you’re over the age of 40 you lift heavy objects or weights on a regular basis you do work which involves lifting your arms, such as painting, plumbing and carpentry. you play sports such as tennis or cricket. Can a supraspinatus tear be prevented? Daily shoulder exercises can strengthen the muscles in your shoulder and help prevent future injury. A physiotherapist can advise you on what exercises will strengthen the back of the shoulder in addition to other parts of the shoulder. Treatment for supraspinatus tear A supraspinatus tear can be treated with medication, physical therapy, steroid injections, or surgery: medication may include pain-relief and anti-inflammatory drugs to reduce swelling in the shoulder physical therapy involves advice on exercises to carry out which restore flexibility and strength to your shoulder. This is a common form of treatment, both for minor shoulder injuries and for patients recovering from shoulder surgery. steroid injections are sometimes recommended to provide short-term pain relief if medication hasn’t worked surgery may be considered if the tendon has been badly torn and unlikely to heal on its own. Surgery might involve reattaching the tendon to the born, or transferring a nearby tendon to replace the damaged one. In extreme cases, surgery might involve replacing the shoulder joint. ...

Surface prosthesis

Surface prosthesis is an alternative procedure to total hip or knee replacement more suitable for patients under 65. Surface prostheses ;preserve a larger amount of the bone and usually last longer than their conventional alternative. ...

Tendinopathy

What is tendinopathy? Tendinopathy is an umbrella term for diseases of the tendons. Tendons are fibrous cords of tissue that hold muscles to bone, and in order to do their job, they must be strong and flexible. Despite this, they can be injured due to overuse. Tendinopathy broadly refers to three varieties of tendon injury, and is often confused with, or used synonymously with them. They are: Tendonitis/tendinitis – inflammation of a tendon, usually due to acute injury caused by overuse or repetitive strain. Tendinosis – chronic tendon injury with little or no inflammation, involving micro-tears in the affected tendon. Tendinosis causes long-term pain and is degenerative. Paratenonitis – inflammation of the outer sheath (paratenon) that surrounds certain tendons, such as the Achilles. There is some debate as to whether this should be considered separate from tendonitis. All of these conditions increase the risk of a more serious tendon tear, or rupture. What are the symptoms of tendinopathy? The common symptom of all types of tendinopathy is pain in or around the tendon, most commonly in the place where it attaches to the bone. Other symptoms depend on the type of tendinopathy – for example, tendonitis is characterised by inflammation, including heat, swelling and redness, while tendinosis is a chronic ache, pain or stiffness without much, if any inflammation. The pain is usually worse during and after activity, and the area around the joint can be stiffer the following day. There are tendons in many parts of our bodies, and tendinopathy can occur in any of them. It most commonly strikes in tendons such as those in the arms, shoulder, hands, and the Achilles tendon (in the heel). What causes tendinopathy? It is thought that the biggest factor in most tendinopathies is overuse, although there are many theories regarding other possible factors, such as thermal damage and load-induced ischemia. Both sudden bursts of exertion leading to injury and repetitive movements are thought to be the main causes of tendonitis, and obesity is thought to be a risk factor. In the case of calcific tendonitis, calcium deposits in the tendon are the cause of the inflammation, but why they build up in the first place is not fully understood. How can tendinopathy be prevented? While it is impossible to prevent with 100% certainty, the best way to prevent tendinopathy is to look after your muscles and tendons by not over-exerting yourself, but keeping them strong and flexible by doing exercise. Warming up before exercise and cooling down afterwards by stretching your muscles is also recommended. What is the treatment? The treatment may depend on the kind of tendinopathy, but in most mild cases the RICE therapy is advised: Rest until the injury improves Ice – apply cold Compress the injury with a bandage or brace Elevate – keep the injured tendon raised while at rest. Painkillers may be prescribed to deal with the pain – particularly NSAIDs if there is inflammation. In more severe cases, shockwave therapy or even surgery may be necessary. ...

Tendon injuries

What are tendon injuries? Tendon injuries, also known as tendinopathies, happen when there is an overload that causes small fibres to tear. When the affected muscles or joints are put under pressure, it causes tendon inflammation which reduces blood flow and can lead to nerve compression. When there is a mild inflammation it is referred to as tendonitis. It is called tendinosis if there is tendon degeneration. Tendon injuries are common in sports. Injury location will depend on the sport. Some common tendon injuries include: Achilles tendon: in the heel, it is common among professional athletes. It causes inflammation, pain, and swelling. Patellar tendon: in the knee, it is more common in women. Exercising is important to avoid discomfort. Supraspinatus tendon: in the shoulder, as it is a fragile area, and recovery tends to take longer. This is usually the tendon affected in rotator cuff injuries. Lateral epicondyle tendon: in the elbow, most commonly known as tennis elbow. It is common amongst tennis players, but can happen in other professions too. Prognosis: Tendon injuries do not tend to be a serious condition, providing adequate treatment is given. Tendon injuries may be: Acute: less than two weeks Subacute: between three to six weeks Chronic: more than six weeks What are the symptoms? The symptoms of tendon injuries vary according to their location. There are several common symptoms, including: Pain and tenderness when moving the tendon or joint Stiffness at night or upon waking Inflammation Heat and redness Hearing or feeling a crack when moving the tendon Thickening of the tendon (in some cases). Medical tests: A physical examination is normally enough to identify the affected tendon and the seriousness of the injury. However, in some cases the specialist may carry out other tests to have a closer look, these may be an ultrasound or an MRI scan. What causes tendon injuries? Some of the most common causes include: Not warming up before exercise Sports injuries Repetitive movements or overexertion Physical changes (such as postural dysfunction and many more) A bad movement, especially when exercising Inadequate training equipment Metabolic dysfunctions or poor hydration How can tendon injuries be prevented? There are different tips that can be followed to avoid this kind of injury. It is important to take care when lifting heavy loads to avoid pushing the tendon beyond its limit. A massage or stretching after lifting a heavy load is one way to prevent a tendon injury. Other things to bear in mind are: Improving sports techniques Lessening loads Using appropriate footwear What is the treatment for tendon injuries? Treatment tends to be conservative, and includes rest and anti-inflammatory measures, depending on the severity of the injury. This may include medications, nutritional supplements, dietary changes, using bandages and manual therapy. The methods used will depend on the injury location, severity, and how long it has affected the patient. Although there are many different treatments, the most common ones are: Rest Stretching Anti-inflammatories Physiotherapy When treatment doesn’t work, surgery may be resorted to instead. What specialist should I see? Tendon injuries are normally treated by a sports medicine specialist, an orthopaedic surgeon or a physiotherapist. ...

Tendonitis

What is tendonitis? Tendonitis (also spelled tendinitis) refers to inflammation of a tendon. It is one of the major sub-types of tendinopathy (tendon disease), along with tendinosis and paratenonitis. Tendons are thick, fibrous cords of tissue that attach muscles to bones. They are tough, yet flexible, and have evolved to withstand tension. However, they can become injured or strained due to overuse, leading to inflammation. Common types of tendonitis include: Achilles tendonitis – affects the Achilles tendon in the heel. Supraspinatus tendinitis – affects the tendon around the top of the shoulder joint. Tennis elbow – a.k.a. lateral epicondylitis. Causes pain on the outer elbow, which may radiate down towards the wrist. Golfer’s elbow – a.k.a. medial epicondylitis. Causes pain on the inner elbow, which may radiate down to the wrist. Tendonitis of the wrist – affects people who make repetitive motions with their wrists, such as badminton players and production line workers. Trigger finger – the affected digit becomes fixed in a bent position due to a thickened and inflamed tendon, and will usually click when forced to straighten. Calcific tendonitis – calcium deposits build up in the tendon, causing pain. This most commonly occurs in the shoulder, but can occur in any tendon. Tendonitis is related to, and often goes hand-in-hand with tenosynovitis (inflammation of the sheath around the tendon, such as De Quervain syndrome). What are the symptoms of tendonitis? Typical symptoms of tendonitis include: Pain – this may worsen during movement. Swelling, redness, and heat A grating or crackling feeling when the tendon is moving The tendon may develop a lump. Symptoms occur where the tendon connects to the bone. They may last anywhere between a few days and several months. Without proper treatment, the condition can develop into chronic tendinosis and leaves the patient more susceptible to ruptures in the tendon. What causes tendonitis? There are two main direct causes of tendonitis: Sudden injury Repetitive movements over time – these could be anything from movements made during activities like gardening, painting, or cleaning, to sports, such as tennis or golf. As we age, our tendons lose their elasticity, and become less flexible and easier to injure or tear. Other risk factors include jobs involving repetitive movements, sport (particularly “weekend warriors”, who are relatively inactive during the week, but push themselves hard at the weekend), and certain health conditions, like diabetes and rheumatoid arthritis, which seem to go hand in hand with a greater likelihood of developing tendonitis. Bad posture and not warming up properly before exercise can also lead to tendonitis. Calcific tendonitis is caused by a build-up of calcium deposits in the tendon. Exactly why this occurs is unknown. How can tendonitis be prevented? Exercise – to prevent tendonitis, it is important to keep your muscles and tendons as strong and flexible as possible. It is equally important not to push yourself too hard, as overloading the muscles with more than they can handle is a prime cause of tendonitis. Stretch before and after exercise to warm up and cool down. Avoid repetitive movement. What is the treatment for tendonitis? The first line of treatment for mild tendonitis is usually RICE therapy for 2-3 days: Rest – avoid exercise or activity with the tendon until the injury improves. Ice – apply cold to the tendon for 15-20 minutes. Compress – wrap a bandage around it. Elevate – keep the injured area raised on a pillow when lying down. It is recommended that you avoid heat, alcohol and massages for the first few days after injury. If the injury is severe or lasts longer than a few days, you should see a doctor, who may recommend different treatments, depending on the nature and severity of the tendonitis. Possible treatments include: Painkillers – NSAIDs, such as ibuprofen, are often the first line of treatment, offering pain relief and anti-inflammation. Steroid injections Shockwave therapy – may speed up healing, or may be used to break down calcium deposits in the case of calcific tendonitis Surgery – in very severe cases, the doctor may recommend removing damaged tissue or calcium deposits or repairing a rupture via surgery. ...

Trigger finger

Stenosing tenosynovitis, also known as trigger finger, is a type of tendonitis that affects the tendons that bend your fingers. When the tendon sheath becomes inflamed, it is difficult to flex or extend the affected fingers, which can suddenly become stuck in a bent position. It is not clear what causes this injury, although it may be related to rheumatoid arthritis, gout or diabetes. The symptoms can begin with discomfort at the base of the finger that can cause some swelling. The treatment can include exercises and stretching, splints, and oral anti-inflammatory medication. If these treatments do not work, you may have to opt for surgery. ...

Ulnar nerve entrapment

What is ulnar nerve entrapment? Ulnar nerve entrapment is a nerve condition where the ulnar nerve becomes compressed. The ulnar nerve travels from the neck to the hand and is responsible for the function of different muscles of the hand and sensitivity in the ring fingers and little finger. When the ulnar nerve is trapped at the elbow it is called cubital tunnel syndrome. What are the symptoms of ulnar nerve entrapment? The main symptoms of ulnar nerve entrapment are: pain tingling in the fingers (little finger and ring finger) numbness a burning sensation In cases of severe entrapment, you may feel a loss of sensation in some fingers and the medial edge of the forearm. The symptoms get worse when the elbow is flexed. Left untreated, you might feel weakness in your hand or even notice muscle wastage. If you have tingling in your other fingers, this may be a sign of carpal tunnel syndrome. What are the causes of ulnar nerve entrapment? Ulnar nerve entrapment can be caused by: thoracic outlet syndrome arthritis in the elbow trauma to the elbow infections tumours You are also more likely to experience ulnar nerve entrapment if you repeatedly place strain on the nerve by keeping the elbow bent. This may be due to the way you sleep or your posture at work. Can ulnar nerve entrapment be prevented? You can help to reduce the chances of trapping your ulnar nerve by: reviewing how your sleep and your posture at work wearing protective clothing during contact sports making sure you warm up before exercise and cool down afterwards How is ulnar nerve entrapment diagnosed? Ulnar nerve entrapment is first diagnosed with a medical examination. The doctor will ask about your symptoms and examine your arm, carrying out a number of tests to check which may nerve may be compressed and where. Follow-up tests can include: an X-ray to get a detailed look at the bones in your arm which may be compressing the nerve nerve conduction studies to assess the function of the nerves in your arm and see where it may be compressed. How is ulnar nerve entrapment treated? The first line of treatment is non-surgical and can include a splint to keep your arm straight at night and anti-inflammatory medication. If these measures fail to improve symptoms, surgical intervention may be required. Surgery can include: widening the cubital tunnel to give the ulnar nerve more space moving the ulnar nerve to avoid compression from the elbow Surgery is generally effective, though you may need to wear a splint for a few weeks after the operation. ...

Ulnar nerve surgery

Compression of the elbow nerve is known as cubital tunnel syndrome. It is the erosion of the ulnar nerve that travels from the neck to the hand. It affects motor skills and sensory function of the ring and little fingers. The patient has pain, tingling, numbness or burning and sometimes altering the sensitivity of the medial edge of the forearm and the ring and pinkie fingers. Symptoms worsen by keeping the elbow bent. To treat this condition, the patient can opt for the conservative treatment (making changes in activities, use of splints, rest, stretching and taking vitamin supplements) or ulnar nerve surgery. This surgery decompresses the nerve from above the elbow to the forearm and moves the nerve from behind the elbow to the front. The goal of such surgery is to provide more space to the nerve and tendons, reducing the pressure on the nerve. ...

Wrist fracture

What is a wrist fracture? A broken wrist or wrist fracture is when one or more of the bones in the wrist is cracked or broken. The most common type of wrist fracture is called a Colles’ fracture (or distal radius fracture). This type of break is a break in the larger of the two bones in the forearm. The bone usually breaks at the end where it connects with the hand and thumb. Wrist fractures occur through impact – either through playing sports, having fragile bones (osteoporosis) or falling down. It is essential to treat a wrist fracture as not doing so could risk the bones healing incorrectly, which may cause problems in the future. Symptoms of a wrist fracture Pain Bruising Swelling Stiffness and inability to move the fingers or thumb Numbness in the wrist or hand Medical tests to diagnose a wrist fracture An X-ray will determine the type of fracture. Sometimes a CT scan or MRI will be carried out as well to give the specialist more detail of any potential damage to soft tissue and blood vessels. What are the causes of wrist fracture? The main causes of a wrist fracture are car accidents, sports injuries and falls. Can a wrist fracture be prevented? Although you cannot prevent unforeseen events, there are measures that can help reduce the chances of injury. You can improve your bone strength by eating a healthy diet with enough calcium and vitamin D. Exercising frequently and being sure to do weight-bearing exercises too. Stop smoking. To avoid falls it is advised to wear practical shoes (not high-heels or platforms). Move any tripping hazards. Make sure your vision is fine, or your glasses prescription is correct. When playing sports, make sure protective gear is being used. Treatments for a wrist fracture If the bones are misaligned, they will need to be reset so that they heal in the correct position. This can be painful, so anaesthesia can be given. A cast will be needed for up to 8 weeks, depending on how bad the fracture is. Medications for a wrist fracture To manage any pain, over-the-counter pain medication can be taken. Which type of specialist treats a wrist fracture? An orthopaedic surgeon is the specialist that will treat wrist fractures. ...

Wrist surgery

What is wrist surgery? There are many types of surgical procedures that can be performed on the wrist, depending on the injury or condition being treated. These include both open and minimally invasive surgery on the bones, tendons, ligaments, and nerves in the wrist. As is often the case, surgery is usually only recommended by your doctor in serious situations, or when more conservative treatment has not worked. Why would you have wrist surgery? There are many things that can happen to your wrist that can warrant surgery. Generally, these are either injuries to the bones, ligaments, or nerves, or serious medical conditions that cause pain or affect the patient’s quality of life. Surgery may be recommended for the following: Broken/fractured wrist – some breaks and fractures may require procedures such as a wrist arthroscopy, while others may require stabilisation via a bone graft. Open fractures that breach the skin may require surgery immediately. Arthritis – while there is no cure, some surgical interventions, such as wrist fusions can reduce pain and increase strength. Carpal tunnel syndrome – surgery can release the pressure on the trapped median nerve. In most cases, the doctor will only advise surgery if other treatment options have failed. What does wrist surgery involve? Different types of wrist surgery involve different things: Surgical fusion – by fusing bones together, it can make the wrist stronger and reduce pain, for example, caused by arthritis. However, it severely reduces movement at the joint. Bone graft – new bone material taken from elsewhere in the patient’s body may be needed to stabilise a fracture. Metal implants, such as pins, a plate, or an external fixator frame can be fixed to broken bones to stabilise them and help them to heal in the optimal way. Arthroscopic wrist surgery is a minimally invasive procedure using a small camera called an arthroscope to guide the surgeon in using tiny surgical instruments inserted into the wrist via a small incision. Ligament surgery Tendon transfer Surgery for carpal tunnel can involve splitting the transverse carpal ligament, removing cysts, cutting tendons, and removing old scar tissue to open up the corridor inside the wrist and release the pressure on the median nerve. ...

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Mr Ioannis Polyzois Orthopaedic surgeryChertsey

Mr Ioannis Polyzois

Orthopaedic surgeon in Chertsey

MB ChB MRCS FEBOT

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Mr Ioannis Polyzois
Orthopaedic surgery
Chertsey

Orthopaedic surgeon in
Chertsey