Soft tissue injuries of the handCarpal tunnel Syndrome. Carpal tunnel syndrome is an arm disorder that causes tingling, numbness and other indications. Carpal tunnel syndrome is associated with a pinched nerve in the wrist. Factors that can contribute to the carpal tunnel syndrome are; patterns of hand use, anatomy of one's wrist or certain health risk factors. Bound by tendons and bones, carpal tunnel is a thin pathway that is situated on the palm flank of the wrist. That passageway protects the main nerve from the hand and tendons that bend the limbs. The compression of the nerve is what produces the tingling, numbness and eventual weakness that characterize the tunnel syndrome. The system starts gradually with numbness in the thumb, middle and index fingers that comes and goes. It is usually associated with the discomfort on the wrist and hand. The common carpal tunnel syndrome include Numbness on the fingers excluding the small finger or hands that occur while holding the steering wheel, newspaper or phone. The tingling can also wake a person from sleep and may spread from the fingers to the arm (Veen, Mischa, and Schipper, 2013). A person may experience weakness on the affected finger and even tend to drop objects. The numbness may be due to the weakness of the thumbs pinching muscles that are controlled by the median nerve. Carpal tunnel disorder occurs due to the firmness of the median nerve. Anything that irritates, crowds or bandages the median nerve in the tunnel space may lead to the carpal tunnel syndrome. In many cases, no single factors that can be identified and it may be a combination of factors that contribute to the condition. Numerous factors have been associated with carpal tunnel syndrome. They include; anatomic factors, nerve damaging, inflammatory conditions, sex, alteration in of the body fluids, work place factors or other medical conditions. The doctor should examine the patterns of the sensation of numbness and the complete history of symptoms because the evaluation may offer clues to the causes. For a comprehensive evaluation, the doctor may opt for X-ray, electromyogram, physical examination or nerve conduction surgery. If the nonsurgical treatment fails to rectify the anomaly, surgery might be an appropriate treatment. The goal of the carpal tunnel surgery would be to relieve the pressure on the median nerve by cutting the ligaments that are pressing the nerve. The two options of the surgery procedure are; Endoscopic surgery and open surgery.
De Quervain Tenosynovitis De Quervain’s tenosynovitis is painful condition that distress the ligaments on the scanned side of the wrist. The condition hurts every time the patient makes a fist, grasps anything or turns the wrist. It is known to be caused by activities that require repetitive wrist or hand movements such as playing golf, racket sports, working in the garden or lifting heavy items. The symptoms of De Quervain conditions are swelling near the thumb base, difficult in moving the thumb when trying to grasp or pinch something, a stop and go sensation in one's thumb when moving it. The condition is usually associated with: the chronic overuse of the wrist, direct injury to tendon, inflammatory arthritis such like rheumatoid arthritis or scar tissues that resist movements of the tendons. Persons between 30 to 50 years have a greater risk of having the condition that those other ages. The disorder is common in females than in males, and it is associated with parenting. Baby care involves using thumbs as leverage to lift the baby many times in a day (Yang, Isaac, et al. 2011).
The physical evaluation by a doctor involves testing whether the patient feels pain when pressure is applied on the thumb of the wrist or perform the Finkelstein test. For the severe cases, the doctor may recommend outpatient surgery that involves opening of the sheath to restore the free tendon gliding. An occupational therapist should teach the patient strengthening exercise after surgery.
Fractures of the handBoxer’s fracture Boxers fracture, also called brawler's fracture is a crack of a long bone that connects the little finger to the wrist. The boxer's fracture occurs in the metacarpal bones. Symptoms of a boxer’s structure are tenderness or pain that is centered in a specific location that corresponds with metacarpal bones. Pain may also be experienced from the knuckles.
Physical evaluation in conjunction with radiological images is essential to diagnose the boxer's fracture properly. Analysis that may suggest the use of radiological images include activities that may increase the risk of fracture, localized tenderness, swelling of the hand among others.
If a boxer's fracture is noticed the crucial goal is to immobilize the hand to permit proper healing and alleviate the pain that is associated with fractures. For severe injuries, a slip should be used to immobilize the joints below and above the position of injury.Soft tissue injuries of the foot.Plantar Fasciitis. Plantar fasciitis is among the common causes of heel ache. It involves swelling of a dense band of tissue that is called the plantar fascia that runs across the lowermost part of the foot and links the heel bone to the limbs. Plantar fasciitis causes piercing pain that follows with the first few steps in the morning. After the foot limbers, the pain reduces but may return after standing for long. Plantar is common in athletes and the overweight people. Under normal circumstance, the plantar fascia acts as a shock absorbing bowstring that support the arch in the foot. If the tension on the bowstring is high, it may create tears in the fascia. The repetitive tearing and stretching can cause the fascia to become inflamed. Factors that increases the risk of developing plantar fasciitis are; being of the age between 40 and 60 years old, certain types of exercise, faulty mechanics, obesity and occupations that keep a person on feet for long hours. For the diagnosis, the doctor refers the patients’ physical evaluation and their history. Occasionally, the doctor may recommend magnetic resonance imaging or X-ray to confirm the cause of pain. If the conservative interventions fail to treat the condition, the doctor may recommend steroid shots, extracorporeal shockwave therapy or surgery.
Fractures of the footStress fractures
Stress fractures are tiny fissures in a bone that are the cause by repetitive application of force. Stress fractures may occur from the normal use of bone that is weakened by conditions like osteoporosis. The fractures can also because by running long distances or jumping up and down repeatedly. They are most common in the weight bearing bones of the lower leg and foot. Long distance athletes are particularly prone to stress fractures because of running for long distances and jumping up and down. Stress fractures may also occur to any person who starts a new exercise and do a lot too soon. The pain that is associated with stress fractures is barely noticeable, but it tends to worsen with time. The tenderness originates from a particular spot, and it decreases when at rest. There may be also some swelling around the painful area.
Causes of stress fracture are: repetitive application of the amount of force that is greater than the capacity of the feet and the lower legs. That excessive force causes an imbalance between responsive and the growth of bone that continues to grows all the time. The repetitive force promotes the turnover of bone cells but new bone cells are added while at rest. When a person is subjected to unaccustomed force without enough time to recover, he or she absorbs bone cells faster than their rate of replacement. Consequently, a person develops bone fatigue, and if the pressure is continued, the fatigued bones develop some tiny cracks that usually progress to become stress fractures. Factors that might increase the chances of suffering stress fractures are a sudden shift in from a sedentary lifestyle to active exercises, sports like gymnastic or basketball, foot problems and weakened bones. Some stress fractures might not heal properly, and that may lead to chronic pain. Although doctors may diagnose a stress fracture from medical history and medical evaluation, image ray tests may be needed to confirm the diagnosis.
Work citedYang, Isaac B., et al. "Interphalangeal dislocation of toes: a retrospective case series and review of the literature." The Journal of Foot and Ankle Surgery 50.5 (2011): 580-584.Veen, Mischa, and Inger B. Schipper. "Irreducible fracture of the proximal interphalangeal joint of the fifth toe." The Journal of emergency medicine 44.1 (2013): e63-e65.
