Many cases of upper limb pain are treatable.
Generally, the road to recovery begins with an accurate diagnosis. Our knowledge and experience can help determine the source of your elbow, hand, and wrist pain. Moreover, we aim to streamline services so imaging can often be accomplished during the first visit. Finally, a variety of treatment options are available to calm joint pain and promote recovery.
Our upper limbs are prone to injury and overuse.
Our hands are such an important part of everyday living. Unfortunately, this reality means more vulnerable to injury. A fall onto an outstretched hand can spell trouble for any part of the arm. Usually, the pain is often immediate. In some cases, it might appear but a few days later.
Perhaps a visit to hospital A&E reveals that a bone is not broken. That’s a relief…maybe. In general, we must always be mindful that a ‘normal’ X-ray does not exclude the potential existence of a break or fracture. Sometimes, fractures are overlooked by busy doctors. Even more problematic is a fracture involving a wrist bone called the scaphoid. Typically, it is often important to follow up an X-ray with another form of imaging, such as an MRI scan.
Other trauma-related injuries to the hand include ligament damage affecting the dorsal aspect of the wrist called the ‘scapholunate ligament’. Depending on the extent of damage to the ligament, some cases will require a cast or surgery.
Overall, this paper spells out the challenges of managing sporting hand and wrist pain.
Dreaded elbow tendonitis
Further up the arm, common elbow injuries include overuse tendonitis, such as tennis elbow and golfer’s elbow. These elbow injuries present with elbow pain when lifting. Traditionally, we treated these tendon injuries with a cortisone injection. However, recent studies suggest that patients who have a cortisone injection do worse than those who receive no treatment. The best care for patients with tennis elbow includes a thorough assessment using MSK ultrasound and exercise therapy. Occasionally, another treatment such as shockwave therapy and other types of ultrasound-guided injections (without cortisone) are needed to hasten recovery. Recently, PRP has been used for tennis elbow with good effect. Overall, tennis elbow can be a difficult condition to treat.
Other common hand and wrist conditions include thumb arthritis, carpal tunnel, trigger finger, and wrist tendonitis.
The thumb joint is the most common site of arthritis in the wrist and is treated with hand therapy, a thumb splint, and an ultrasound-guided injection of cortisone into the thumb joint. At Sportdoctorlondon, we use ultrasound and ultrasound guidance to improve the accuracy and effectiveness of an injection. Other common injuries include trigger finger and carpal tunnel syndrome, both of which are treated with a cortisone injection. We also treat cases of wrist tendonitis such as De Quervain’s tenosynovitis, which is common in new mums or individuals who use their thumbs and wrists repetitively, such as gardeners or knitters. Wrist tendonitis is also common in active athletes such as tennis players, rowers, and gym participants. Finally, trigger finger is where the tendon of the finger or thumb gets caught in a tiny pulley causing pain and clicking. An ultrasound-guided trigger finger injection is usually effective. Overall, hand and wrist conditions are common in sporty people.
Can you treat a lump in the wrist?
One of the most common causes of a slowly growing lump in the wrist is a ganglion cyst. Ganglion cysts are benign and arise from the small wrist joint or tendon sheath. These ganglion cysts are diagnosed using musculoskeletal ultrasound. Reassurance is all that is required. However, on occasion, a sports doctor will need to drain the ganglion cyst using a needle, local anaesthetic, and MSK ultrasound. Generally, the use of musculoskeletal ultrasound to perform this procedure is important. Images enable the doctor to drain the entire ganglion cyst and avoid harming structures, such as tendons or blood vessels.
Specific elbow and hand conditions: