Every year, thousands of people find themselves in an emergency room due to an upper extremity injury. Many of those injuries are the result of sports or other physical activity.
Others suffer for years with chronic pain and lack of full functioning of one or both of their upper extremities due to a neuro-muscular disease. While some conditions are rare, others are not so rare but less well known, and still others are fairly common.
“Trauma, medical conditions, infections, and degenerative disease are all contributors to musculoskeletal pain and disfunction,” notes Dr. Brian Cable, a certified member of the American Board of Orthopaedic Surgery. “Upper extremity nerve damage and injury should be evaluated by an orthopedic surgeon to identify the cause for distress and devise a treatment plan specific to the patient’s injury, lifestyle, physical condition, and long-term mobility goals.
Common upper extremity conditions affect various parts of the body, and when untreated, they can lead to immobility, debilitating pain, and overall loss of function. Recognizing the signs, symptoms, and indications of these common conditions can help in identifying the need for medical attention.
Wrist Conditions
Carpal Tunnel Syndrome (CTS)
The median nerve runs down the forearm, through the wrist, and into the hand and fingers. The nerve is responsible for the feeling on the palm side of the hand and thumb. When the passageway narrows, pressure is put on the nerve, causing wrist and hand pain.
CTS is caused by repetitive movements of the hand such as typing or working with vibrating tools. The condition is more common in women and can be caused by wrist fractures. Medical conditions such as diabetes and arthritis are often contributors to CTS.
This painful condition of the thumb can only be relieved by surgery. While it is unknown if repetitive movements—gardening, playing racket sports, or lifting heavy objects—can cause De Quervain’s Tenosynovitis, those activities and movements are known to contribute to pain.
Ganglion Cysts
These cysts occur in the upper extremities and are the most common lumps found in the hand. They are generally found around the thumb and at the end of a finger, near the nail.
Ganglion cysts are benign, and if not causing pain, there is no need to worry about them. They often do cause pain as they apply pressure to the nerves of the hand or arm. Those who play sports that involve repetitive motions of the wrist are most susceptible to developing these cysts.
Sports Injuries of Upper Extremities
Shoulder Instability and Dislocations
A dislocated shoulder occurs when a person is injured, generally during sports activity. The upper arm bone pops out of the shoulder socket. Although a person with a dislocated shoulder may regain use within a few days or a week, once a person has had a dislocated shoulder, the joint becomes unstable and prone to repeated injury.
Shoulder Impingement Syndrome
When constant rubbing of the rotator cuff occurs between the top outer edge of the shoulder and the humerus, shoulder impingement is likely. The constant rubbing causes swelling which narrows the space and results in more pain and discomfort. Treatment may involve rest, ice, cortisone injections, or—ultimately—surgery.
Elbow Injuries
Tennis elbow is a condition that affects the tendons in the elbow. It may be caused by the repetitive motion of playing tennis, but it is often found in painters, carpenters, plumbers, and other workers who use the same type of arm motion in their work.
An often debilitating condition, if tennis elbow pain cannot be relieved by conservative treatment and pain medication, surgery is often indicated.
Rotator Cuff Injuries
The rotator cuff is the area around the shoulder joint and includes tendons and muscles. It allows the arm to raise above the head and to rotate away from the body.
When this cuff is injured, a person experiences pain while moving the arm away from the body. Painters, window washers, and carpenters are prime targets of this condition since they stretch their arms overhead while performing their jobs. Those who participate in sports like baseball, volleyball, tennis, or swimming are also vulnerable to rotator cuff injuries.
If the rotator cuff is torn, surgery may be necessary to try and repair the damage. If surgery is not successful, physical therapy may help improve range of motion. Without treatment, the loss of motion may be permanent.
Medical Conditions
Osteoarthritis of the Shoulder
Osteoarthritis is a degenerative disease that occurs in the body’s joints. When it occurs in the shoulder, it can result in severe pain and lack of mobility. The risk of developing osteoarthritis in any joint increases with age. Those who have had an injury to their shoulder sometime during their life are more susceptible to developing osteoarthritis in the joint.
Bursitis
Bursitis can occur in any joint of the body but commonly occurs in the shoulders and elbow. The condition is caused by the inflammation of a small, fluid-filled sac which surrounds the joint to cushion movement. When the sac is inflamed due to extensive use, pain results. As in other joint conditions, this is often found in those who do repetitive actions in sports, like throwing balls overhead, hitting golf balls, or serving in tennis, or their work, like carpenters and window washers, or gardeners who rake and shovel.
When upper extremity pain and discomfort begin, it’s important to seek a skilled medical opinion. Early intervention can lead to restored mobility or a treatment plan to avoid further degeneration of nerves, muscle and bone. With a proper plan in place, a positive outcome is more likely and a better quality of life is the ultimate goal. If you are experiencing upper extremity pain or discomfort affecting your mobility and daily function, please reach out to your primary provider.