By Chris Vitello, OT
The human body is an amazing thing. With all of the bones and all of the muscles, it is amazing how it all works together so smoothly without fault. Most of the time we lose sight of this marvel, that is of course, until something does not go quite right. It is then when we question the marvel that is our body and why it is now not working quite to our specifications. My name is Chris Vitello and I am an Occupational Therapist and Certified Hand Therapist working at Brattleboro Memorial Hospital. I would like to touch upon some of the common ailments of the upper extremity that you may notice when our bodies are not working as smoothly as we would hope. Some of the names you may have heard, such as tennis elbow or golfer’s elbow; others you may not have including, de Quervain’s tenosynovitis. What does it mean if you visit your doctor because you are experiencing arm pain and they tell you that you have one of these common afflictions?
First let’s speak about tennis elbow. Tennis elbow also called lateral epicondylitis is a common tendonitis in your arm. It is typically marked by pain over the outside of your elbow; the muscles on the back of your forearm may be quite sore and painful as well. Those with tennis elbow may complain of weakness and pain with gripping or lifting and twisting activities. With golfer’s elbow, also known as medial epicondylitis, it is common to have pain on the inside of your elbow and the pain and soreness may involve the muscles on the front side of your forearm. As with tennis elbow, those with golfer’s elbow may complain of pain and weakness with lifting, twisting and gripping activities. De Quervain’s tenosynovitis was at one time referred to as Washerwoman’s Thumb, a tribute so to speak of those who would wash clothing by hand. De Quervain’s is marked by pain in the area where the base of your thumb meets your wrist. The pain may radiate up or down from that area as well. It is common for those with de Quervain’s to experience difficulty with grip and pinch as well as twisting and lifting tasks.
What do these diagnoses have in common? They all involve the tendons of certain muscles in the lower part of your arm. The tendon is the part of the muscle that attaches the muscle to the bone allowing our muscles to move around at our joints. The tendons may become inflamed and changes in their composition may occur. The intensity of the symptoms may depend on how chronic the ailment may be. Sometimes you may be able to pin point exactly what caused the onset of these common ailments, but in many cases it is not unusual that the precipitating event or events may be unclear. You may be left wondering how did this happen to me? These ailments, although not life threatening, can be quite a nuisance and may prevent you from being able to participate in the activities that are meaningful to you. You may be thinking, “Well that doesn’t sound like much fun, but what can I do to help myself?” There is help. Occupational therapy specializes in treatment of such conditions. Occupational therapists work with you to get a better understanding of what may seem like random and unexplainable pain and decreased function in your arm. We can help you uncover the tasks that may have led to the pain and the lack of function associated with these issues. By learning what is causing the pain and what to watch out for, you can then modify the way you approach tasks decreasing the pain associated with these conditions. This also allows your body to rest and heal while you can still complete your daily activities. Occupational therapists are also experts in fabricating custom splints, if necessary, to rest the affected areas. We can also help alleviate these ailments with manual techniques and modalities as well as teach you how to keep these nuisances from limiting your enjoyment of life. Common activities you may be asked to complete, once you can tolerate them, are exercise regimes to stretch and strengthen the involved muscles and tendons. Although the ailments discussed in this article are only a few of the injuries that can occur to the upper extremity, they are some of the more common. Occupational therapy can help you with all your upper extremity rehabilitation needs. A trip to your doctor to discuss your symptoms is a great first step. Your doctor can then refer you to Occupational Therapy in Rehab Services to get started on your road to recovery. .
Chris Vitello is an Occupational Therapist and Certified Hand Therapist with Brattleboro Memorial Hospital Rehab Services. He is located in the Richards Building on the Brattleboro Memorial Hospital Campus. He can be reached by calling 802-257-8255.