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Protecting and Treating Our Hands

Protecting and Treating Our Hands

When our hands are healthy and pain-free, we are able to quickly and effortlessly perform countless tasks, from tying shoes to signing our names, swinging a tennis racket or steering a vehicle, texting a loved one to gardening with our grandchildren.

But because our hands are made up of a network of complex bones, muscles, nerves, and ligaments, even the smallest injury or ailment can cause pain or loss of mobility. Fortunately, there are orthopedic doctors that specialize in hand and upper extremity disorders, including those at DOC Orthopaedics and Sports Medicine. There are many injuries and conditions that can affect the hands, but here are some of the most common hand disorders as well as how they can be treated.

Carpal Tunnel Syndrome
One of the most common disorders is carpal tunnel syndrome. Essentially a pinched nerve in the wrist, this condition causes pain, numbness, and tingling in the hand and arm. Carpal tunnel syndrome may be caused by a combination of different factors that can increase pressure on the median nerve and narrow the carpal tunnel, including repetitive hand use, prolonged extreme flexion or extension of the hand and wrist, or heredity. It can also result from obesity, pregnancy, or other inflammatory conditions including diabetes, rheumatoid arthritis, and thyroid disease. Because carpal tunnel usually worsens over time, early diagnosis and treatment is especially important.
If carpal tunnel is diagnosed and treated early, patients often see results from nonsurgical treatments such as bracing or splinting, activity changes, nerve gliding exercises, or steroid injections.
If surgery is required, carpal tunnel release can be performed in an open procedure or endoscopically.
Arthritis, an inflammation of one or more joints, primarily impacts the joints of the hand and wrist in two different forms: osteoarthritis and rheumatoid arthritis. Osteoarthritis, often called “wear-and-tear arthritis,” is caused by the cartilage in joints wearing away over time, while rheumatoid arthritis is a chronic disease that causes the lining of the joints to swell, often starting in the hands or feet.
Nonsurgical treatments include anti-inflammatory medications to reduce pain, injections and splinting. Surgical intervention may be needed for pain relief and joint preservation. If the joint can’t be repaired and preserved, then joint replacement is an option.
Trigger Finger
Also called stenosing tenosynovitis, trigger finger causes one of your fingers to feel like it is locking or catching when you try to bend it. The condition causes pain and stiffness in affected fingers, most often the ring finger and thumb.
Trigger finger is caused by inflammation in the sheath surrounding the finger’s tendon and may develop after forceful hand use, but the exact cause is unknown. People with diabetes and rheumatoid arthritis are at higher risk of developing trigger finger. There are nonsurgical treatment options including rest, splinting, special exercises, pain medication, and steroid injections. Surgical treatment of trigger finger is called “tenolysis” or “trigger finger release.”
Dupuytren’s Disease
WIth Dupuytren’s Disease, the layer of tissue that lies between the skin and muscle of your palms and fingers – called the fascia – thickens and tightens over time, causing the fingers to be pulled in toward the palm in what is called Dupuytren’s contracture.
The cause is unknown, and there is no evidence that it is related to hand injuries, repetitive motion, or overuse. If the contracture limits hand function, Dr. Riehl, with DOC Orthopaedics and Sports Medicine, offers a non-surgical solution for Dupuytren’s contracture.
Ganglion Cysts
Ganglion cysts are benign (noncancerous) lumps that develop along the tendons and joints of the hands and wrists. Ganglion cysts, ranging in size from pea-sized to an inch in diameter, become painful when they press on a nerve in the hand. Depending on the location, they may also cause difficulty with joint movement.
Immobilizing the affected hand or wrist with a brace or splint may allow a cyst to shrink and relieve pain. Another procedure, called aspiration, is used to drain the fluid from the cysts. If non-surgical treatments are unsuccessful, the doctor may recommend a surgery called an excision to remove the ganglion cyst.
Dr. Randy Riehl of DOC Orthopaedics and Sports Medicine specializes in providing both surgical and non-surgical treatments for hand conditions and injuries. In addition to Xiaflex injections to treat Dupuytren’s Contracture, Dr. Riehl also performs an endoscopic carpal tunnel surgery, which offers a less invasive alternative to traditional surgery with shorter recovery time. He also specializes in sports medicine, hip, knee and shoulder pain, and joint replacement.
Dr. Riehl is a native of North Alabama raised in Huntsville, Alabama and began his education at Birmingham Southern College. He attended The University of Alabama at Birmingham School of Medicine on an academic scholarship and completed his orthopaedic residency at the internationally renowned Campbell Clinic in Memphis, TN. He has served as president of the National Clinical Orthopaedic Society and is currently Medical Staff President at Decatur Morgan Hospital.

He has board certifications in both orthopaedic surgery and sports medicine. He specializes in delivering state of the art sports medicine and upper/lower extremity musculoskeletal care utilizing advanced arthroscopic surgery, minimally invasive joint replacement, hand surgery, and complex fracture fixation. Dr. Riehl serves as the team physician for many of our area schools including Decatur High School and has been involved in many community projects in the Decatur Parks and Recreation Department as well as international medical mission trips.
Dr. Riehl continues to refine his skills by keeping abreast of the latest advances in surgical and nonsurgical techniques for musculoskeletal care. This commitment to excellence combined with over 20 years of experience ensures you will receive the best skilled orthopaedic care possible.
To schedule an appointment with DOC Orthopaedics’ skilled team of orthopaedic and sports medicine specialists, call 256-350-0362.

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