Upper Extremity Injury

The upper extremity includes the hand, wrist, forearm, elbow, upper arm, and shoulder. Injuries to the arm are commonly treated by physical therapists. Signs of upper extremity injury are deformation, limited range of motion, numbness, tenderness, pain, swelling, or bruising. For more information on shoulder conditions, specifically, visit our page on shoulder pain.

Physical therapy for elbow, wrist, and hand pain

There are many reasons why pain in the elbow, wrist, hand, and forearm occur. Repetitive stress can injure the muscles, tendons, nerves, and other soft tissue found throughout the arm. Many activities require proper use of the upper extremities. An injury can not only be painful but directly impact daily life or athletic performance. It is important to seek treatment as soon as pain or difficulty moving occurs. If ignored, these injuries can lead to further degeneration and prolonged recovery times. We will identify the cause of pain, develop an individualized plan of care, address strength, mobility, and stability, and return patients to daily activities.

Diagnosing elbow pain

Ulnar nerve injury is usually the result of excessive valgus stress on the elbow during repeated throwing or direct damage to the nerve as a result of “hitting your funny bone.” Symptoms include tingling and numbness in the ring and pinky fingers. Therapeutic exercise can help reduce inflammation in the elbow. Injury can also occur to the lateral or medial epicondylalgia, causing tennis or golfer’s elbow. These painful conditions are associated with the forearm tendons, elbow joints, or radial nerves, and often occur during repetitive use of the arm, especially with a clenched fist. Local tenderness and pain are common when extending or flexing the wrist. Activity modification, icing, progressive stretching, and strengthening will relieve most cases. Physical therapists provide an in-depth evaluation of the upper extremity to determine the source of each patient’s specific pain.

Fractures and dislocations in the arm

Many areas of the arm can suffer a fracture or dislocation. Elbow and wrist injuries often involve a fall onto the outstretched arm, while fingers are susceptible to injury during household mishaps, recreational activities, and work-related trauma. Some common injuries are the Colles, Smith’s, Scaphoid, Hook of the Hamate, or Mallet (Baseball) Finger Fracture. Early intervention helps reduce pain, increase range of motion, and ultimately restore strength and function. At times, splinting may be necessary to protect and heal the injured area.

Carpal Tunnel

Carpal tunnel syndrome is a compression of the median nerve within the carpal tunnel. Symptoms include pain, tingling, numbness in the fingers, and it is often worse at night or with driving. As the condition progresses, there may be a loss of grip strength that occurs. The cause is typically repetitive tasks involving the hand and wrist or typing on a computer. Physical therapists can help educate the patient on factors that lead to the reoccurrence of the problem and provide activity modification. Treatment includes strengthening and improved range of motion. Similar to Carpal Tunnel is Guyon’s Canal Syndrome, or Handlebar Palsy, as it’s often seen in cyclists when resting the palms of the hand on the handlebars.

Diagnosing Thumb Pain

Two commonly diagnosed thumb conditions are Skier’s Thumb and De Quarvain’s Tenosynovitis. Skier’s Thumb is when an impact on the thumb forces it out, damaging the ligament. Signs and symptoms include pain in the knuckle of the thumb, swelling, and an unstable joint. De Quarvain’s Tenosynovitis is when the tendons that extend or strengthen the thumb become inflamed. Pain is located at the base of the thumb and wrist and is often associated with repetitive work activities such as wringing and scissoring tasks.

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