Wednesday, April 27, 2011

Understanding Carpal Tunnel Syndrome

In the United States, 1 out of every 20 people will suffer from the effects of carpal tunnel syndrome at some point in their lives. Out of this 5%, women are the most vulnerable and 3 times more likely to develop the condition in comparison to males. Carpal tunnel syndrome is also most common in middle aged and elderly individuals, with over 80% of patients over 40 years of age.


What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is believed to occur when the median nerve traveling through the carpal tunnel of the wrist is entrapped or compressed. The carpal tunnel is a passageway within the wrist that connects the forearm to the palm. This tunnel consists of bones, several tendons and connective tissue. This tunnel is also rather narrow and when any tendons passing through it swell, the narrowing of the tunnel often results in the median nerve becoming entrapped or compressed.


The Symptoms of Carpal Tunnel Syndrome

There are a variety of symptoms associated with Carpal Tunnel Syndrome, but the condition typically causes pain and discomfort, muscle weakness and a sensation of numbness or tingling in the hand. More specifically the most common symptoms of Carpal Tunnel syndrome include:

  • Hand and wrist pain or discomfort

  • A Tingling sensation in the fingers

  • Numbness in the fingers or hand

  • A sense of weakness in the hands

  • Pain radiating from the wrist up the arm to the shoulder


The Causes of Carpal Tunnel Syndrome

The underlying causes of Carpal Tunnel Syndrome are relatively unknown and genetic factors may be the leading cause of the condition. However, some common systemic conditions that can lead to Carpal Tunnel Syndrome include hypothyroidism, obesity, arthritis, diabetes and trauma.


Treatments for Carpal Tunnel Syndrome

Possible treatments for Carpal Tunnel Syndrome include splinting or bracing, corticosteroid injection, activity modification, anti inflammatory medications and surgical release of the transverse carpal ligament.


Immobilizing Braces for Carpal Tunnel Syndrome
The importance of wrist braces and wrist splints for reducing the amount of discomfort caused by Carpal Tunnel Syndrome is well known, but many people are unwilling to use these orthotic devices on a regular basis. However, wrist braces and splints have become lighter, cheaper and more comfortable in recent years making this form of treatment more desirable. For example, Ossur makes a Carpal Tunnel wrist brace that features a lightweight low profile design that limits motion, but maintains a high level of comfort. In addition, Swede-O manufactures several wrist braces for Carpal Tunnel Syndrome that not only limits movement, but also provides the added benefits of heat therapy.


About MMAR Medical: MMAR Medical Group Inc. is a wholesale distributor of medical devices and comfort footwear for diabetics. Whether you are looking for hinged knee braces, back braces or carpal tunnel wrist supports, MMAR Medical has the highest quality products and professional expertise to find you what you need.

Tuesday, April 26, 2011

Healing Contractures Around the Globe - Some Rigidness with a Little Give

These pictures are of a little girl I met in China who has Cerebral Palsy. Her clinicians took me to see her because of her "deformed, twisted back, right elbow and both hands." They were hopeful that my experience with contracture management would provide some relief for the girl.


The first thing I did was to find a little straight backed chair and have them to sit her up with good 90 degree Pelvic tilt. As you can see, all the neurological tone that was twisting her spine and upper body was relaxed – notice her right hand! Her left hand and right elbow had already sustained a moderate amount of shortened tissue so they were fit with Restorative Medical’s NeuroFlex® Contracture Management splints, but positioning her body in an upright position with good 90 degree pelvic tilt was all the rest of her body needed.

Every patient is different and some respond better than others to positioning, but we use the same basic guidelines with all Restorative patients. As close to upright positioning as possible. Nothing rigid. Gentle stretching, and never beyond the stretch threshold. Treatments must be comfortable and not present a potential for pressure. Splints must have "Flex" properties with memory. As Dr. Ken Mook, a prominent physiatrist in Louisville Kentucky notes "I have found that a static, rigid splint is not effective in controlling spasticity because it provides a persistence of a spastic event by not allowing the muscle to shorten. A splint that has static properties with some dynamic "give" during a spastic event allows the muscle to shorten, thereby the spastic event regresses, and yet the splint maintains the proper positioning of the joint. The NeuroFlex Restorative braces made by Restorative Medical are the best I’ve seen and used with my patients. I whole-heartedly recommend this company’s products for bracing of limbs with spasticity."


When nerves are damaged in the Central Nervous System (brain and/or spinal cord) they may cause muscles to contract with no message getting back down from the brain/spinal cord to make them relax. This is what we refer to as neurological tone or "tone." This tone begins the 3rd day after many Central Nervous System injuries. If we stop it then with the appropriate technology, we can prevent most if not all of the life-altering deformities that might occur. If the person has already developed shortened tissue, we begin to work them back toward normal alignment. Tone can result in shortened tissue. Tone and/or shortened tissue result in a loss of range of motion of the joint(s)/body parts. Loss of range of motion is commonly referred to as "contracture." Contractures in neurological patients are preventable and very treatable. Neurological patients are those with conditions like Cerebral Palsy; Multiple Sclerosis; Traumatic Brain Injury, stroke and other injuries to the brain; Parkinson’s; Dementia; Spinal Cord Injury and end stage Alzheimer’s disease. When we talk about Orthopedic/Rehab treatment we talk in days and weeks, but when we talk about Restorative patient’s treatment it is months and years.


About the Guest Author: Karen L. Bonn, RN, COF and CFO at Restorative Medical, Inc. (RMI). Headquartered in Brandenburg, Kentuckym, RMI designs and manufactures medical splints and braces for treating patients with lost range of motion resulting from immobility and diagnoses like cerebral palsy, traumatic brain injury, spinal cord injury, stroke, Parkinson’s disease and Alzheimer’s disease. RMI pioneered the massage and gentle stretch approach to treating contractures, as opposed to the old range-of-motion (ROM) exercises. MMAR Medical is grateful to Karen Bonn and RMI for their invaluable expertise as well as their philanthropic service to those in need around the globe. You can learn more about Restorative Medical’s NeuroFlex® Contracture Management elbow splint here.

Monday, April 25, 2011

Knee Injury Series Part IV - Painful Conditions & Diseases of the Knee

There are several knee diseases or conditions that can also contribute to chronic knee discomfort. These diseases often affect the soft tissues, joints, nerves and/or bones within the knee area. The most common knee diseases and conditions include arthritis, arthritis-related cysts, infections, calcification and softening of vital cartilage. An overview of each of these ailments can be found below.


Knee Arthritis

There are several types of arthritis, including genetic, degenerative and inflammatory. Genetic arthritis includes both rheumatoid arthritis and gout. An individual with these conditions is genetically predisposed to have chronic inflammation of the joint, which can be painful as well as limit movement. Osteoarthritis is the most common form of arthritis and is degenerative in nature. The cartilage gets worn down over time due to repeat usage of the knee joint. Knee arthritis can be treated with an arthritis knee brace or, in very severe cases, knee replacement surgery. In some arthritis cases, the knee’s swelling can lead to fluid building up in a cyst typically located in the back of the knee. These are often referred to ask Baker cysts. If the cyst becomes large and painful, you can have a physician drain the fluid, as well as use physical therapy and medication.


Infection on the Knee Joint or Bone

Following a puncture wound, a bacterial pathogen can penetrate the knee area through the joint, bursa, bone or skin and lead to an internal infection in the knee joint or bone. While the knee may not experience explicit pain as the result of an infection, the individual may develop a fever, experience chills in their body and a localized heat around the knee. Once diagnosed, these infections are typically treated with a round of antibiotics.

Tumors

Knee tumors are rare, but when they do appear they can impede walking and cause pain. The best treatment for tumor is surgical removal, but in a few extreme cases, it may also require lower leg amputation.


Calcification

The collateral ligament located on the inside of the knee can calcify. This is usually seen in people who have had a significant MCL ligament injury in their past and is known as Pellegrini-Stieda syndrome. The calcification leads to inflammation, but it can be treated effectively with continuous cold therapy, immobilization and rest. In some instances a cortisone shot can help.


Chondromalacia

Chrondromalacia is a condition characterized by the softening of cartilage under the patella (knee cap). It is most often seen in women, likely due to how their hips distribute weight to their knees. When the cartilage softens, it can cause significant deep knee pain as well as stiffness. Most cases of Chrondromalacia are effectively treated with anti-inflammatory medication, strengthening exercises for the quads, rest and cold therapy.


About the Author: MMAR Medical Group Inc. is a wholesale medical supplier specializing in orthopedic braces including wrist and hand braces, cervical braces and a wide variety of arthritis and hinged knee braces.

Tuesday, April 19, 2011

Knee Injury Series Part III – Types of Major Knee Injuries

In part three of our Knee Injury Series, we address the more serious knee injuries. These injuries almost inevitably result in acute pain and debilitation, but if diagnosed accurately early on, treatment can minimize discomfort and get the individual back on their feet. The primary serious knee injuries include tendinitis, fractures, ligament injuries and meniscus tears.


Chronic tendinitis in the knee

Tendons are durable, yet flexible fibrous bands of tissue that connect muscles to bones allowing the body to move. You can find tendons just about anywhere your body moves, from your fingers to your toes. There are literally 100’s of tendons throughout the human body, but there are a select few tendons that appear to be more prone to injury. One of the most common tendon injuries is tendonitis. Tendinitis is the chronic inflammation of the tendon typically as the result of overuse, though there are occasionally genetic root causes for tendonitis. Tendonitis leads to swelling, tenderness and pain during movement.


If you develop tendonitis of the knee (aka "jumper’s knee"), you experience inflammation of the patellar (below the kneecap) or popliteal tendons (located at the back of the knee). Most cases of knee-area tendonitis can be treated with reduced use, continuous cold therapy devices and anti-inflammatory medication. In some instances a medical knee brace or strap can mitigate pain and allow for increased activity.


Knee fractures

The knee is a very solid and sturdy bone, but fractures occasionally occur. Typically the result of massive trauma such as a high impact injury or automobile accident, a knee fracture requires immediate medical attention. Treating a fracture may involve surgery, a cast or bracing.


Knee ligament injuries

Perhaps one of the most common-place sports-related injuries, a knee ligament injury can be quite mild like a sprain or very severe as is the case with a full blown ligament tear. There are three possible areas the ligament can tear: the inside of the knee (medial collateral ligament), the outside of the knee (lateral collateral ligament) or inside the knee (cruciate ligaments). You will know immediately if you tear a ligament as it can be quite painful, especially when bending the knee, and many report a loud popping noise upon occurrence. It is not unusual, however, to have difficulty pin-pointing exactly where the pain is coming from and the ligaments and their respective nerves are all located within close proximity. Other symptoms of a torn ligament include swelling and localized temperature increase. Depending on the severity of your injury, ligament injuries are treated with continuous cold therapy, immobilization and elevation to decrease swelling. The individual should avoid placing weight on the injured knee, and crutches or a hinged knee brace may be required. In very severe cases surgery and long-term rehabilitation may be required.


Meniscus tears

The meniscus is a flexible c-shaped disk that cushions the knee cap. If the knee is forcefully rotated suddenly, the meniscus can tear. We see this most often in contact sports and activities that required sudden pivoting. Likewise, the risk increases for older sports participants due to degenerated cartilage. In some instances, you can have more than a single tear. These tears are characterized by a locking sensation, instability and can lead to swelling and localized warmth. In most cases, however, it takes a doctor’s expertise and an MRI to accurately diagnose a torn meniscus.


None of these knee injuries are pleasant, but they can be successfully treated with minimal discomfort if diagnosed properly early on. You should always consult a physician when you experience a traumatic knee injury, but specifically when:


  • The pain is acute, surpassing a mild throbbing sprain sensation

  • Swelling occurs instantaneously and persists

  • You cannot bear weight on your knee

  • The knee appears deformed

  • You cannot feel below the injury site

  • The lower leg, foot or ankle turn cold post injury

  • No pulse can be detected in ankle

About MMAR Medical Group: MMAR Medical Group Inc. is a supplier of medical products including a wide selection of braces and supports. To find a quality hinged knee braces, wrist braces or lumbar braces, please visit MMAR Medical online.

Thursday, April 14, 2011

Common Elbow Injuries

Joints are the body’s shocks – they absorb the impact of our falls, runs, jumps and other activities. As the center of articulation between the upper bone of the arm (humerus) and the forearm bones (ulna, radius), the elbow is an important joint for range of motion and mobility; as such, elbow injuries can prove quite a serious hindrance. Those who are at most risk include the elderly and those who are involved in more demanding sports activities such as snowboarding, skiing, mountain climbing, etc.


Dislocation:

Elbow dislocation usually occurs when one falls on an outstretched or extended arm, typically while playing contact sports or during a fall. The resulting injury involves acute pain in the elbow as well as a loss of range of motion and extension, it may also appear as though the elbow is deformed or bent awkwardly.


Dislocation can be remedied by re-aligning the elbow joint correctly, a procedure that should only be performed by a medical provider as the patient will need pain medication and an x-ray.


Fracture

A bone fracture is defined as a break in the continuity of the bone and is usually the result of high force impact or stress. Bone fractures may also be a result of a pre-existing medical condition that weakens the bones such as cancer or osteoporosis.


Much like a dislocation, fractures cause acute, localized pain, swelling, bruising and joint deformity. In the case that you believe you have experienced an elbow fracture, be sure to have it attended to as soon as possible to minimize long term complications. Typically a fracture will need time to heal so the arm may be placed in an arm brace or other elbow support.


Chronic Elbow Injuries

Chronic elbow injuries are conditions that occur over the long term, usually lasting more than 2 weeks, and are accompanied by recurrent pain, stiffness, or loss of motion. These injuries can be the result of repeated injuries, other medical conditions, or previous trauma. One of the most common causes of chronic elbow (and general joint) pain is arthritis. There are three type of arthritis – OA (osteoarthritis), PA (posttraumatic arthritis), and RA (rheumatoid arthritis), all of which may cause recurring elbow pain. Patients with OA may experience a locking or catching sensation in the joint, while those with RA typically experience swelling and joint deformity.


Another familiar chronic elbow injury is tendinitis, the inflammation of a tendon. Tendons are a tough tissue that connect bones to muscles and withstand substantial tension and their inflammation can arise from frequent, physically demanding activity (repetitive motion injury). For example, mountain climbers will typically develop tendinitis in their fingers and elbows while swimmers may develop it in their shoulders. Symptoms of tendinitis can include stiffness, aches, pains and burning around the inflamed tendon. Fortunately, anti-inflammatory medicines and psychical therapy can alleviate pain and injury. Rest, ice, compression and elevation are the four main components to recovery from tendinitis. Using cold therapy to keep swelling and inflammation at bay can alleviate pain and minimize long term damage.


Keep in mind that older adults are at higher risk for elbow injuries and fractures because they lose muscle mass and bone strength as they age. Vision and balance problems may also contribute to falling and injuries.



About the Author: MMAR Medical Group Inc. is a wholesale medical supplier specializing in diabetic footwear, cold therapy systems and various medical braces. Please visit www.mmarmedical.com for more information.