Splash-Conditions

Conditions We Treat

Arthritis

In normal joints, the end of the bone is covered with cartilage that serves as a shock absorber to allow smooth, pain-free movement. In osteoarthritis, that cartilage layer wears out, resulting in direct bone-to-bone contact and producing pain and deformity. One of the most common joints to develop osteoarthritis in the hand is the base of the thumb. A common symptom is pain that can be aggravated by activities that require pinching, such as turning door knobs or keys, and writing.

Arthritis that is less severe will usually respond to non-surgical treatment. Medication, splinting and cortisone injections can help reduce pain. Patients with advanced arthritis may be candidates for surgical treatment. Dr. Tsai can evaluate your arthritis and determine the best course of treatment for you.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is caused by increased pressure on the median nerve in your wrist. Carpal tunnel syndrome happens when pressure builds up from swelling and puts pressure on the nerve. When the pressure from the swelling becomes great enough to disturb the way the nerve works. Similar to a pinched nerve at the wrist, the symptoms may include numbness, tingling, and pain in the arm, hand, and fingers.

Often, symptoms can be relieved without surgery. Changing the patterns of hand use, identifying underlying medical condition or keeping the wrist splinted in a straight position may help. Sometimes, a steroid injection into the carpal tunnel may be used to relieve symptoms by reducing swelling around the nerve.

When symptoms are severe or do not improve, surgery may be needed to make more room for the nerve. Call Dr. Tsai in Corvallis, Oregon for a consultation to determine the best course of treatment for you.

Cubital Tunnel Syndrome

Cubital tunnel syndrome is cause by increased pressure on the ulnar nerve at the elbow. The location is sometimes called the “funny bone.” The ulnar nerve lies directly next to the bone and is sensative to pressure. If pressure becomes great enough to disturb the way the nerve works, numbness, tingling, and pain may be felt in the elbow, forearm, hand, or fingers. Cubital Tunnel Syndrome can develop several ways. In some patients, the ulnar nerve at the elbow clicks back and forth over the bony bump (medial epicondyle) as the elbow is bent and straightened. If this occurs repetitively, the nerve may be significantly irritated. Additionally, pressure on the ulnar nerve can occur from holding the elbow in a bent position for a long time.

Symptoms can sometimes be relieved without surgery, especially if pressure on the nerve is minimal. Changing the patterns of elbow use may significantly reduce the pressure on the nerve. When symptoms are severe or do not improve, surgery may be needed to relieve the pressure on the nerve. Dr. Peter Tsai can recommend treatment for you after a consulation.

Elbow Pain (Tennis Elbow)

Lateral epicondylitis, more commonly known as “tennis elbow,” affects the tendons that attach to the bone on the outside (lateral) part of the elbow. With lateral epicondylitis, there is degeneration of the tendon’s attachment which weakens the anchor site and puts stress on the area. This causes pain associated with activities such as lifting, gripping, and/or grasping. While tennis is commonly associated with this, the problem can occur with many different types of activities.

Treatment for tennis elbow/lateral epicondylitis usually involves limiting the aggravating activity, modifying grips or techniques, physical therapy and/or anti-inflammatory medications. A tennis-elbow brace might also help. Other treatments include steroid injections and shockwave treatment. Surgery is only considered when the pain is incapacitating and has not responded to conservative care and symptoms have lasted more than six months.

Fractures

Dr. Tsai is a respected expert in arm, elbow, wrist and hand fractures. Examination and x-rays are needed so that he can tell if there is a fracture and assess the position of the bones, in order to help determine the treatment. A splint or cast may be used to treat a fracture that is not displaced, or to protect a fracture that has been set. Fractures that are displaced or unstable are more likely to need surgery to realign and stabilize the fragments, or sometimes to remove bone fragments, and ideally allow for early motion.

Nerve repair

Nerves are wires of the body that carry information to and from the brain. They can sustain damage by pressure, stretching, or cutting. A cut nerve may result in muscles not firing properly or a loss of feeling in the area supplied by the nerve. When nerve fibers are broken, the end of the fiber farthest from the brain dies, while the insulation stays intact, leaving empty tubes which used to carry the nerve fibers. The end that is closest to the brain does not die, and after some time may begin to heal. To fix a cut nerve, the insulation around both ends of the nerve is sewn together. A nerve in a finger is only as thick as a piece of thin spaghetti, so the stitches have to be very tiny and thin. The repair may need to be protected with a splint for the first 3 weeks to protect it from stretching apart since it is so delicate. The goal in fixing the nerve is to repair the outer cover so that nerve fibers can grow down the empty tubes to the muscles and sensory receptors and work again.

The nerve may take a significant amount of time to heal. During this time you may need therapy to keep joints flexible. If the joints become stiff, they will not work even after muscles begin to work again. When a sensory nerve has been injured, the patient must be extra careful not to burn or cut their fingers since there is no feeling in the affected area. Factors that may affect results after nerve repair include age, the type of wound and nerve, and location of the injury. While nerve injuries may create lasting problems for the patient, care by a physician like Dr. Tsai and proper therapy help return to more normal use.

Shoulder Pain

Shoulder pain can be caused by anything from rotator cuff tears (partial or full thickness) to arthritis to fractures, infection and other issues. Pain can also occur in the rotator cuff, a the group of four muscles and tendons that surround the shoulder joint, providing strength and stability. If you are experiencing shoulder pain, you should contact Dr. Peter Tsai for a consultation. As an upper-arm and hand surgeon, he is specially qualified to diagnose and treat hand, elbow, and shoulder-related problems.

Trigger finger

Stenosing tenosynovitis, commonly known as “trigger finger” or “trigger thumb”, occurs when the pulley at the base of the finger becomes too thick and constricting around the tendon, making it hard for the tendon to move freely through the pulley. Sometimes the tendon develops a nodule (knot) or swelling of its lining. Because of the increased resistance to the gliding of the tendon through the pulley, one may feel pain, popping, or a catching feeling in the finger or thumb. When the tendon catches, it produces irritation and more swelling of the pulley.

Treatment may include wearing of a splint or taking an oral anti-inflammatory medication. An injection of steroid into the area around the tendon and pulley is often effective in relieving the trigger finger/thumb. If non-surgical forms of treatment do not relieve the symptoms, surgery may be recommended. Dr. Tsai can help determine the best trigger finger treatment for you.