Symptoms

Hand

Numbness of fingers (fingers go to sleep, feel cold, feel different, or don’t feel as well):

All fingers: You probably have carpal tunnel syndrome. You may also have cubital tunnel syndrome. I will need to examine your arm to confirm this. Call 713-800-1120 for a consultation. We will obtain a “nerve conduction study” to assess the extent of the compression. While nerve studies are only “one piece of the puzzle”, not the “answer to the puzzle” and may be wrong, it’s important to get them anyway to make sure that no other nerve problems are contributing. Unless there is nerve damage, I usually recommend a night splint for 4 weeks as the first line of treatment for the carpal tunnel syndrome. Unless there is nerve damage, for cubital tunnel syndrome I usually recommend avoiding leaning on the elbow, as is often done when driving or sitting at a desk, and avoiding prolonged elbow flexion. Prolonged elbow flexion usually occurs when you talk on the phone and at night, as we all sleep in the fetal position, with our arms bent. To avoid prolonged elbow flexion, use the other hand to hold the phone, or get a “hands-free” device, such as a blue tooth, etc. Elbow flexion is tougher to avoid at night when we sleep. Try wrapping a towel around your elbow or putting a tennis elbow brace over the elbow (higher than it’s usually worn) to prevent the elbow from bending all the way. Some recommend cutting a hole in a pillow case and putting your arm through it to have the pillow splint your arm in extension at night.

Thumb / index / middle finger: You probably have carpal tunnel syndrome. I will need to examine your arm to confirm this. Call 713-800-1120 for a consultation. We will obtain a “nerve conduction study” to assess the extent of the compression. While nerve studies are only “one piece of the puzzle”, not the “answer to the puzzle” and may be wrong, it’s important to get them anyway to make sure that no other nerve problems are contributing. Unless there is nerve damage, I usually recommend a night splint for 4 weeks as the first line of treatment for the carpal tunnel syndrome.

Small finger / ring finger: You probably have cubital tunnel syndrome. I will need to examine your arm to confirm this. Call 713-800-1120 for a consultation. We will obtain a “nerve conduction study” to assess the extent of the compression. While nerve studies are only “one piece of the puzzle”, not the “answer to the puzzle” and may be wrong, it’s important to get them anyway to make sure that no other nerve problems are contributing. Unless there is nerve damage, for cubital tunnel syndrome I usually recommend avoiding leaning on the elbow, as is often done when driving or sitting at a desk, and avoiding prolonged elbow flexion. Prolonged elbow flexion usually occurs when you talk on the phone and at night, as we all sleep in the fetal position, with our arms bent. To avoid prolonged elbow flexion, use the other hand to hold the phone, or get a “hands-free” device, such as a blue tooth, etc. Elbow flexion is tougher to avoid at night when we sleep. Try wrapping a towel around your elbow or putting a tennis elbow brace over the elbow (higher than it’s usually worn) to prevent the elbow from bending all the way. Some recommend cutting a hole in a pillow case and putting your arm through it to have the pillow splint your arm in extension at night.

Finger or thumb gets stuck or locks: You probably have trigger finger / trigger thumb. I will need to examine your hand to confirm this. Call 713-800-1120 for a consultation. I recommend a steroid (cortisone) injection as the first treatment for trigger fingers and trigger thumbs.

Thumb or fingers pain, especially when using them, and you’re 55 years or older. You may also have stiffness without much pain:

At the base of your thumb: You may have Basilar (basal) thumb arthritis. I will need to examine your hand to confirm this. Call 713-800-1120 for a consultation. I recommend a steroid (cortisone) injection, splinting and activity modification (not grasping or pinching small objects, if possible) as the first treatment for basilar thumb arthritis.

At your finger joints: You may have Finger Arthritis. I will need to examine your hand to confirm this. Call 713-800-1120 for a consultation. I recommend a steroid (cortisone) injection and either splinting or “buddy taping” as the first treatment for finger arthritis.

Fingers getting stiff and curling down due to a rope-like cord in your palm: You probably have Dupytren’s contracture. I will need to examine your hand to confirm this. Call 713-800-1120 for a consultation. I usually don’t recommend surgery unless the MP joint (the large knuckle where your finger attaches to your hand) is flexed 30° or the PIP joint (the middle knuckle of your finger) is involved.

Wrist

Pain on the thumb (radial) side of your wrist, especially when lifting or pulling: You may have DeQuervain’s Tendinitis. I will need to examine your wrist to confirm this. Call 713-800-1120 for a consultation. I recommend a steroid (cortisone) injection, splinting and avoiding pulling or lifting with your thumb up as the first line of treatment for DeQuervain’s tendinitis.

Bump on your wrist: You may have a ganglion. I will need to examine your wrist to confirm this. Call 713-800-1120 for a consultation. Ganglions on the back of your wrist are initially treated by aspirating them. This provides a permanent cure in 1/3 to 1/2 of patients. If the ganglion returns you can either live with it or have it removed surgically. Ganglions on the front of your wrist shouldn’t be aspirated, because they’re usually directly over the radial artery. These can be left alone or removed surgically.

Pain on the small finger (ulnar) side of your wrist, especially when putting weight on it, extending it or rotating it: You may have a triangular fibrocartilage tear. I will need to examine your wrist to confirm this. Call 713-800-1120 for a consultation. I recommend a steroid (cortisone) injection, splinting and avoiding heavy activities as the first line of treatment for triangular fibrocartilage tears.

Elbow

Pain on the outside or inside of your elbow: You probably have tennis elbow or golfer’s elbow. I will need to examine your elbow to confirm this. Call 713-800-1120 for a consultation. I recommend at least 3 months of good physical therapy (strengthening the elbow muscles), avoiding stressful activities, using a tennis elbow brace and a steroid (cortisone) injection as first line of treatment for tennis or golfer’s elbow.

Pain all over your elbow and you’re over 55 years or injured your elbow: You may have elbow arthritis. I will need to examine your elbow to confirm this. Call 713-800-1120 for a consultation. I recommend at least physical therapy (strengthening the elbow muscles), avoiding stressful activities, and a steroid (cortisone) injection as first line of treatment for elbow arthritis.

Painful pop in the front of your elbow: You may have a biceps tendon tear. I will need to examine your elbow to confirm this. Most active patients desire to have this surgically repaired in order to preserve the strength of their arm. This is best performed early (within a few weeks). If you think you’ve torn your biceps tendon it’s best to call 713-800-1120 immediately for a consultation.

Shoulder

Shoulder pain, especially at night and/or when reaching up in the air: You probably have a rotator cuff injury. If you’ve had trauma (a fall, motor vehicle accident, etc) you may even have a rotator cuff tear. I will need to examine your shoulder to confirm this. Call 713-800-1120 for a consultation. I usually recommend at least 3 months of good physical therapy (strengthening the shoulder muscles), avoiding stressful activities, and a steroid (cortisone) injection as first treatments for rotator cuff problems. However, if you’ve sustained trauma (a bad fall, sports injury, motor vehicle accident, etc.) and have trouble lifting your shoulder you may have traumatically torn your rotator cuff, and will probably do best with an early arthroscopic repair.

Shoulder feels unstable or has come out of the socket: You probably have shoulder instability. I will need to examine your shoulder to confirm this. Call 713-800-1120 for a consultation. I usually recommend at least 3 months of good physical therapy (strengthening the shoulder muscles) and avoiding stressful activities as initial treatment for shoulder instability. However, if you’re a young athlete (25 years old or younger) and have dislocated your shoulder, you’ll probably do better with an early arthroscopic stabilization.