Tuesday, May 31, 2011

Orthopedic Spine Center in Chesterfield offers non-operative treatment for back pain

The Washington University Orthopedic Spine Center in Chesterfield was featured on the cover of the May 27th Ladue News.

The Washington University Orthopedic Spine Center, conveniently located at the Outpatient Orthopedic Center in Chesterfield, provides comprehensive, specialized care to patients with acute back pain and neck pain. Appointments are given within 48 hours of your inital phone call (314-514-3500), because we understand that acute back pain cannot wait a week. Non-surgical treatment modalities are offered, including medications, physical therapy, massage therapy, occupational therapy, acupuncture, bracing and injections. At the Orthopedic Spine Center, surgery is a last resort.

Psychiatry, Podiatry, but what the heck is PHYSIATRY?

Many people have never heard of a Physiatrist. However, patients who need comprehensive evaluations and conservative treatment of orthopedic conditions will benefit from an appointment with a Washington University Orthopedics physician specializing in non-operative care, also known as a physiatrist.

Dr. Heidi Prather explains more about this unique specialty within our orthopedic department. Click here.

My 50-year-old father has numbness in his left small finger. My friends believe he has carpal tunnel syndrome. Is that accurate?

Hand Surgeon, Ryan Calfee, MD:
There are actually several common nerve compression syndromes in the upper extremity. Family and friends of individuals with numbness and tingling in the hand, often suggest carpal tunnel syndrome. However, your father's symptoms are more likely related to compression of the ulnar nerve.

Carpal tunnel syndrome, the most common upper extremity nerve compression syndrome, is produced when the median nerve is compressed at the wrist. Patients with carpal tunnel syndrome may note that the thumb, index, and middle fingers feel "asleep." They may drop small items, and awaken at night feeling the need to shake out the hand to regain feeling.

In contrast, the ulnar nerve provides the sensation to half of the ring finger and the small finger. It also controls many of the small muscles within the hand. The ulnar nerve can be compressed at the elbow (most common) and at the wrist. The ulnar nerve courses around the back of the elbow where, when struck, it is responsible for the common complaint that, "I hit my funny bone." Ulnar nerve compression at the elbow is termed cubital tunnel syndrome. Numbness and tingling in the small and ring fingers is characteristic of ulnar nerve compresion. Individuals may also note atrophy of the hand muscles and difficulty bringing the small finger together against the other digits.

The diagnosis of cubital tunnel syndrome is based upon patient history, physical examination, and electrodiagnostic studies, which test the nerves ability to transmit sensory and motor signals.

Once diagnosed, treatment is dictated by the severity of compression. Mild nerve irritation can be effectively managed with bracing designed to avoid full bending of the elbow and activity modification. As the nerve becomes more involved, surgery can be performed to release the tissues that are compressing the nerve or even to move the nerve to a more protected location in the front of the elbow. Current medical literature indicates that such surgery is largely successful although severe cases may realize only a halting of disease progression as opposed to a complete reversal of symptoms.