UE Conditions Pt. 2

Definition and Overview: Characterized by pain and severe loss of movement or stiffness in the shoulder joint.
Symptoms:
- Unable to move shoulder
- Dull, aching pain
Etiology:
- Repetitive movement
- Occurs after immobility
- Risk Groups:
- Thyroid conditions
- Ischemic heart disease
- Degenerative disc disease of cervical spine
Prognosis:
- Lasts $1-3\,\text{years}$ with complete resolution or only mild symptoms persisting
- Possible surgical manipulation of shoulder

Definition and Characteristics:
- Progressive condition where connective tissue thickens and scars
- Fingers move into contracted position
- Fingers flex normally but cannot be extended
Etiology:
- Autosomal dominant condition
- Unknown cause
- Often associated with diabetes, alcoholism, and epilepsy
- Demographics: Men, aged $45\,\text{years}+$
Symptoms:
- Ring and little finger are most affected
- Decreased hand function
- Nodules, pitting, and cord formation
Prognosis and Post-Operative Outcomes:
- Post-op extension: $80\%$ near normal extension
- Loss of flexion is common post-operatively
- Complications: Infection and additional loss of mobility
- Recurrence: May reoccur, especially in younger individuals and those with a family history
- Splinting may be contraindicated if contracture is too severe
Treatment:
- Corticosteroid injection
- Conservative treatment is NOT effective
- Surgical Indications: Surgery is indicated if contracture is present in the MP joint ( $20^\circ+$ ) or PIP joint ( $30^\circ+$ )
- Post-Surgical Management: Wound management, edema management, scar management, and restoring range of motion (ROM) and strength

Definition and Characteristics:
- Tumor or swelling located on top of a joint or covering a tendon
- Cyst consists of thick, sticky, clear, colorless, jelly-like material
- Depending on size, may feel spongy
Etiology:
- Unknown cause
- Trauma
- Flaw in joint capsule or tendon sheath
Symptoms and Demographics:
- Demographics: Women, aged $20-40\,\text{years}$
- Most individuals are symptom-free
- Edema, pain, and a non-stop ache (which worsens with joint motion)
- Anatomical Locations:
- Back of hand ( $60-70\%$ )
- Wrist joint
- Palm side of wrist
Prognosis:
- Good prognosis overall, though it may return
- Some cysts disappear on their own
- May require surgery

Definition and Characteristics:
- Tendon sheath malfunction
- Locking or catching in finger during extension
- Generally can hear popping during flexion and extension
Etiology:
- Inflammation of tendons and tendon sheaths
- Thickening or nodule within the tendon prevents normal excursion of the tendon
Demographics and Risk Factors:
- Demographics: Women, aged $60\,\text{years}+$
- Commonly present with diabetes and Rheumatoid Arthritis (RA)
- Several fingers may be affected at the same time
- Affected Digits (by frequency): Thumb is most common, followed by ring, middle, little, and index fingers
Symptoms:
- Small lump
- Pain in palm or digits
- Swelling
- Catching/popping sensation
- Symptoms become worse after activity
Prognosis:
- Splinting is successful in $60-66\%$ of cases
- Symptoms lasting longer than $6\,\text{months}$ are less likely to respond to non-operative treatment
- Contraindication: Sustain from activities that increase symptoms, such as gripping
Treatment:
- Corticosteroid injection
- Splint
- Surgery aimed at reducing inflammation, scar massage, pain reduction, and functional tasks

Definition and Characteristics:
- Centered on a trigger point, defined as a small hard knot
- Knot can be painful (especially when poked) and often produces referred pain
- Results from trauma to tissue
Etiology:
- Unknown cause
- Lyme disease correlation
- Exacerbating Factors: Symptoms can be exacerbated by environmental or emotional stress, poor sleep, trauma, or exposure to dampness or cold
Prognosis:
- Can be mild or disabling
- Approximately $\approx 30\%-40\%$ of individuals have to stop work or change jobs
Treatments:
- Antidepressants
- Muscle relaxants
- Stress reduction
- Healthy lifestyle
- Exercise program
- Relaxation techniques
- Biofeedback
- Receiving information about chronic pain

Definition and Characteristics:
- Compression of nerves or blood vessels
- Group of disorders that occur when blood vessels or nerves in the space between the clavicle and first rib (thoracic outlet) are compressed
Etiology:
- Poor or strenuous posture
- Carrying heavy loads
- Occupations requiring repetitive overhead arm movement can produce symptoms of compression
Symptoms:
- Swelling or edema in arm or hand
- Bluish discoloration of the hand
- Feeling of heaviness in arm or hand
- Easily fatigued arms/hands
- Superficial vein distention in the hands
- Muscle weakness
- Difficulty with fine motor tasks of the hand
- Pain in arm and hand
- Tingling and numbness in the neck, shoulder region, and arm
Treatment:
- Body mechanics
- Improve posture
- Exercise program

Definition and Overview: Damage to the network of nerves running from the spine to the shoulder, arm, and hand.
Etiology:
- Shoulder trauma
- Tumors
- Inflammation
Symptoms:
- Paralyzed arm
- Lack of muscle control in arm, hand, and wrist
- Lack of feeling/sensation in arm or hand
Prognosis:
- Depends on the severity of the injury
- Stretch injury has the best potential for recovery
- Recovery is poor when the nerve is cut or severely torn
- Surgery may improve the outcome