All Posts Tagged: wrist

prp for wrist osteoarthritis

Regenerative Platelet Rich Plasma Injections for Wrist Osteoarthritis

Orlando, Florida – Wrist osteoarthritis is a “wear and tear” degeneration of the joint surfaces in your wrist. The wrist contains 8 carpal bones that serve as a junction between the other bones of your thumb, hand and forearm. Inflammation can occur at any of these joint surfaces, causing pain and decreased range of motion. Your doctor can make the diagnosis of wrist osteoarthritis by your history, physical examination, and x-rays.

Wrist osteoarthritis can range from mildly irritating to severely debilitating. Gordie Howe, a.k.a. “Mister Hockey,” had to retire from the game because of severe arthritis in his left wrist. Howe is widely regarded as one of the greatest hockey players of all time, but wrist osteoarthritis prematurely ended his career in the National Hockey League.

The mainstays of wrist osteoarthritis treatment are activity modification, immobilization, and specific physical therapy exercises. In essence, the goal is to stop the activities that led to the arthritis, perhaps by immobilizing or bracing the wrist with a splint for time, and then performing selective exercises to increase strength, stability, and range of motion. People with moderate or severe wrist osteoarthritis may require steroid injections such as cortisone into the wrist to reduce inflammation. If surgery is necessary, an orthopedic surgeon may perform a proximal row carpectomy, which is a procedure to remove several carpal bones in the wrist. Another more limiting option is a fusion, where the bones of the wrist are fused together so they cannot move relative to one another.

A newer, non-surgical option for wrist osteoarthritis is the use of platelet rich plasma (PRP). Unlike most medications, platelet rich plasma is produced from a patient’s own blood. “A small amount of blood is drawn and spun down to isolate a portion of the blood that contains platelets, growth factors, and other molecules that help facilitate healing,” reports Dr. Jason Pirozzolo, a sports medicine physician in Orlando, Florida and President of the American Regenerative Medicine Society.  “These are the same substances that are circulating in your blood normally; however, the PRP procedure concentrates the substances so they can be reinjected into the arthritic wrist.”

People with wrist osteoarthritis at the base of the thumb benefited from platelet rich plasma (PRP) injections in clinical studies. PRP treated individuals had less pain, greater strength, and greater wrist function than those treated with a placebo injection.1 Furthermore, platelet rich plasma improved outcomes in people with osteoarthritis in the carpal bones of the wrist.2

Wrist osteoarthritis is a chronic, painful, degenerative arthritis that limits range of motion and interferes with work and daily activities. In athletes, wrist osteoarthritis has been career-ending. As with other forms of osteoarthritis, treatment usually starts conservatively, with wrist splints, activity modification, and physical therapy. Physicians may use occasional steroid injections to reduce pain and inflammation. Severe cases of wrist osteoarthritis may require orthopedic surgical treatment. “Fortunately, platelet rich plasma therapy may prove to be an additional treatment tool in the physician’s toolbox. While additional research is needed, PRP may be able to help patients delay or avoid invasive treatments such as surgery,” said Pirozzolo.

 

Authored by © The American Regenerative Medicine Society

Dr. Jason Pirozzolo is the Director of Sports Medicine and Trauma at Orlando Hand Surgery Associates and Orlando Regenerative Medicine Center. He specializes in non-surgical orthopedic treatments, regenerative medicine and platelet rich plasma injections. He is also the President of The American Regenerative Medicine Society and serves on the Board of Governors at the Florida Medical Association and as a delegate to the American Medical Association.

References

  1. Loibl M, Lang S, Dendl LM, et al. Leukocyte-Reduced Platelet-Rich Plasma Treatment of Basal Thumb Arthritis: A Pilot Study. Biomed Res Int. 2016;2016:9262909. doi:10.1155/2016/9262909
  2. Steiner MM, Calandruccio JH. Biologic Approaches to Problems of the Hand and Wrist. Orthop Clin North Am. Jul 2017;48(3):343-349. doi:10.1016/j.ocl.2017.03.010
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What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a common and painful disorder of the wrist and hand. In most cases, carpal tunnel syndrome symptoms worsen over time. If you think you may be dealing with carpal tunnel syndrome, it is important to receive a proper diagnosis and treatment before symptoms become more severe.

What Is carpal tunnel syndrome?

The carpal tunnel is a narrow passageway that allows the median nerve to pass from the forearm to the hand. Carpal tunnel syndrome occurs when the median nerve is pinched or pressed. Pressure from the pinched nerve may cause swelling in the tunnel resulting in pain, numbness, and tingling in the hand and wrist.

Causes

There are various factors that may contribute to the development of carpal tunnel syndrome. Risk factors for this condition include:

– Repetitive Stress
– Arthritis
– Joint dislocations
– Fractures
– Fluid retention during pregnancy
– Swelling of the flexor tendons

Symptoms

Symptoms usually occur along the nerve path and may cause the hand to “fall asleep.” Symptoms are often times felt during the night, but may be noticed during the day as well, while performing normal activities. In most cases, symptoms begin gradually and may come and go. In severe cases, permanent damage may occur, causing loss of sensation and strength in the hand and wrist.

Some symptoms include:

– Numbness and pain in the thumb, index, middle, and ring fingers
– Weak grip
– Tingling
– Sensitivity to cold
– Muscle deterioration

Diagnosis 

Providing a detailed summary of medical conditions, injuries, and how the hands are currently being used, are necessary when diagnosing carpal tunnel syndrome. Nerve tests and x-rays may be taken in order to check for fractures, arthritis, and other possible nerve issues.

Treatment

Treatment options will depend on the severity of the condition. Early treatment options include:

– A wrist splint to reduce pressure on the nerve
– Steroid injections to reduce swelling
– Activity modification

If symptoms persist, or become severe, surgery may be recommended.

To learn more about carpal tunnel syndrome, make an appointment with one of our doctors at Orlando Hand Surgery Associates at any of our three locations.

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