Upper Extremity Orthopedic Specialist in Kalispell, Montana

 

Orthopedic Services

Hands on, one on one care, without the use of assistants or techs, every time and every touch.

 

Hands are how we interact with the world around us.  We touch, hold, grasp, feel, manipulate, push, pull and carry with them everyday.  They are incredibly useful, tough, sensitive, resilient, and complex.  The number of bones, muscles, tendons, ligaments, nerves and blood vessels packed into such a small space make them one of the most complex parts of the human body orthopedically.  When they become injured or no longer work correctly it impacts everything we do and the impact is greater than with any other part of the body.  Therapy for the hand and arm is a specialized field that requires special training and experience.  Only trust your hands and arms to a Certified Hand Therapist who is trained and experienced in how to provide the specialized care you need.

Rick has been treating hand and arm injuries for 26 years and is one of only a handful of fellowship trained Certified Hand and arm Therapists in the country.  At TrueNorth Upper Extremity and Orthopedic Specialists hand, arm, shoulder and lymphedema rehab is all we do.  It is our focus and our passion.  Helping you regain the function in your hand or arm so you can return to living life to the fullest is our highest priority!   

“We can land men on the moon, but for all our mechanical and electrical wizardry, we cannot reproduce an artificial fore-finger that can feel as well as beckon.”  John Napier

 

Carpal Tunnel - Carpal tunnel is caused by the compression of the median nerve at the wrist.  It can cause numbness, tingling and pain in the hand, most commonly in the thumb, index and middle fingers.  Dropping things and having increased symptoms at night are common complaints.  It is the most common peripheral nerve compression in the body and it affects 3-6% of the population.  It affects women and caucasions more frequently but anyone can get it.  It most commonly occurs between the ages of 45 -60.  Carpal tunnel often responds to non-surgical treatment and therapy can provide advice on the best splints to wear and when to wear them.  It is also important to avoid certain activities and wrist positions and we provide the correct exercises and skilled manual therapy to help alleviate your symptoms.

 

Tennis Elbow also known as lateral epicondylitis - Tennis elbow is a dysfunction of the tendon that inserts into the outside of the elbow.  This tendon is primarily responsible for helping to lift your wrist.  There is controversy as to whether this condition is a tendonitis, meaning it is an inflammatory condition of the tendon, or whether it is a tendonosis, indicating it is a degenerative condition of the tendon.  For most people it probably has phases of both and it depends on what stage of the condition you are in.  It can be very painful and debilitating and often it does not resolve quickly.  Research has shown, however, that therapy provides better client satisfaction long term than steroid injections which often mask the pain resulting in continued trauma to the tendon and increased pain when the steroid wears off.  Specialized therapy is important to help guide how activities should be modified to reduce the strain on the tendon.  Manual therapy to increase the blood flow to the tendon and to stimulate the tissue to remodel and reorganize is important.  Research has shown that there is a specific mobilization of the elbow that can help provide pain relief for this condition for many people.  Stretching and strengthening are also key components to the rehab process but need to be performed within safe parameters and at the right time and in the right amount to avoid reaggravating the condition. 

 

Trigger finger - Trigger finger is a condition in which a finger gets stuck in a bent position when gripping or making a fist and then snaps straight when the finger is extended.  This can happen in one or multiple fingers. 

Trigger fingers are caused when the lining around the tendon, the tenosynovium,  in the affected finger becomes inflamed. This causes the tendon to thicken and swell creating a nodule or bump on the tendon.  When this occurs it makes it difficult for the tendon to slide through a series of tunnels or pulleys in the hand and finger.  Women, people with diabetes or arthritis, some rheumatological conditions and people whose regular activities involve forceful gripping, squeezing or strain to their hands are more at risk for this condition.  However, it can occur in anyone and occasionally babies are born with this condition in their thumbs.

Symptoms include stiffness, a popping or clicking sensation, often felt in the middle knuckle of the finger rather than in the palm where the problem resides, and tenderness in the affected finger or hand below the triggering finger. Triggering often occurs during the night causing people to wake up with their finger in a flexed or locked position and their symptoms are usually worse in the morning.

Treatment includes modifying activities to reduce the triggering and therapy, including splinting which has shown up to 87% effectiveness in reducing symptoms and avoiding injections or surgery.  Splinting helps by preventing triggering and resting the involved finger and tendon allowing the inflammation to decrease and the tendon nodule to shrink.  Manual therapy can also be beneficial.  Cortisone injections and surgery are also options in more severe cases or if the condition does not respond to more conservative treatment.  

 

Thumb arthritis -  Arthritis at the base of the thumb is one of the most common forms of arthritis in the hand.  It is common with aging and with activities that require frequent or forceful pinching or pressure through the thumb.  It occurs when cartilage wears away from the ends of the bones that form the joint at the base of your thumb — also known as the carpometacarpal (CMC) joint or basal joint.

Thumb arthritis is usually progressive over time and results in loosening of the joint capsule and ligaments around the base of the thumb.  This can cause the thumb to become unstable or partially slide out of the joint.  Pain with pinching and use of the thumb, swelling and enlargement of the base of the thumb are common side effects.  However, the degree of pain is not always reflective of the severity of the arthritis.  It can also cause decreased strength and range of motion, making it difficult to do simple tasks, such as holding a pen, turning a key or opening jars. The thumb will often gradually lose the ability to open widely and laying your hand flat on a table may be difficult.  Therapy to provide splints which support and position the thumb has been shown through research to decrease pain over time.  Exercises to stabilize the thumb and to improve the thumb position or posture can also be beneficial.  Modalities to warm the hand, learning how to modify activities and using adaptive devices to lessen the stress on the thumb can also help to ease the pain.  Medication may also help to manage the pain.  Severe thumb arthritis might require surgery.

 

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