Why Arthritis Flares After Surgery And What To Do About It;

Transcript

Why Arthritis Flares After Events

The Movement Trap And More Pain

What Not To Do With Arthritis

Morning Heat To Ease Stiffness

Cold Running Water For Flares

How Often To Use Cold

Personalized Care And Key Takeaway

SPEAKER_00 0:03

Welcome back to the Hand to Shoulder Solution where pain meets its match. I'm your host, Carl Petito. I'm an occupational therapist and a board certified hand therapist specializing in the rehabilitation of orthopedic conditions that affect the fingertips through the shoulder. Today I'd like to talk a little bit more about arthritis. It's quite common that after surgery, whether it be a small surgery or a larger surgery, that arthritis gets exacerbated or really excited. Arthritis can very easily get worse after an event, whether it be a small car accident or a surgery or a fall or even just bumping your hand and wrist, bumping your elbow. But quite often, after, for example, a trigger finger release surgery or a carpal tunnel release surgery or a tennis elbow surgery or a fracture that has to put be repaired with plates and screws, for example. The old saying is the arthritis loves a party. And the party is whatever event occurred, and now the arthritis is all excited. So remember the itis means inflammation and arthro means joint. So let's take, for example, a carpal tunnel release surgery. A small incision is made, a tool is placed underneath, uh, a thick, heavy ligament is cut, and I discussed this on a previous episode. And it's very uh non-invasive surgery. However, it's quite common where a few days after that, patients will start having stiffness and and and pain and some swelling of the joints, and sometimes even a grinding, crunching feeling, which is that grinding crunching feeling is called crepitus. And that is a uh those are all signs of exacerbated arthritis. Well, there's some temptations because when the arthritis expands, it makes the joints feel very stiff, so patients will want to just try to keep it moving. But the trap here is that when you try to keep it moving, it'll feel good while people are doing it, but then when people stop, now the inflammation is worse because the joint surface is rubbing, rubbing, rubbing on itself, and it causes increased irritation, which therefore causes more expansion internally and makes it even tighter. Additionally, the pain will increase, and with increased pain, people will want to rub their joints, which that's a natural thing to want to do too. So if you hit a bigger part of your body, say, let's say, for example, your shin, you hit your shin on the edge of the table or or on something, you want to the first thing you want to do is reach down and rub it. That's natural because deep pressure releases chemicals that decrease pain. However, in the wrist and hand, all of these tiny bones, all of these areas, and they you can notice that there's some of them have some smaller rounded areas that sort of point out. The skin is just over the surface, so there's some connective tissue and skin. There's a there's a lot of parts in a very small area, but when you rub your fingers and you rub your hand, rub your wrist, you're right on those bones, and it's immediately aggravational to the arthritis, and it increases the itis, the inflammation. I invite you to watch other videos that I have posted on how to really specifically handle the arthritis. But here's what not to do do not fall into the trap of habitual range of motion, habitual movement. Also, do not fall into the trap of self-massage, rubbing those painful joints. What a person could do is first thing in the morning when the inflammation is at its lowest point, use electric heating pad around the wrist and hand for 10 or 15 minutes in the morning only. The breast, the hand and wrist has been resting all night long, therefore, the irritation or the inflammation is at its lowest point of the day. During the day, you start using your hand, and that's good range of motion, that's good movement, use of the hand. And it should wake up naturally, not being forced to start moving. It should wake up naturally, which the heat will allow it to wake up naturally as well. It'll increase the blood flow and bring more oxygen and nutrients to all the joint surfaces. Now, during the day, it starts to get aggravated because they're using it and abusing it and just you know using it for everyday activities. So cold shrinks. So then what's a lot more effective for the wrist in hand versus a cold pack is cold running water. So you you put the fingers and wrists under the cold running water only until it's deeply cold, and I'll go up to this bony area right here. You can see on my wrist where it if on your wrist, you can see where it where it juts up. I would go up to that point back and forth from the fingertips right down here, only until it's deeply cold, which should take 10 to 20 seconds. The time doesn't really matter. I've had patients come back to the clinic and say, Boy, you know, that really helps a lot. My pain is gone. But gee, whiz, putting it underneath that cold running water is just torture. So, well, if it's torture, it's under there way too long. So, right when it starts to feel cold, done. And that is more effective than an ice pack for 10 minutes. It's rare in life that something easier and quicker is better, but this is one of those times, so let's take advantage of it. I have some people come in with huge painful joints, and they're experiencing eight out of ten pain, and their hand is physically warmer than the other side due to the inflammation. So I have those folks go home and use that cold running water technique every hour on the hour, and then the next day I'll have them do it every two to three hours. But typically, a nice way to keep the inflammation at bay is to do it maybe late morning, after lunch, after dinner, and before bed. After a few weeks, folks tend to really feel a good uh get a good handle on what works for them. There's a lot of different situations out there, a lot of uh, you know, everybody is a little bit different. It's really optimal to be seen by your healthcare professionals so you can really get a good perfect plan that fits for you. But I want you to have an awareness that it is very, very common to have an uptick or an exacerbation of that arthritis after really any event, especially after surgery. It's it's super common, very easily fixed. Thank you for watching the Hand to Shoulder Solution, where we are the solution to your pain.