A NOTE FROM DR. ALTMAN

Have you ever awoken in the morning with stiff fingers and inability to make a tight fist? Only after some time, or perhaps after running your hand under hot water, do you regain mobility in the fingers. Do your fingers occasionally pop or get stuck when you try to straighten them? Or what about a stiff and painful shoulder. You used to be able to reach objects overhead, or reach for something in the back seat of the car, but now that is no longer possible without marked discomfort. Stiffness and loss of mobility are very common symptoms, manifestations of musculoskeletal disease or injury.

Many assume a stiff hand is due to “arthritis”, however, this is usually not the case. Due to the many joints and moving parts in our hands, we often wrongly assume any restricted motion must be due to arthritis. The working units in the hand that move our fingers and wrist are, in fact, the tendons attached to muscles in the forearm. Loss of mobility perceived as stiffness is most often due to tendon swelling and inflammation called “tendonitis”. This is often simple to treat with either medication, rest, or a simple injection.

Certainly an arthritic joint can cause stiffness, but often not until the arthritic breakdown of the joint cartilage is far more advanced. Early arthritis usually presents as discomfort often brought on by weather changes, not stiffness.

How about the shoulder? Again we often assume that loss of mobility in the shoulder is due to the rotator cuff or perhaps arthritis. Again, this may not be the case. A “frozen shoulder”, not uncommon, can present with loss of mobility, stiffness, and pain. A frozen shoulder can often be misdiagnosed, but it is easily managed with physical therapy and predictably, a full recovery of motion. Surgery is rarely indicated.

A stiff wrist may well be related to an old injury from years back, or some repetitive trauma to the wrist from past work activities. Stretching of wrist ligaments can result in wrist instability and eventual arthritis.

Stiff elbows may result from an arthritic condition or, more commonly, soft tissue inflammation, such as tennis elbow or golfer’s elbow. People who have spent years lifting heavy objects subject the elbow to unusual loads, giving rise to wearing away of the cartilage surfaces in the joint. Construction workers, brick layers, and body builders are examples of individuals who can experience the development of arthritic elbows with loss of mobility and stiffness. A stiff elbow can make it difficult to bring your hand to your mouth making simple daily routines difficult.

It becomes evident how all the joints of the entire upper limb are uniquely inter-connected allowing for overall functionality.

OTHER COMMON SYMPTOMS