The body's upper extremity includes the hand, wrist, shoulder, arm and elbow. The intricate bones, joints, muscles, tissue and nerves in the upper extremity make it possible for you to hold a book while reading, pick up a child, type on the computer, chop garlic, rake leaves, throw a baseball or knit a scarf.

Injury or degenerative diseases such as arthritis in any part of the upper extremity can make everyday tasks and the activities you enjoy a painful challenge. According to the American Academy of Orthopaedic Surgeons, some common upper extremity conditions include:

• Carpal Tunnel Syndrome: The median nerve travels from the forearm to the hand through the carpal tunnel in the wrist. Carpal tunnel syndrome occurs when the median nerve is "squeezed" at the wrist, resulting in numbness and tingling in the hand.
• Trigger Finger: This condition affects the tendons and pulleys in the hand that make it possible for the finger to bend. Tendons connect the forearm muscles with the bones of the fingers and thumb. The tendons are covered by a slick lining allowing the tendons to easily glide back and forth, guided by the pulley.  If the tendon lining becomes irritated or inflamed, a knot may develop preventing the tendons from gliding easily and causing the finger to become locked in a "trigger" or bent position. Although the cause is unknown, people over 40 with diabetes or rheumatoid arthritis seem to be at a greater risk for developing trigger finger.
• Tennis Elbow: A degenerative condition of the tendon fibers attached to the bony "outer" portion of the elbow. The tendons affected fasten the muscles that allow you to extend or lift the wrist and hand. Repetitive and rigorous use of the forearm muscles, such as playing tennis, may result in deterioration of the involved tendons. The result is often a severe, burning pain in the outside part of the elbow.
• Biceps Tendinitis: The biceps muscle in the front upper arm stabilizes the upper arm bone in the shoulder socket. Tendons connect the biceps muscle to the shoulder, as well as to the bone in the lower arm. The biceps controls arm movements over your head, such as swinging a tennis racket or throwing a ball. Tendinitis occurs when tendons become irritated or inflamed. Injury to the biceps tendons are typically caused by repetitive motion. The result is often pain when the arm is over the head or bent, or a snapping sound in the shoulder area.
• Rotator Cuff Tears: Muscles and tendons surrounding the top part of the upper arm bone make up the rotator cuff. These muscles and tendons hold the rotator cuff in the shoulder joint. Repetitive motion or injury may cause a painful tear of the rotator cuff. Symptoms include consistent pain especially when the arm is over the head, cracking sounds when the arm is moved and limited motion.
• Arthritis: This disease affects the joints in the body including those in the hands, elbow, arm and shoulder. Osteoarthritis is the most common degenerative joint disease, caused when the cartilage between joints wears out and bone rubs against bone. Rheumatoid arthritis is the most common inflammatory arthritis typically affecting the joints in the fingers, wrists, arms and legs.

Orthopedics is the area of medicine specializing in the diagnosis and treatment of bone, joint, tissue and nerve disorders, including those in the upper extremity. Because of this, an orthopedic physician can best diagnose and treat any upper extremity injuries or disorders.

If you are experiencing a problem in your hand, wrist, shoulder, arm or elbow, talk with your primary care physician about a referral to Valley Orthopedic Associates or call VOA at 425-656-5060.

Additional Resources:
All About Arthritis
American Academy of Orthopaedic Surgeons
American Shoulder and Elbow Surgeons
American Society for Surgery of the Hand
Arthritis Foundation