Author: drertv

WHAT YOU NEED TO KNOW:

Mastitis is an infection of breast tissue that most often occurs in women who breastfeed. It can happen any time during breastfeeding, but usually occurs within the first 3 months after giving birth. Usually only one breast is affected.

DISCHARGE INSTRUCTIONS:

Contact your healthcare provider if:

• Your symptoms do not get better within 2 days.
• You have a painful lump in your breast.
• You have swollen and tender lymph nodes in your armpit on the same side as the affected breast.
• You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

• Antibiotics help treat or prevent a bacterial infection.
• Acetaminophen decreases pain and fever. It is available without a doctor’s order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
• NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor’s order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
• Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Manage your symptoms:

• Continue to breastfeed from the affected breast. This will help to prevent an abscess from forming. Breastfeed your baby on the affected side first. Apply a warm, wet cloth on your breast or take a warm shower before you feed your baby. This can help increase your milk flow. If it is painful when you breastfeed from the affected breast, feed your baby from the other breast first. Pump the affected side to completely drain your breast after breastfeeding, if needed. You may save the pumped milk to feed your baby.
• Use different positions to breastfeed. Change the position of your baby during feedings. This may help to relieve your discomfort.
• Apply heat on your breast for 20 to 30 minutes every 2 hours for as many days as directed. Heat helps decrease pain.
• Apply ice after feedings. Apply ice on your breast for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.
• Massage your breast. Gently massage your breast before and during breastfeeding to help drain your milk.
• Drink liquids as directed. Ask how much liquid to drink each day and which liquids are best for you.
• Rest as needed. Do not sleep on your stomach until your infection is gone.

Prevent mastitis:

• Breastfeed every 2 or 3 hours to prevent engorgement. Breast engorgement develops when too much milk builds up in your breast. Take your time when you breastfeed to allow your baby to empty your breast. Try not to switch breasts too early. Express or pump after you breastfeed if your baby is not emptying your breasts when he feeds.
• Prevent sore and cracked nipples. A good latch prevents sore and cracked nipples. If you have sore nipples after breastfeeding, your baby may not be latched on properly. Gently break suction and reposition if your baby is only sucking on the nipple. Talk to a lactation consultant if you need help with your baby’s latch.
• Care for your breasts. Keep your nipples clean and dry between feedings. Check them for cracks, blisters, or other irritated areas. Ask a lactation specialist or your healthcare provider how to treat sore and cracked nipples. Wash your hands before and after you breastfeed your baby or pump your breasts. Wear a comfortable nursing bra that supports your breasts but is not too tight.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

What is a lumbar puncture?

A lumbar puncture is sometimes called a “spinal tap.” It’s a medical procedure that can involve collecting a sample of cerebrospinal fluid (CSF). CSF is the fluid that surrounds your spinal cord and brain. A laboratory can test it for signs of certain medical conditions and infections.

When is a lumbar puncture used?

Your doctor may order a lumbar puncture for a few different reasons. They may use it to check for signs of certain medical conditions, such as:

• meningitis
• myelitis
• demyelinating diseases, such as multiple sclerosis
• cancers that can affect your spinal cord and brain
• subarachnoid hemorrhage

In some cases, they may use a lumbar puncture to administer medication directly into your spinal canal. For example, they may use it to give you chemotherapy drugs.

What are the benefits of a lumbar puncture?

A lumbar puncture can help your doctor accurately diagnose or rule out certain medical conditions, including some life-threatening illnesses. The quicker they make a diagnosis, the sooner you can get appropriate treatment. Some conditions, such as bacterial meningitis, can be fatal if you don’t get treatment for them quickly enough.

A lumbar puncture can also help your doctor give you some types of medication.

What are the risks of a lumbar puncture?

A lumbar puncture is generally considered safe, but it can involve some risks. According to the Mayo Clinic, up to a quarter of people who get a lumbar puncture develop a headache afterward. Lying down for a few hours after the procedure may lower your risk of getting a headache.

Other potential risks include tenderness or pain in your lower back and bleeding near the puncture site. You may experience some pain and numbness that shoots down your legs. In rare cases, people experience brainstem herniation, which is the movement of brain tissue from its normal position in your skull. This is uncommon.

How should you prepare for a lumbar puncture?

Tell your doctor about all of the medications you’re taking and ask them if you should stop taking any of them before your lumbar puncture. For example, they may advise you to stop taking blood thinners, such as aspirin or warfarin.

Your doctor may also order a CT or MRI scan before your lumbar puncture. They can use it to check for signs of swelling around your brain or other problems.

What should you expect during a lumbar puncture?

Your doctor will conduct a lumbar puncture using a needle and syringe. They’ll collect a sample of your spinal fluid in a tube attached to the syringe. Then, they’ll send it to a laboratory for testing.

The procedure usually takes about 45 minutes. It usually includes the following steps:

1. They’ll likely position you on your side.
2. They’ll clean your back with an antiseptic solution to reduce your risk of infection and numb it with a local anesthetic.
3. They’ll inject a hollow needle into your subarachnoid space to collect a sample of your CSF. You may feel some pressure at this point, but the procedure usually isn’t painful.
4. After they remove the needle, they’ll clean and bandage the puncture site.

For a short period after the procedure, it’s likely they’ll monitor you for a headache, dizziness, or other side effects.

What do the results of a lumbar puncture mean?

They’ll send the CSF sample to a lab for testing. Professionals in the lab may:

• evaluate its appearance for cloudiness
• check it for the presence of protein and glucose
• measure the level of red and white blood cell levels it contains
• check it for the presence of bacteria or viruses

It may take anywhere from a few hours to several days for them to analyze your sample. Your doctor can help you understand what the results mean. They’ll also advise you on any follow-up steps you should take.

What is the outlook?

Your long-term outlook will depend on your final diagnosis. Ask your doctor for more information about your specific condition, treatment plan, and long-term outlook.

Ludwig’s Angina is a true emergency. It is caused by severe dental infection in the oral cavity and is left untreated long enough that it has spread to the surrounding areas and forms a large cellulitis in the sublingual region. The condition can be so serious that the patient’s airway is compromised and needs to be immediately admitted to the hospital for IV administration of antibiotics.

Prevention: treat dental infections early to avoid any complications.

Symptoms of Ludwig’s Angina

Ludwig’s angina often follows a tooth infection or other infection or injury in the mouth. Symptoms include:

• pain or tenderness in the floor of your mouth, underneath your tongue
• difficulty swallowing
• drooling
• problems with speech
• neck pain
• swelling of the neck
• redness on the neck
• weakness, fatigue
• earache
• swollen tongue pushing against your palate
• fever, chills
• confusion

Treatment for Ludwig’s Angina

If swelling is interfering with breathing, the first goal of treatment will be to clear your airway. Your physician may insert a breathing tube through your nose or mouth and into your lungs. In some cases, an opening can be created through the neck into your windpipe. This procedure is called a tracheotomy, and is performed in emergency situations.

Surgery is sometimes necessary to drain excess fluids that are causing swelling in the oral cavity.

Oral or intravenous antibiotics will be required to fight the infection. Any additional dental infections must also be addressed.

Your Care Instructions

Temporal arteritis is an inflammation of blood vessels leading to your head and eyes. It usually affects people older than 50. It is more common in women. This condition is also called giant cell arteritis.

Temporal arteritis causes a dull, throbbing headache on one side of the head around the eye or near the temple. Sometimes the pain feels like stabbing or burning. It may also cause jaw pain and vision loss.

Temporal arteritis is treated right away to prevent blindness or stroke. Your doctor will prescribe steroids that you take as pills. The steroids can also be given to you through a needle in your vein. Most symptoms should get better quickly, usually in 1 to 3 days. But if you have vision loss, it isn’t likely to improve with treatment. You may need to take medicine for more than 2 years to prevent problems.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

• Take your medicines exactly as prescribed. Call your doctor or nurse call line if you have any problems with your medicine.
• Take your steroid in the morning with food unless your doctor tells you otherwise.
• Eat a balanced diet.
• If you are on long-term steroids, take a daily vitamin containing calcium and vitamin D. This can prevent bone thinning caused by the steroids.
• Get regular, gentle exercise to keep your bones strong and prevent bone loss. Walking is a good choice. Exercise can also help you cope with the illness.
• Tell any health professional that cares for you that you are taking steroids. You may want to wear medical alert jewellery that lists this medicine.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You have twitching, jerking, or a seizure.
• You passed out (lost consciousness).
• You have symptoms of a stroke. These may include:
  • Sudden numbness, tingling, weakness, or loss of movement in your face, arm, or leg, especially on only one side of your body.
  • Sudden vision changes.
  • Sudden trouble speaking.
  • Sudden confusion or trouble understanding simple statements.
  • Sudden problems with walking or balance.
  • A sudden, severe headache that is different from past headaches.

Call your doctor or nurse call line now or seek immediate medical care if:

• Your symptoms start to return.
• You get new headaches.
• You have nausea or heartburn.
• You have side effects of your steroid medicine, such as:
  • Weight gain.
  • Mood changes.
  • Trouble sleeping.
  • Bruising easily.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

• You do not get better as expected.

Jock itch (tinea cruris) is a red, itchy rash in the groin caused by a fungal infection. It occurs in skin folds where it’s warm and moist. It commonly starts as a small, red, itchy patch that grows larger. The patch may be in the shape of a round ring, 1 to 2 inches wide. It may cause the skin to flake. It may also spread to the scrotum or the skin that covers your testicles. This infection is treated with skin creams or oral medicine.

Home care

• If you were prescribed a cream, use it exactly as directed. You can buy some antifungal creams without a prescription.
• It may take a week before the fungus starts to go away. It can take about 2 to 3 weeks to completely clear. To stop the rash from coming back, keep using the medicine until the rash is all gone.
• Wash the area at least once a day with soap and water. Pat dry and apply medicine. 
• Wear loose-fitting underwear to let your skin breathe. Change your underwear daily.
• Once the rash is gone, keep the area clean and dry to prevent reinfection. If recurrence is a problem, use a medicated antifungal powder daily. This is available over-the-counter.

Prevention

These tips may help prevent jock itch:

• Don’t share clothes, towels, or sports gear with others unless they have been washed.
• Change your underwear daily.
• Keep skin clean and dry, especially after showering or swimming.
• If you are overweight, lose weight.
• Do’nt wear tight underwear.
• Treat athlete’s foot if it occurs.

Follow-up care

Follow up with your healthcare provider, or as advised. Call your provider if the rash is not starting to improve after 10 days of treatment, or if the rash continues to spread.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

• Increasing pain in the rash area
• Redness that spreads around the rash
• Fluid draining from the rash
• Rash returns soon after treatment
• Fever of 100.4°F (38°C) or higher, or as directed by your provider

Tinea versicolor is a rash caused by a fungus in the top layers of the skin. This fungus is normally present in the pores of the skin and causes no symptoms. But when the fungus overgrows, it causes a rash. The fungus grows more easily in hot climates, and on oily or sweaty skin. Health experts don’t know why some people get this rash and others don’t. Experts also don’t know why the rash will suddenly appear in someone who has never had it before.

The rash is made up of irregular pale or tan spots and patches. The rash is usually on the neck, upper back, chest, and shoulders. You may have mild itching, especially if you become overheated. But it doesn’t cause other symptoms. Because these spots don’t change color with sun exposure like normal skin, the rash may be lighter or darker than your normal skin.

This rash is harmless and usually causes no symptoms. The only reason for treatment is to improve appearance. Follow the suggestions below to clear the rash. It might take several months for normal skin color to return.

Home care

• Use a special medicated shampoo over your whole body while in the shower. Don’t use soap. Let the shampoo stay on for about 10 minutes before rinsing off. Do this every day for one week.
• As a different treatment, you may buy an antifungal cream (miconazole or clotrimazole, both available without a prescription). Use this daily for 2 weeks. . 
• This rash is not contagious to others. It can’t be spread if someone touches it. So you don’t have to worry about exposing others at school, daycare, or work.
• Your healthcare provider may also prescribe oral antifungal medicines to help stop the rash.

Prevention

This fungus can come back again (recur) after treatment. To prevent return of the rash, use medicated dandruff shampoo over your whole body when in the shower. Do this once a month for the next year. This is very important to do in the summertime. That is when the rash is most likely to recur.

Other prevention tips include:

• Don’t use oily skin products
• Wear loose clothing. Try to let your skin stay cool and breathe.
• Use sunscreen and protect yourself from sunlight
• Don’t use tanning beds

Follow-up care

Follow up with your healthcare provider, or as advised. Call your provider if the rash doesn’t get better with the above treatment, or if new symptoms appear.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

• Increasing redness of the rash
• Change in appearance of the rash
• Fever of 100.4ºF (38ºC) or higher, or as directed by your provider

Tinnitus is when you hear ringing, clicking, buzzing, or hissing in one or both ears. You may also hear whistling, chirping, or pulsing. It may be soft or loud, and at a low or high pitch. Tinnitus that lasts for longer than 6 months is considered chronic.

DISCHARGE INSTRUCTIONS:

Call 911 if:

• You feel like hurting yourself or others because of the constant noise.

Contact your healthcare provider if:

• You have headaches.
• You are tired and have trouble concentrating or remembering things.
• You have more anxiety or stress than usual.
• You have deep sadness or depression.
• You have trouble falling asleep or staying asleep.
• Your symptoms do not go away or they get worse.
• You have questions or concerns about your condition or care.

Manage tinnitus:

• Counseling can help you learn ways to relax, decrease stress, and make your tinnitus less noticeable.
• Cognitive behavioral therapy helps you understand your condition. Your therapist will help you learn to cope with tinnitus. You may also learn new ways to relax and retrain your behavior to decrease your symptoms.
• Sound therapy, such as white noise machines, may help cover your tinnitus with a pleasant sound. Sound therapy devices can help you fall asleep or help you relax. These devices can be worn in your ear or placed next to your bed at night.
• Hearing aids or cochlear implants may help if you have hearing loss.
• Do not smoke. Nicotine decreases blood flow to your ear and can make your tinnitus worse. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help quitting.
• Decrease how much alcohol and caffeine you drink. Alcohol and caffeine can make your tinnitus worse.

Prevent tinnitus:

• Avoid exposure to loud noise, such as loud music or power tools. Occasional exposure can still cause tinnitus. Move away from the noise or turn down the volume.
• Wear ear protection when you are exposed to loud noises. Good ear protection includes ear plugs or headphones that reduce noise.

Follow up with your healthcare provider in 1 to 2 months:

Your healthcare provider may refer you to an otolaryngologist, audiologist, or neurologist. You may need to return for regular follow-up visits. Write your questions down so you remember to ask them during your visits.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Toxoplasmosis is a disease that results from infection with the Toxoplasma gondii parasite, one of the world’s most common parasites. Infection usually occurs by eating undercooked contaminated meat, exposure from infected cat feces, or mother-to-child transmission during pregnancy.

Toxoplasmosis may cause flu-like symptoms in some people, but most people affected never develop signs and symptoms. For infants born to infected mothers and for people with weakened immune systems, toxoplasmosis may cause serious complications.

If you’re generally healthy, not pregnant, and have been diagnosed with toxoplasmosis, you probably won’t need any treatment other than conservative management. If you’re pregnant or have lowered immunity, you may need medical management to avoid severe complications. The best approach, though, is prevention.

Symptoms

Most healthy people who are infected with toxoplasmosis have no signs or symptoms and aren’t aware that they’re infected. Some people, however, develop signs and symptoms similar to those of the flu, including:

• Body aches
• Swollen lymph nodes
• Headache
• Fever
• Fatigue

In people with weakened immune systems

If you have HIV/AIDS, are receiving chemotherapy or have recently had an organ transplant, a previous toxoplasma infection may reactivate. In that case, you may develop more-severe signs and symptoms of infection, including:

• Headache
• Confusion
• Poor coordination
• Seizures
• Lung problems that may resemble tuberculosis or Pneumocystis jiroveci pneumonia, a common opportunistic infection that occurs in people with AIDS
• Blurred vision caused by severe inflammation of your retina (ocular toxoplasmosis)

In babies

If you become infected for the first time just before or during your pregnancy, you can pass the infection to your baby (congenital toxoplasmosis), even if you don’t have signs and symptoms yourself.

Your baby is most at risk of contracting toxoplasmosis if you become infected in the third trimester and least at risk if you become infected during the first trimester. On the other hand, the earlier in your pregnancy the infection occurs, the more serious the outcome for your baby.

Many early infections end in stillbirth or miscarriage. Infants who survive are likely to be born with serious problems, such as:

• Seizures
• An enlarged liver and spleen
• Yellowing of the skin and whites of the eyes (jaundice)
• Severe eye infections

Only a small number of babies who have toxoplasmosis show signs of the disease at birth. Often, infants who are infected don’t develop signs — which may include hearing loss, mental disability or serious eye infections — until their teens or later.

When to see a doctor

If you are living with HIV or AIDS or are pregnant or thinking of becoming pregnant, talk to your doctor about being tested if you think you may have been exposed to toxoplasmosis.

The signs and symptoms of severe toxoplasmosis — blurred vision, confusion, loss of coordination — require immediate medical care, particularly if your immune system has been weakened.

Causes

Toxoplasma gondii (T. gondii) is a single-celled parasitic organism that can infect most animals and birds. Because T. gondii infectious organisms are excreted only in cat feces, wild and domestic cats are the parasite’s ultimate host.

Although you can’t “catch” toxoplasmosis from an infected child or adult, you can become infected if you:

• Come into contact with cat feces that contain the parasite. You may accidentally ingest the parasites if you touch your mouth after gardening, cleaning a litter box or touching anything that has come in contact with infected cat feces. Cats who hunt or who are fed raw meat are most likely to harbor T. gondii.
• Eat or drink contaminated food or water. Lamb, pork and venison are especially likely to be infected with T. gondii. Occasionally, unpasteurized dairy products also may contain the parasite. Water contaminated with T. gondii isn’t common in the United States.
• Use contaminated knives, cutting boards or other utensils. Kitchen utensils that come into contact with raw meat can harbor the parasites unless the utensils are washed thoroughly in hot, soapy water.
• Eat unwashed fruits and vegetables. The surface of fruits and vegetables may contain the parasite. To be safe, thoroughly wash and peel all produce, especially any you eat raw.
• Receive an infected organ transplant or transfused blood. In rare cases, toxoplasmosis can be transmitted through an organ transplant or blood transfusion.

When a person becomes infected with T. gondii, the parasite forms cysts that can affect almost any part of the body — often your brain and muscle tissue of different organs, including the heart.

If you’re generally healthy, your immune system keeps the parasites in check. They remain in your body in an inactive state, providing you with lifelong immunity so that you can’t become infected with the parasite again. But if your immune system is weakened by disease or certain medications, the infection can be reactivated, leading to serious complications.

Risk factors

Anyone can become infected with toxoplasmosis. The parasite is found throughout the world.

You’re at risk of serious health problems from toxoplasmosis infection if:

• You have HIV/AIDS. Many people with HIV/AIDS also have toxoplasmosis, either a recent infection or an old infection that has reactivated.
• You’re undergoing chemotherapy. Chemotherapy affects your immune system, making it difficult for your body to fight even minor infections.
• You take steroids or other immunosuppressant drugs. Medications used to treat certain nonmalignant conditions suppress your immune system and make you more likely to develop complications of toxoplasmosis.

Complications

If you have a normal immune system, you’re not likely to experience complications of toxoplasmosis, although otherwise healthy people sometimes develop eye infections. Untreated, these infections can lead to blindness.

But if your immune system is weakened, especially as a result of HIV/AIDS, toxoplasmosis can lead to seizures and life-threatening illnesses such as encephalitis — a serious brain infection.

In people with AIDS, untreated encephalitis from toxoplasmosis is fatal. Relapse is a constant concern for people with toxoplasmosis who also have a weakened immune system.

Children with congenital toxoplasmosis may develop disabling complications, including hearing loss, mental disability and blindness.

Prevention

Certain precautions can help prevent toxoplasmosis:

• Wear gloves when you garden or handle soil. Wear gloves whenever you work outdoors and wash your hands thoroughly with soap and water afterward.
• Don’t eat raw or undercooked meat. Meat, especially lamb, pork and beef, can harbor toxoplasma organisms. Don’t taste meat before it’s fully cooked. Avoid raw cured meat.
• Wash kitchen utensils thoroughly. After preparing raw meat, wash cutting boards, knives and other utensils in hot, soapy water to prevent cross-contamination of other foods. Wash your hands after handling raw meat.
• Wash all fruits and vegetables. Scrub fresh fruits and vegetables, especially if you plan to eat them raw. Remove peels when possible, but only after washing.
• Don’t drink unpasteurized milk. Unpasteurized milk and other dairy products may contain toxoplasma parasites.
• Cover children’s sandboxes. If you have a sandbox, cover it when your children aren’t playing in it to keep cats from using it as a litter box.

For cat lovers

If you’re pregnant or otherwise at risk of toxoplasmosis or its complications, take these steps to protect yourself:

• Help your cat stay healthy. Keep your cat indoors and feed it dry or canned cat food, not raw meat. Cats can become infected after eating infected prey or undercooked meat that contains the parasite.
• Avoid stray cats or kittens. Although all stray animals need good homes, it’s best to let someone else adopt them. Most cats don’t show signs of T. gondii infection, and although they can be tested for toxoplasmosis, it may take up to a month to get the results.
• Have someone else clean your cat’s litter box. If that’s not possible, wear gloves and a face mask to change the litter. Then wash your hands well. Change the litter daily so that excreted cysts don’t have time to become infectious.

Trigger Finger and Trigger Thumb, medically termed Stenosing Tenosynovitis, are common hand conditions.  This condition occurs when the tendons in the thumb and fingers do not glide smoothly.  Tendons are strong tissues that connect our muscles to our bones.  Trigger Finger and Trigger Thumb causes the tendons to catch or get stuck when the fingers or thumb bend.  This condition makes it difficult to straighten the fingers and thumb back out. It can also cause pain, discomfort, and swelling.  Trigger Finger can occur in one or more fingers or the thumb at the same time, or it may occur in different fingers with or without thumb involvement at different times.

Anatomy We have tendons that attach to our thumb and finger bones.  The tendons pass through a tunnel, called a tendon sheath, and connect to the muscles from our forearm.  These muscles allow our fingers and thumb to straighten or extend, such as when our hand is placed flat on a table. Normally, our tendons glide smoothly through the tendon sheath allowing for smooth and easy movements.  However, tendons can have difficulty fitting through the tendon sheath if they are swollen or develop a nodule, a small round mass.  The tendon sheath may also swell from irritation, creating a smaller opening for the tendons to fit through.  When the tendon gets stuck in the tendon sheath it can cause pain, swelling, and a popping or catching feeling.  Your finger or thumb may become stuck in one position and may be difficult to bend or straighten.

Causes The cause of Trigger Finger and Trigger Thumb is not always clear.  The condition is more common among women than men.  It occurs most often in individuals between the ages of 40 and 60 years old. Trigger Finger and Trigger Thumb develop more frequently in people with certain medical conditions, such as diabetes, rheumatoid arthritis, autoimmune disease, and gout.  Additionally, some individuals may be born with a nodule on their tendon. In some cases, repetitive gripping, such as holding tools, can cause the tendons to become irritated.

Symptoms The symptoms of Trigger Finger and Trigger Thumb usually begin with pain and discomfort at the base of the finger or thumb.  You may also feel pain in the palm of your hand. The area may be swollen and you may feel a small lump. You will have difficulty bending and straightening your fingers or thumb.  It may feel like they catch or get stuck when you try to move them.  The stiffness and catching may be worse when you first wake up in the morning or after periods of inactivity.  Your fingers or thumb may loosen up with movement.  Your pain may increase when your finger or thumb becomes free. In severe cases, the fingers or thumb can become stuck and unable to move.

Diagnosis Your doctor can diagnose Trigger Finger or Trigger Thumb by examining your hand. Your doctor will ask you about your symptoms and level of pain.  Your doctor will feel for any clicking or popping during movement and note any restricted movement.  A locked finger or thumb typically leads to diagnoses of Trigger Finger or Trigger Thumb.

Treatment For people with mild symptoms, rest and pain relief may relieve symptoms.  Your doctor may recommend that you wear a splint for support and to promote healing.  Your doctor may suggest over-the-counter pain medication to reduce discomfort and swelling. In some cases, physicians choose to inject an anti-inflammatory cortisone medication into the site.

Surgery Surgery is recommended when other treatments have failed or if the thumb or finger is stuck in a bent position.  There are a couple of surgical options, and your doctor will help you decide which is best for you.  One surgery is performed on an outpatient basis.  Your surgeon will numb the area and make a small opening on the palm side of your hand.  Your surgeon will make an incision in the tendon sheath.  This will create a larger tunnel for the tendons to fit through and enable them to glide easily. Another option is a procedure that can take place in your doctor’s office.  In some cases, the tendon sheath can be safely opened with the tip of a needle.  This will also create a larger tunnel for your tendons to move through with ease.

Recovery Recovery is individualized and dependent on the extent of the condition and the type of surgery performed.  Your doctor will be able to tell you what to expect.  You will be able to move your fingers or thumb immediately following surgery.  You may experience discomfort or swelling for a short period.  A few individuals may require hand therapy to help regain movement, but most people achieve a full recovery in just a few weeks.

Torticollis is a severe tightness of the muscles on one side of the neck. The tight muscles can make the head turn to one side, lean to one side, or be pulled forward or backward. It is also called wryneck.

Your doctor asked questions about your health and examined you. You may also have had X-rays or other tests. If your doctor thinks another medical problem is causing your tight neck muscles, you may need more tests.

Torticollis usually gets better with home care. Your doctor may have you take medicine to relieve pain or relax your muscles. He or she may suggest exercise and physiotherapy to help increase flexibility and relieve stress. Your doctor may also have you wear a special collar, called a cervical collar, for a day or two. The collar may help make your neck more comfortable.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

• Be safe with medicines. Read and follow all instructions on the label.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• Try using a heating pad on a low or medium setting for 15 to 20 minutes every 2 or 3 hours. Try a warm shower in place of one session with the heating pad.
• Try using an ice pack for 10 to 15 minutes every 2 to 3 hours. Put a thin cloth between the ice and your skin.
• If your doctor recommends a cervical collar, wear it exactly as directed.

When should you call for help?

Call your doctor or nurse call line now or seek immediate medical care if:

• You have new or worse numbness in your arms, buttocks, or legs.
• You have new or worse weakness in your arms or legs.
• Your neck pain gets worse.
• You lose bladder or bowel control.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

• You do not get better as expected.