Older adults and upper extremity issues

November 1, 2022

The risk for upper extremity injuries increases with age, said Dr. Brett Bentley, a sports medicine physician at University Medical Center. Bentley provided information about common upper extremity issues in older adults during an October Mini Medical School presentation. The Mini Medical School lecture series is a collaboration of The University of Alabama OLLI program and CCHS, which operates UMC. Bentley is also assistant professor of family medicine at CCHS.

According to Bentley, the most common upper extremity issues in older adults are:

Shoulder arthritis, a condition seen mostly in people older than age 50 and marked by progressive pain with activity, and a decreased range of motion.
Rotator cuff injuries, which are frequently caused by progressive wear and tear of the tendon tissue over time and seen most often in people ages 70 and older. Bentley said 65% of individuals in this age group “have a full-thickness tear in their rotator cuff. That’s a pretty high number. But we’re not seeing a lot of surgeries because there are three other muscles in the rotator cuff that can be strengthened before considering surgery.”
Tennis elbow results from overuse of tendons in the elbow, usually by repetitive motions of the wrist and arm. The condition can cause tenderness, decreased grip strength, and pain and weakness, Bentley said.
Olecranon bursitis is characterized by swelling, redness and pain at the tip of the elbow.
De Quervain tenosynovitis is a painful condition affecting the tendons on the thumb side of the wrist. Bentley said people with this condition often feel pain when they turn their wrist.
Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist. The carpal tunnel, a narrow passageway of ligament and bones at the base of the hand, houses the median nerve and the tendons that bend the fingers. “Tendons get inflamed from overuse and when that happens the median nerve gets pinched,” Bentley said.
Trigger finger is a condition in which a finger gets stuck in a bent position. Bentley said this occurs when the tendon in the affected finger becomes inflamed and swells “and then it sticks and catches and the finger gets stuck.”

Bentley said many of these upper extremity issues and injuries can be treated with anti-inflammatory medications, steroids, splints. He said they rarely require surgery.