Loic Bullock

Answers to patient questions

• General topics

  Who do I see about wrist/thumb pain? I have had pain in my thumb and wrist, mostly when picking things up (like a mug of tea). I was rock climbing regularly when it started to bother me, and after resting it for two months, it still is causing me pain. There was no specific moment that caused the injury.
  • For wrist and thumb pain, especially related to activities like rock climbing and exacerbated by gripping or lifting, you should see a hand specialist. Here are your options for specialists and steps to take:
    
    1. Orthopedic Hand Specialist
    
    • These are orthopedic doctors who focus on injuries and conditions of the hand, wrist, and forearm. They can evaluate structural issues like tendinitis, ligament damage, or early arthritis.
    
    2. Certified Hand Therapist (CHT)
    
    • Hand therapists specialize in rehabilitation of the hand and wrist. They can help with movement assessments, strengthening, and pain management. O...ften, they work in conjunction with orthopedic doctors.
    
    3. Physical Therapist (PT)
    
    • A physical therapist can help assess functional impairments and provide exercises to improve strength, mobility, and reduce pain.
    
    4. Sports Medicine Physician
    
    • Since this injury likely originated from your climbing, a sports medicine doctor can evaluate overuse injuries and work with specialists to develop a treatment plan.
    
    Possible Diagnoses
    
    Some conditions related to your symptoms and activities include:
    • De Quervain’s Tenosynovitis: Inflammation of the tendons on the thumb side of the wrist, common in repetitive gripping activities.
    • Tendinitis or Overuse Injury: General inflammation of the tendons from climbing.
    • Ligament Sprain or Tear: Minor or moderate ligament damage, which could still cause pain after two months.
    • Cartilage Damage: Rare but possible from repetitive stress or small undetected injuries.
    • Trigger Thumb: If your thumb feels stuck or clicks.
    
    Immediate Steps
    
    • Stop Climbing or Aggravating Activities: Ensure you’re fully resting the area.
    • Use a Thumb Spica Brace: These braces immobilize your wrist and thumb to allow healing.
    • Apply Ice or Heat: Ice for inflammation and heat for stiffness can provide relief.
    • Over-the-Counter NSAIDs: Medications like ibuprofen can reduce inflammation.
    • Seek Imaging if Advised: X-rays or MRIs can rule out structural damage.
    
    Since it hasn’t improved after two months of rest, it’s time to consult a professional to prevent chronic issues. Read more

    Loic Bullock

• Knee pain

  Hi, I think I sprained my left knee. So, I got a knee support from the pharmacy to support recovery. As a self-diagnosis, I have no problems walking, the inner side ligaments seem to be healing better, but even after 8 weeks, the knee still feel sore. I can swim, but not really run and certainly not do any contact sports. It's probably best to finally see a general doctor. After seeing a general doctor, in case it is necessary, what could be the possible next steps to investigate what is wrong with the knee?
  • If your knee has been sore for 8 weeks and hasn't fully healed despite using knee support, it's definitely a good idea to see a general doctor. Here are the possible next steps after seeing the doctor:
    
    1. **Physical Examination**: The doctor will likely start with a physical examination of your knee to assess the range of motion, stability, and specific areas of pain. They might perform specific tests to check for ligament or meniscus injuries.
    
    2. **Imaging Studies**:
    - **X-ray**: To rule out any fractures or bone-related issues.
    - **MRI (Magnetic Resonance Imaging)**: This is the most effective way to eval...uate soft tissue injuries, such as ligament tears (like ACL or MCL), meniscus tears, or cartilage damage.
    
    3. **Referral to a Specialist**: Based on the initial assessment, your general doctor might refer you to an orthopedic specialist for further evaluation and treatment.
    
    4. **Possible Treatments**:
    - **Physical Therapy**: A physical therapist can provide exercises to strengthen the muscles around the knee, improve flexibility, and promote healing.
    - **Medications**: Nonsteroidal anti-inflammatory drugs (NSAIDs) might be recommended to reduce pain and inflammation.
    - **Bracing or Orthotics**: Depending on the injury, a more specialized knee brace might be recommended to provide better support.
    - **Injections**: In some cases, corticosteroid or hyaluronic acid injections might be used to reduce inflammation and pain.
    
    5. **Surgical Options**: If conservative treatments are not effective and the injury is severe (such as a complete ligament tear or a significant meniscus injury), surgery might be considered. This could range from minimally invasive arthroscopy to more extensive reconstructive surgery.
    
    6. **Activity Modifications**: Until a definitive diagnosis and treatment plan are in place, you might need to avoid high-impact activities, such as running and contact sports, to prevent further injury.
    
    It's important to follow through with these steps to ensure proper diagnosis and treatment, which will help in achieving a full recovery. Read more

    Loic Bullock

• General topics

  hello which doctor is best to advice on tendon/ligament pain and arthritis in the knee? thank you
  • For tendon/ligament pain and arthritis in the knee, the best type of doctor to consult is:
    1. Orthopedic Specialist:
    • These doctors specialize in the musculoskeletal system, including bones, joints, tendons, ligaments, and muscles. They can diagnose and treat conditions like arthritis, tendonitis, or ligament injuries.
    2. Sports Medicine Doctor:
    • If your pain is related to physical activity or sports, a sports medicine doctor can offer non-surgical treatments, rehabilitation plans, and advice on preventing further injury.
    3. Rheumatologist:
    • For arthritis, particularly if it’s inflammatory (e.g., rheumatoid ar...thritis or gout), a rheumatologist specializes in autoimmune and joint conditions and can provide comprehensive care.
    4. Physical Medicine and Rehabilitation (PM&R) Specialist:
    • Also known as physiatrists, these doctors focus on non-surgical treatments to improve function and reduce pain in musculoskeletal conditions.
    
    Hello,
    If you’re unsure where to start, a primary care physician can assess your symptoms and refer you to the appropriate specialist. Read more

    Loic Bullock