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or inflammation of the connecting tissues between http//www.arthritis.org.za the heel bone (calcaneus) and the tissue of the fore and midfoot. Walking is painful until pressure is ARTHRITIS taken off the heel. FOUNDATION The carpal tunnel syndrome Registered Nonprofit Organisation - No. 002-847 NPO The median nerve passes through a fibrous tunnel Helpline No: 0861 30 30 30 (the carpal tunnel) on its way from the forearm to E-mail: 539-5094 (031) Tel/Fax: 4014 Dalbridge X04, P/B 309 # POSTNET Branch Kwazulu-Natal [email protected] E-mail : 421-7330 (021) Fax: 425-4759 (021) Tel: 8012 Roggebaai 6775 Box PO 8001 Town Cape Avenue Strijdom Hans C entre Tulbagh 705 Branch Cape Western E-mail : 0382 576 082 Cell: 365-1419 (041) Tel: 6055 Park Newton 7740 Box PO Branch Cape Eastern E-mail: 447-0451 (051) Fax: 4234 921 082 Cell: 9320 Willows 20269, Box PO Branch Bloemfontein the hand. The median nerve supplies sensation to

the thumb, index and half of the middle finger. [email protected] [email protected] [email protected] Pain, numbness and tingling in the thumb and index finger disturbs sleep. Shaking or rubbing the hand improves the symptoms. In advanced cases , there may be wasting and weakness of the muscles at the base of the thumb. TENDINITIS Treatment of Bursitis / tendinitis My payment is made by: Please contact your local branch ( For details of Associate membership (individuals joining through the community outreach programme. 1. Rest is beneficial for up to 48 hours, and keeping Postal Address (if different): ______Home Address (number, name of dwelling, street, suburb, city/town/district, postal code: ______Preferred form of address for corespondence ie. Dear ______Surname: ______First Names ______Contact Details: Title (Mr., Mrs., Ms., Dr., Professor, other: ______      Please tick relevant boxes: THE CARPAL

the arm in a sling may be very helpful. A wrist Electronic Payment to: Crossed cheque Donation Corporate membership Individual membership New application Branch Code: 02090900 Standard Bank on splint, worn at night, will help to relieve the Account No.: 070965226 pain of the carpal tunnel. TUNNEL 2. Ice cubes rolled in a towel and applied to the MEMBERSHIP APPLICATION/ANNUAL RENEWAL FORM Registered Non-profit organisation number 002 847 NPO ARTHRITIS FOUNDATION painful area for 15 - 20 minutes 3 - 4 times daily may also help. SYNDROME

3. After a period of rest graduated exercise must ______Date be started to keep the joints moving freely. and RELATED 4. Anti-inflammatory drugs may be prescribed to R R5 000 R reduce inflammation and pain. ). 100 CONDITIONS In some cases cortisone drugs may be injected into Card number, on front of Credit Card the area of inflammation. The cortisone acts locally Signature: Plus card verification code (last 3 digits at BACK of your 

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so there is little danger of serious side effects. Local Other International membership Renewal cortisone acts very quickly. Surgery is rarely need- ed for resistant problems at the shoulder, elbow or ______This information leaflet is published by the Arthritis Foundation as for the carpal tunnel. part of our continuing education programme for all people with arthritis.

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Bursitis leaflet ENG.indd 1 6/29/11 10:38:13 AM What do these mean ? Unaccustomed repetitive use of the shoulder (par- produce pain over these two prominences which A bursa is a closed sac-like structure which allows ticularly in older individuals), such as painting a may be very disabling. The pain of the outside two tissues to glide freely over one another. Common wall, may cause part of the rotator cuff to become prominence is called a lateral epincondylitis or bursal sacs are at the tip of the elbow, at the shoul- inflamed, and whenever this inflamed area is , while the other is called a medial der, at the patella (knee-cap). Bursitis means inflam- moved it produces pain which (unexpectedly) is epicondylitis or golfer’s elbow. mation of the bursal sac. felt at the mid upper arm, and not at the shoulder. The common movements which cause pain are 3. Hand Tendons are specialised extensions of muscles raising the hand above the shoulder or turning the The flexor tendons which bend the fingers may which attach muscles to bones. Tendinitis is inflam- arm to put on a coat. Sleep is disturbed when lying become inflamed, or a small nodule (lump) may mation of a tendon. An enthesis is the point of on the affected side, particularly if both sides are form in one or more tendons. These lumps may attachment of a ligament or tendon to bone. affected. In some there may be calcium crystals in cause the tendon to stick as it slides in its sheath. Inflammation at this point is called an enthesopa- the rotator cuff (seen on X-Ray of the shoulder) thy. which may start an attack. This is usually very The finger will remain bent until it has been severe and any movement causes intense pain. straightened by applying pressure to the finger, or What causes bursitis/tendinitis ? by massaging the palm of the hand over the lump. One of the complications of tendinitis of the shoul- Repeated, particularly unaccustomed, use is one This is called a . In others the tendons der (frozen shoulder, when the movements are cause. Gout, rheumatoid arthritis and infection are of the thumb become inflamed (such as pruning, ‘frozen’ and may cause pain and stiffness) is that common causes of bursitis. Some specific bursal typing, etc.). This produces pain at the base of the the hand, on the same or opposite side, may start to problems have common names such as house- thumb or a lump may be felt over the radius (the swell for some obscure reason and become stiff. maid’s knee, weaver’s bottom, clergyman’s knee, forearm bone above the thumb). The skin becomes very sensitive and turns a purple- which emphasises the role of repeated use of white colour. With time (usually more than 18 certain parts of the body in causing inflammation. 4. Hip months) the shoulder movements will return, but if An inflammation of the bursa between the tendons the hand is not treated promptly the fingers may Tendinitis or an may be caused of the buttock muscles and trochanter (the promi- remain permanently bent. by repeated or over-use. Some less common nent part of the thigh bone on the outside of the causes are rheumatoid arthritis and infections. The hip). This may be very troublesome and cause The frozen shoulder also occurs in patients after a entheses are frequently affected in ankylosing anxiety about possible arthritis of the hip. Lying on stroke, in some people who have Parkinson’s spondylitis. the affected side may disturb sleep. disease and in diabetics. What are the symptoms of bursitis / tendinitis ? Inflammation of the bursa lying over the ischium The rotator cuff may rupture following use, this (the bone in the buttock) will cause difficulty in sit- The main symptom is pain which may vary from a causes pain and difficulty in raising the arm to a ting. mild ache to quite severe pain which limits move- horizontal position. ment. A characteristic feature is pain which dis- 5. Knee turbs sleep especially when lying on the affected The biceps tendon (the biceps muscle lies in front of side. the humerus) may also be injured; this is called a Several bursal sacs around the knee may become bicipital tendinitis. inflamed. One over the knee cap is called prepatel- Some common types of bursitus / tendinitis lar bursitis (housemaid’s knee), one just below the 1. Shoulder 2. Elbow knee cap is called infrapatellar bursitis (clergy- man’s knee) and on the inside of the knee the The shoulder is a joint which allows very complex The lower end of the humerus above the elbow joint anserine bursa may swell and cause pain, but it movement, and the tendons and the shoulder has two prominences, one on the inside and the does not cause pain when the knee is bent. bursa are commonly injured. Some of the tendons other on the outside of the elbow. All the muscles which permit rotational movements are arranged which move the fingers and wrist are attached to 6. Ankle as a cuff around the humerus (upper arm bone). these prominences (the muscles which bend the This is called the rotator cuff. The rotator cuff is fingers and wrist come from the inside prominence, The commonest tendon problem of the ankle is separated from the acromion (the bony promi- and those which straighten the fingers and wrist inflammation of the achilles tendon behind the nence at the tip of the shoulder) by a bursa called come from the outside prominence). Both these ankle. This is very common in sportsmen. Another the subacromial bursa. attachments may be torn or become inflamed and troublesome problem at the ankle is plantar

Bursitis leaflet ENG.indd 2 6/29/11 10:38:14 AM