Arthritis in the hand is extremely common. In most cases, this is due to osteoarthritis, but may also be related to previous injury, rheumatoid arthritis, and/or other systemic illness. There are many factors that can affect your symptoms and function. Treatment for arthritis is patient-specific, your doctor can help develop a plan tailored to your goals.

Causes and risk factors

• Age
• Obesity
• Females are more susceptible than men
• Prior injury
• Repetitive stress
• Genetics
• Diabetes Mellitus
• Auto-immune disease such as Rheumatoid Arthritis or Lupus

Symptoms

• Burning pain
• Sharp pain with use
• Stiffness
• Swelling
• Bone spurs

Diagnosis and treatment

In most cases, the diagnosis can be made based on a physical exam and obtaining x-rays. Treatment for osteoarthritis varies depending on a patient’s goals. The following nonsurgical treatment options can be effective.

• Activity modification
• Massage
• Over the counter anti-inflammatory medications (ibuprofen, naproxen)
• Anti-inflammatory herbs such as turmeric or ginger
• Topical pain relief creams/gels
• Occupational/Physical Therapy
• Corticosteroid injections
• Prescription anti-inflammatory medications

If these treatments do not work, surgery may provide pain relief and/or improved function. On rare occasions, and/or if the arthritis is related to an auto-immune disease than evaluation by a rheumatologist can be warranted.

Dupuytren’s Contracture develops when the fibrous tissue layer underneath the palm and fingers begins to thicken. Small bumps form under the skin and may lead to the fingers contracting and curling in.

Causes and risk factors

• Common in people of Northern European or Scandinavian ancestry
• Frequently runs in the family
• May be associated with drinking alcohol
• May be associated with certain medical conditions such as diabetes and seizures
• Increases with age

Symptoms

• Initially, small sensitive lumps form in the palm. Usually with time, the pain subsides and goes away
• Nodules may thicken and contract creating tough bands of tissue under the skin inside the fingers and in the palm
• Most commonly the ring and little finger are affected, curling in towards the palm
• Becomes hard to straighten the bent fingers

Diagnosis and treatment

Your orthopedic surgeon will examine your hand and test the feeling in your thumb and fingers. The specified hand’s grip and pinch strength may also be evaluated. Your doctor will be able to use these recorded measurements to determine if the disease is systematic. There are multiple types of treatment for this disease, although there is no cure. In many cases, Dupuytren’s can be treated with a minimally invasive procedure performed in the office.

Carpal Tunnel Syndrome is a common condition that causes pain, numbness and tingling in the hand and wrist. This is caused when the tunnel becomes narrow or when the tissues surrounding the flexor tendons become inflamed and swell causing pressure on the median nerve.

Causes and risk factors

• Heredity
• Repetitive hand use
• Doing activities with extreme flexion or extension of the hand and wrist
• Pregnancy or other conditions that cause your body to hold onto fluid
• Diabetes
• Rheumatoid arthritis
• Wrist injuries

Symptoms

• Tingling and numbness in fingers – primarily in the thumb, index, middle, and ring fingers.
• Pain or tingling that travels up the arm toward the shoulder.
• Lack of strength in grip and finger coordination – this may make it difficult to participate in normal activities such as buttoning your shirt.
• Dropping things due to weakness or numbness
• Nighttime symptoms are very common and may awaken you from sleep.

Moving or shaking your hands can sometimes help to relieve symptoms.

Diagnosis

Most people that have carpal tunnel will notice that their symptoms gradually worsen over time. It is important to be evaluated in the early stages to slow or stop the progression of carpal tunnel syndrome. An orthopedic surgeon will examine your hand and wrist and test for nerve damage. An EMG or Nerve Conduction Study will help confirm if there is too much pressure on the nerve. Sometimes an ultrasound, x-ray or MRI will also be ordered. These tests help your doctor determine the severity of your carpal tunnel syndrome.

Treatment

Nonsurgical treatments include rest, ice, wrist splints, nonsteroidal anti-inflammatory drugs (NSAIDS), or steroid injections. Other options may include modifying your activity to reduce symptoms and slow the progression of the disease.

If conservative treatment options do not relieve your pain, your orthopedic surgeon may recommend surgery. A carpal tunnel release surgery increases the size of the carpal tunnel and decreases pressure on the nerve. This procedure can either be performed using endoscopic surgery or with traditional open surgery. There are risks and benefits to both and your doctor will discuss both with you. Some patients who choose endoscopic carpal tunnel release may be eligible to utilize wide-awake local anesthesia rather than general anesthesia.

Recovery

After surgery you may be encouraged to do the following:

• Elevate your hand above your heart and move your fingers to reduce swelling and prevent stiffness.
• Ice the surgical site for a given amount of time, a few times a day.
• You may need to wear a splint or wrist brace for several weeks.
• Follow your doctor’s specific instructions on when it’s okay to return to work and whether you will have any restrictions on your work activities.
• If you experience increased pain and weakness for more than two months following surgery, you may be referred to a hand therapist to help improve your recovery.

It is likely that surgery will improve your previous symptoms, but recovery can be gradual, and in some cases, can take up to one full year. Other factors that can contribute to longer recovery times are preexisting conditions, such as arthritis or tendonitis, which could also be contributing to pain and stiffness.

Carpal tunnel surgery aftercare and milestones you can expect to meet with carpal tunnel release can vary. Click here for one example of how your recovery could progress.

Train Your Brain is presented to third grade classrooms across Central Oregon. Prompted by an alarming increase of preventable head injuries in young people, The Center Foundation pioneered Train Your Brain as part of the Brain Trust initiative.

This elementary school outreach provides innovative, research-based curriculum on the importance of helmet use and brain and spinal cord injury prevention. The program reaches more than 2,000 students each year and distributes more than 1,000 helmets annually to those in need. These helmets should always be worn when participating in any non-motorized wheeled sport, including bicycling, skateboarding, roller blading and scooter riding.

Please help kids stay safe and healthy by encouraging them to be active and take all possible precautions to prevent injury – like wearing a helmet. 

Helmet Safety Tips

If you would like more information, or know of a child in need of a helmet, please call Stuart Schmidt at 541-322-2323 or email [email protected]. 

2025 Presentation Schedule

Train Your Brain is brought to you with the help of our generous sponsors! Thank you! 

 

How Train Your Brain got started

Years ago, a young Bend boy was struck by a car while riding his bike without a helmet. He was rushed to the ER where one of The Center Foundation’s board members, a neurosurgeon, was on call. Tragically, and in spite of our board member’s best effort, the boy did not survive.

As a result, and with the intention of preventing further tragedies, The Center Foundation adopted programs to educate our grade school kids on the importance of protecting their brain and spinal cord by learning and using good safety skills.

Today, St. Charles continues what The Center Foundation started by offering educational presentations to youth organizations in Central Oregon, including: elementary schools, boy scouts, pre-schools, summer camps, and English as a second language class. The presentations include age-appropriate discussions of brain and spinal cord anatomy and injury prevention techniques such as street, car, and bike safety. These active and fun sessions conclude with a melon drop helmet demonstration.

Students are asked to bring their helmets for a fit and function assessment. If a child’s helmet is ill fitting or damaged, or if they do not have a helmet, a new helmet will be properly fit and provided by our team of helmet experts at no cost.

Grand Rounds - March 7, 2025
"The Human Touch: Enhancing Patient Experience Through a Culture of Belonging"

Speaker: Ian Jenkins, MD. SFHM Chair, Patient Safety Committee, Associate Professor of Medicine, Division of Hospital Medicine, UCSD School of Medicine.

Objectives

1. Utilize AIDET techniques to improve the patient experience and sense of belonging.
2. Implement empathetic listening rather than only focusing on tasks/problem-solving.
3. Review evidence relating patient experience with clinical outcomes.
4. Navigate barriers to communicate effectively.
5. Reflect on how patient care and outcomes is most affected by inadequate listening and communication and consider how implicit bias may impact appropriate care.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)^TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals.

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

St. Charles is committed to a team-based approach to your care. These providers are working together to help you get back to living the life you want to live:

Physiatrist

Your care will be directed by your physiatrist – a doctor who specializes in rehab medicine and treats a variety of medical conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles and tendons. The physiatrist will see you regularly to assess and adjust your individualized treatment plan and will coordinate consultations with specialists, all with the ultimate goal of helping you maximize your function and quality of life.

RN case manager

An RN case manager works with the physiatrist to ensure consulting specialists receive the information they need to provide you with the best possible care. They handle care coordination, follow-up appointments and referrals, can provide expertise on rehab nursing care and will meet with you to discuss your goals and discharge date. 

Rehab nurse

A rehab nurse will provide 24/7 nursing care during your stay in the hospital, including administration of medications, wound care, bowel and bladder management and managing chronic conditions. At the same time, your nurse will teach these skills to you and your caregivers to help you regain your independence and wellness.

Speech therapist or speech language pathologist

Our speech specialists will work with you on various aspects of cognition and communication, including remembering, paying attention, problem solving, understanding what you hear and read, expressing yourself verbally and in writing, and making your words sound clear. They will also work with you to improve chewing and swallowing if needed.

Occupational therapist

An occupational therapist will help prepare you for day-to-day activities at home, such as bathing, grooming, getting dressed, going to the bathroom and preparing food. That means working to improve your strength, body control, visual perception, hand-eye coordination and cognitive processes. They’ll also identify equipment needed for you to be successful.

Physical therapist

A physical therapist will work with you to increase your physical strength, balance and endurance. The goal: To get you back to standing and moving to the very best of your ability. They’ll also identify equipment needed to enhance your mobility and will provide guidance on using equipment like a walker or wheelchair.

Neuropsychologist

A neuropsychologist specializes in caring for people with brain injuries, strokes and other brain-related issues. They’ll work with other members of the care team to create a plan just for you — to help you think more clearly, manage your emotions and improve your overall quality of life. They’ll also give your family advice on how to best support you at home.

Social services specialist

A social services specialist will work with you and your family to support your transition home. They’ll order mobility and bathroom equipment you may need, set you up with home health therapies, connect you with community resources and assist with advanced directives. They’re your best point of contact for all things related to your discharge.

It’s official: The Center Orthopedic & Neurosurgical Care & Research — a longtime provider of orthopedic, neurosurgical, occupational and physiatric care in Central Oregon — is now a part of St. Charles Health System.

Its new name is the St. Charles Center for Orthopedics and Neurosurgery, and about 250 people who worked for The Center — including 27 physicians and 29 advanced practice providers — decided to join our team. They work in clinics in Bend, Redmond, Sisters, La Pine and John Day, and the surgeons among them provide surgical care at the Bend and Redmond hospitals, Cascade Surgicenter and Bend Surgery Center.

I want to thank those folks for their patience as we’ve worked through this complicated integration process. We are excited to have them on our team and are making every effort to make sure they feel welcome at St. Charles.

I also want to thank the many St. Charles caregivers who worked hard over the past few months to make this transition as seamless as possible. We are stronger today because of their efforts.

The history of The Center and of St. Charles are deeply intertwined. The Center physicians and providers have always been essential members of the St. Charles medical staff, and over the years many served in St. Charles leadership roles, including on the boards of St. Charles and the St. Charles Foundation. And yet this integration is still a big change for all of us — providers, employees and patients. I believe it was absolutely necessary. 

Over the past few years, Central Oregon experienced a rapid reduction in access to care across many different types of medicine, due in part to increasing costs to provide care and flat or declining reimbursements. The number of orthopedic, neurosurgery, physical medicine and rehabilitation providers in the region has decreased dramatically, making access to necessary care a significant burden for patients and their families.

The Center tried to fill care gaps as best they could, but as a stand-alone practice found it very difficult to recruit and retain providers at a pace fast enough to stabilize the service. Their leadership was concerned that without immediate financial support, more providers would leave the region, worsening the long delays patients are experiencing for care.

Like The Center, St. Charles is committed to providing the best possible care in the communities we serve. So, it made sense for us to step in and help shore up these critical services and ensure care remains locally owned and operated.

It’s the right thing to do, not just for St. Charles, but to ensure Central Oregonians continue to have access to a wide variety of health care services close to home.

As a patient or visitor, your experience should largely remain the same as it has been in recent years. You may notice a new sign on the building, but once inside, you can expect to encounter great people and receive great care.

That’s what we do here at St. Charles. As always, I’m proud to be a part of it.

Sincerely,
Steve

Today, St. Charles Health System announces that its integration with The Center Orthopedic & Neurosurgical Care is officially complete, helping to secure and stabilize access to orthopedic, neurosurgical, physical and rehabilitation medicine throughout Central Oregon. The Center is now part of St. Charles Health System and is operating under a new name – St. Charles Center for Orthopedics and Neurosurgery.

One primary goal of this integration is to restore and expand access to orthopedic care, addressing the significant reduction Central Oregonians have experienced over the past two years. Now that the integration is complete, the St. Charles team can turn its attention to recruiting additional providers in these specialty areas to serve the region and provide more access to care for patients.  

“Today we are celebrating this integration as securing and stabilizing a critical health care function for our region. We are thrilled that 27 physicians and 29 advanced practice providers will be part of the new St. Charles Center for Orthopedics and Neurosurgery,” said St. Charles President and CEO Dr. Steve Gordon. “We anticipate it will take some time for patients to see an improvement in access to orthopedic care as we work to recruit additional physicians to fill the gap in the community. Please be patient with us during this time of transition.”

Dr. Christopher Healy, former Board President of The Center, now Senior Medical Director, Orthopedics, Neurosurgery & Physiatry, has helped lead the transition.

“Leadership teams from both The Center and St. Charles have put forth a profound effort to help ensure a smooth transition. The former physicians and staff of The Center have been proud to provide excellent care to the Central Oregon community for several decades, and while the name is changing, our commitment to exceptional care remains. Without any loss of providers or staff with this transition, we look forward to maintaining and expanding services for our beloved region.”

All locations where The Center formally operated remain open under the St. Charles Center for Orthopedics and Neurosurgery name. The phone number for appointments remains the same at 541-382-3344. Patients with questions about appointments, billing or medical records can find information on our website. Teams answering the phones are expected to have high call volumes and appreciate understanding as they work to address each and every call.

Imaging

When you see a provider at the St. Charles Center for Orthopedics & Neurosurgery for pain or an injury, your exam will often start with questions to understand your medical history. After a thorough physical evaluation, your provider may order diagnostic imaging to evaluate and confirm the location of any damage that may be causing your symptoms. This may include:

• X-rays
• MRI (magnetic resonance imaging)
• CT (computed tomography)

MRI, or Magnetic Resonance Imaging, uses radio waves, magnets, and a computer to provide an in-depth look at your bones and tissues. Insurance approval is required prior to booking an appointment. Once we receive authorization, our staff will contact you to schedule your MRI.

The St. Charles Center offers MRI at our Neff Road and Medical Center Drive clinic locations in Bend. To learn more about what to expect, please watch this video.