What is a cervical radiculopathy?

Cervical radiculopathy, also known as a pinched nerve, is a condition caused by an irritation or compression of nerve roots in the cervical spine. Because these nerves travel to the shoulders, arms and hands, it can cause numbness, tingling or weakness in these areas.

Causes and risk factors

• Degenerative disc disease
• Osteoarthritis
• Herniated disc
• Spinal stenosis

Symptoms

• Numbness, tingling or weakness in the hand or fingers
• Weakness in the arm, shoulder or hand muscles
• Loss of sensation
• Pain decreases when hands placed on top of head

Diagnosis and treatment

Cervical radiculopathy typically responds well to nonsurgical treatment. After a physical exam, your physician may use imaging such as x-ray or MRI to help diagnose the condition. An EMG or Nerve Conduction Study will help confirm if your symptoms are caused by too much pressure on the nerve. Physical therapy and nonsteroidal anti-inflammatories are often the initial treatment for cervical radiculopathy. Steroid injections can help alleviate swelling and relieve your neck pain to allow the nerve to recover. If this does not relieve the symptoms, your doctor may recommend surgery.

Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. It occurs when a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. As a result, the small piece of bone and the cartilage covering it begin to crack and loosen.

Causes and risk factors

Repetitive high stress forces on the joint can result in a series of minor injuries on the elbow that can eventually lead to bony fragmentation and ultimately detachment of the bony fragment from the bone. Commonly seen in the adolescent sporting population; who partake in repetitive throwing or overhead activities such as baseball and gymnastics. More frequently seen in males (ages 10-14) than females and often affecting the dominant arm.

Symptoms

• Lateral Pain over the joint
• Stiffness
• Feeling of instability
• Stiffness after resting
• Locking
• Giving way
• Popping/clicking

Treatment

In most cases, OCD lesions in children and young teens will heal on their own, especially when the body still has a great deal of growing to do. Resting and avoiding vigorous sports until symptoms resolve will often relieve pain and swelling. There are different surgical techniques for treating OCD, depending upon the individual case.

Mallet finger is an injury to the thin tendon that straightens the end joint of a finger or thumb.

Causes and risk factors

Although it is also known as “baseball finger,” this injury can happen to anyone when an unyielding object (like a ball) strikes the tip of a finger or thumb and forces it to bend further than it is intended to go. As a result, you are not able to straighten the tip of your finger or thumb on your own.

Symptoms

The finger is usually painful, swollen, and bruised. The fingertip will droop noticeably and will straighten only if you push it up with your other hand.

Diagnosis and treatment

A mallet finger injury requires medical treatment to ensure the finger regains as much function as possible. Most doctors recommend seeking treatment within a week of injury. However, there have been cases in which treatment was delayed for as long as a month after injury and full healing was still achieved.

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 & Surgery

Carpal tunnel syndrome is a common condition that occurs when the median nerve — which runs from your forearm into the palm of your hand — becomes compressed at the wrist. This compression can cause numbness, tingling, weakness, or pain in the hand and fingers, particularly the thumb, index, and middle fingers.

What causes Carpal Tunnel Syndrome?

Carpal tunnel syndrome can develop from a combination of factors that increase pressure on the median nerve. These may include repetitive hand movements, wrist injuries, arthritis, or underlying health conditions like diabetes or thyroid disorders.

When to see a Specialist

If symptoms are persistent or worsening — especially if they interfere with daily activities, sleep, or hand function — it may be time to consult an orthopedic or neurological specialist. Early diagnosis and treatment can prevent long-term nerve damage.

Treatment options

Most cases begin with non-surgical treatments such as wrist splinting, anti-inflammatory medications, corticosteroid injections, or activity modification. However, when these options don’t bring relief, surgery may be recommended.

Carpal Tunnel Release Surgery

Carpal tunnel release is a surgical procedure that relieves pressure on the median nerve by cutting the ligament that forms the roof of the carpal tunnel. This creates more space in the tunnel and reduces nerve compression. It’s typically performed on an outpatient basis, often using minimally invasive techniques, and many patients experience significant symptom relief within weeks.

At St. Charles, our experienced orthopedic and neurosurgery teams provide individualized care, using advanced techniques to support optimal recovery and long-term hand function.

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