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Get to Know Dr. Dennis Nutini from NRH


Dennis Nutini, MD, is a physician with NRH Regional Rehab Bethesda, one of National Rehabilitation Hospital’s 34 outpatient centers. He specializes in Musculoskeletal Medicine.

Dr. Nutini previously worked at the Center for Pain Medicine and Physiatric Rehabilitation in Maryland.

After graduating from Drexel University College of Medicine, Dr. Nutini completed his internship at Stony Brook University Hospital in Stony Brook, NY and his residency in the Department of Physical Medicine and Rehabilitation at The Mount Sinai Medical Center in New York. 

Dr. Nutini is a member of the American Association of Neuromuscular and Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation (AAPM&R), where he serves on the Musculoskeletal Council. 

To schedule an appointment, please call 301.581.8030
Union Memorial Orthopedic
and Sports Medicine Locations

No matter where you live, work or play in the region, chances are our specialists are near you, giving you access to the best in orthopedic and sports medicine care- from bones, joints and muscles to rehabilitation and sports performance training and injury prevention.
For more information, please visit

Union Memorial Hospital
3333 N. Calvert Street, Ste 400

Bel Air:
Bel Air Athletic Club
658 Boulton Street, Suite B

Howard County:
Dorsey Hall Medical Center
9501 Old Annapolis Road, Suite 125

The Galleria Shopping Center
1407 York Road, Suite 100A

SurgiCenter at Pasadena
8109 Ritchie Highway

Susquehanna Bank Building
532 Baltimore Blvd., Suite 201

We're Listening!!! Thank you for your feedback!

In the spirit of designing a process that works for you and the workers comp patient, UMH has designed a WC appointment request form to facilitate and quickly respond to your requests for appointments!  Email Molly Zmuda at if you're interested in participating in the pilot of the **New and Improved** Appointment Request Form for Union Memorial Orthopedics and Sports Medicine, Curtis National Hand Center and Curtis Work Rehab Services!!"
From the Desk Of Dr. Michael Murphy

Thumb Pain: A Common and Treatable Condition
The human thumb is a complex structure involving multiple nerves, tendons, muscles and joints. This unique joint is unlike any other in the human body.  It evolved over thousands of years as our ancestors developed and allows for many varied tasks ranging from gross manual grasp to a myriad of precise pinching tasks. Professional athletes and concert musicians all depend on this fascinating appendage.

The thumb joint is shaped like a horse’s saddle, which allows for multiple planes of motion. The “saddle” is covered with a smooth cartilage which is nature’s shock absorber. With time, stress and injury the thumb’s cartilage breaks down causing pain as raw bone contacts raw bone. Inflammation and swelling results, and deformity of the thumb will become apparent.
This problem occurs most frequently in women over the age of 40. Middle-aged men, however, often develop this condition. The exact cause is unknown, but there is a strong association with gender, genetics, previous injury and ligament laxity.

Usually, the onset of pain progresses slowly. Patients experience increasing difficulty with gripping and pinching activities. Initially, the pain often waxes and wanes with long, pain-free periods. With time, turning a key, opening a jar and gripping a golf club all grow to be more and more difficult. Next, a bump at the base of the thumb becomes apparent. Weakness increases as dexterity decreases.

When seeking medical attention, patients complain about increasing pain with gripping and pinching. An exam reveals swelling and a bump at the thumb base. The physician usually compresses and shifts the thumb to elicit a pain response. Decreasing grip and pinch strength is revealed and X-rays demonstrate joint changes. More sophisticated testing such as MRI is rarely necessary.
Non-surgical treatment consists of rest, anti-inflammatory medication such as ibuprofen, and splinting. Limited use of cortisone injections may provide varying degrees of relief. Alternative treatments such as Glucosamine-Chondroitin Sulfate, acupuncture and chiropractic manipulation have all been tried with varying degrees of success.

When these measures fail, surgical reconstruction of the arthritic joint is performed. A variety of procedures exist, but all involve removal of the arthritic surfaces and replacement with either tendon or synthetic substitutes.
In most cases, surgery is performed on an outpatient basis. Regional or general anesthesia is usually required. Patients experiencing varying degrees of discomfort often require a few days of oral prescription pain relievers. Immobilization is usually needed for six to eight weeks. Frequently, supervised physical therapy is needed for six weeks to aid in the restoration of hand function.  Patients typically require six months to recover fully with some occasionally needing a full year.
Surgical patients uniformly recover with limited complications. To date, traditional procedures involving tendon joint reconstructions have demonstrated excellent long-term durability. Revision surgery is rarely needed. Most patients find their quality of life greatly improved with nearly all returning to previous work and leisure activities.

Pain at the base of the thumb is a common and disabling condition that can be corrected. Non-invasive treatments often provide excellent pain relief. When indicated, surgical reconstruction provides uniformly excellent results.
Dr. Michael S. Murphy is a board certified surgeon with Greater Chesapeake Hand Specialists, P.A., which focuses on providing successful outcomes for the entire spectrum of problems associated with the hand, wrist, elbow and shoulder. He works from the practice’s Lutherville headquarters, as well its Clarksville/River Hill location.
For more information, call 410- 296-6232 or visit

How Ergonomic Intervention Keeps Workers
on the Job
and Diminishes the Cost of Musculoskeletal Disorder Claims
By: Eileen Koenigsberg, PT Curtis Work Rehab Services

In spite of the opportunity for low cost solutions (much less pricey than one big MSD claim), ergonomic intervention is underutilized and not typically part of the overall plan of care. 

Research has shown that employees appreciate the concern and interest from the employer when an ergonomic intervention occurs; new claims from co-workers do not rise when a worker(s) has an ergonomic intervention.

For successful and sustained return to work, the odds improve with ergonomic intervention and should be considered before return to work.  Intervention is appropriate for jobs that involve repetition, force, awkward, sustained or extreme postures, and diagnoses such as tendonitis, arthritis and back pain.
What is ergonomics?  It’s the science of fitting jobs to people – one person or an entire company.  The review considers the worker’s physical abilities and limitations; it is the interface of the worker’s physical characteristics relevant to the job description.  A comprehensive ergonomic intervention can facilitate maximum productivity, maintain consistent quality and promote long term worker health.
There are three essential pieces to this intervention - analysis of the actual work site, education of the worker(s) and modifications.  Research has shown that an ergonomic intervention including all three components, efficiently and significantly diminishes symptoms, the number of lost days of work and the cost of the claim.  Research also shows that out patient physical therapy is beneficial; but, if the root cause of the problem persists in the work place (i.e., awkward or sustained postures), the symptoms diminish more significantly when ergonomic intervention is included in the overall plan. 
Ergonomic analysis   Work place design (i.e., forceful exertions, work position, any task requiring space) is generic and based on attributes that assume 95% of all workers will be able to perform a task essentially risk free.  Because each person’s body is unique, there is potentially a mismatch – a musculoskeletal risk.  The most difficult attribute to specify is work surface height.  If a short person works at the same work station as a tall person, the most desirable solution is an adjustable height work surface; but, this is an expensive option especially if it is not part of the initial fit-out of an office or industry.  Analysis also includes worker habits and tasks at the job site.
Ergonomic education of the worker(s) is based on the analysis and addresses safe work practices and can be for one individual or an entire company.  Education will vary by job demands.  One purpose of education is to inform the worker in ways they can participate in their own well being, long term, by controlling musculoskeletal risk factors.
Ergonomic modifications or equipment change will reduce, eliminate or prevent risk factors.  Engineering controls are a one time change to protect all employees; work place controls are personnel and procedure driven by task; and, administrative controls reduce frequency, duration and severity of exposure to musculoskeletal risks.

For more information, please call Curtis Work Rehab Services @ Union Memorial Hospital at 410-554-2170 or Click Here




3 CEU's to be provided at each event! Attend all 5 events and enter to win free registration to the 2011 MWCEA conference!

May 3rd, 2011:

"Flowers, Blooms, and Buds...
Injuries, Aches,

and Thuds"
Co-Sponsored by CARPPS 

Registration starting
at 10:30am
Conference ending at 3pm

*Lunch to be provided

Union Memorial Hospital
Conference Center
201 East Univeristy Pkwy
Baltimore, MD 21218

Free Parking in
Off-Site Garage:

2600 N. Charles Street
Baltimore, MD 21218
For directions,
*Once you park in garage, a shuttle will pick you up outside and bring you to the front entrance of UMH Hospital.  Shuttle will run every 15 minutes*


Mister of Ceremonies-
Dr. Richard Hinton

Dr. Raymond Wittstadt
- "Soft Tissue Crush Injuries of the Hand"

Dr. Stuart Miller- "Foot and Ankle Trauma"

Dr. Jason Hammond- "Knee Injuries in the Workers Comp Patient"

Dr. Ibrahim Elsamanoudi- "RSD and the Role of Spinal Cord Stimulators"

Educational Tour of Curtis Work Rehab Services and Curtis National Hand Center

credits pending
*1 Unit (3 credit hours) for MDWCC pending

$20 Registration Fee for those needing CEU's to be paid at the door. *MDWCC NO CHARGE*


Save the dates for upcoming Project 15 programs!!

July 14th, 2011
Co-Sponsored by CARPPS
Program in Development
Richlin Ballroom

Bel Air,MD

TO RSVP in advance,
Click Here

Looking for a way to contact us or our physicians within MedStar?  Click Here to access our MedStar Worker's Compensation Resource Contact List!!!


Hospital Based Services:

National Rehabilitation Hospital

Curtis National Hand Center

Curtis Work Rehab Services

Physician Services:

UMH Orthopedics and Sports Medicine

National Hand Specialists

National Rehabilitation Hospital

Georgetown University Hospital

Harbor Hospital

Specialty Services:

Medstar Affiliates:
Greater Chesapeake Hand Specialists

Sleep Services of America

Other Resources:

Double D Sports, Inc.
1010 Prince Frederick Blvd.
Prince Frederick, MD 20678
Catherine Kuegler, PT- Store Owner
Michael Kuegler, PT

Worksite Health & Safety Consultants
Providing on-site consultation for ergonomics, wellness, & safety training


For questions about any of our sites or services, please visit

To view current job openings in the NRH network,
please visit

NRH is looking for an Admissions Liaison,
Click Here for more information


Meet the Editor:

Jeannine McNelly

I have been with MedStar Health since 1999 and have worked as a clinic assistant, Certified Athletic Trainer and Massage Therapist at our outpatient site in Lutherville, MD.  Currently, I have been a part of the Business Development & Recruitment Team at NRH since 2004 and I am also the current Insurance Liaison.

Feel free to contact me at
or 202-877-1914 with any questions or if you would like one of our physicians to present at your location.

Please remember to update me with your email contact information so you can continue to receive the MedStar newsletters!!

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*National Rehabilitation Hospital
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