Hand & Wrist

Your hands and wrists are essential to nearly every one of life's daily activities—typing, gripping, lifting, or simply holding a cup of coffee. When pain, numbness, or limited movement interferes with your quality of life, the hand and wrist specialists at Aligned Orthopedic Partners are here to help. We provide comprehensive orthopedic care and treatment options for a wide range of hand and wrist conditions that will help restore your mobility.

Understanding Hand and Wrist Pain

Hand and wrist pain can stem from a variety of causes—overuse, repetitive motion, injury, or underlying conditions like arthritis or nerve compression. Because these joints are so intricate and constantly in use, even minor issues can lead to significant discomfort or functional limitations. Whether your pain is sharp, dull, stiff, or accompanied by numbness or tingling, our goal is to restore comfort, mobility, and confidence in use of your hands and wrists.

Conditions We Treat

Our fellowship-trained hand and wrist orthopedic specialists diagnose and treat:

  • Carpal tunnel syndrome
  • Trigger finger (stenosing tenosynovitis)
  • Wrist arthritis
  • Tendonitis and overuse injuries
  • Fractures and dislocations
  • Ligament injuries
  • Nerve compression disorders
  • Ganglion cysts
  • Sports-related hand and wrist injuries

Surgical & Non-Surgical Solutions

At Aligned Orthopedic Partners, we prioritize non-surgical treatments whenever possible, using:

  • Splinting and bracing
  • Corticosteroid injections
  • Physical and occupational therapy
  • Activity modification and ergonomic guidance

When surgery is needed, our orthopedic hand and wrist surgeons perform advanced procedures such as:

  • Carpal tunnel release (including endoscopic technique)
  • Tendon and ligament repair
  • Fracture fixation and joint reconstruction
  • Arthroscopic wrist surgery
  • Trigger finger release
  • Joint fusion or replacement (when appropriate)

Why Choose Aligned Orthopedic Partners?

  • Board-certified and Fellowship-trained hand and wrist specialists
  • Minimally invasive techniques to reduce recovery time
  • Integrated care teams including surgeons, therapists, and rehabilitation experts
  • Multiple convenient locations across Virginia, Maryland, and the D.C. metro area
  • Compassionate, patient-first care backed by leading orthopedic expertise

Schedule Your Same-Day Hand or Wrist Appointment Today

Don’t let hand or wrist pain limit your activities, abilities, or lifestyle. Whether it’s a nagging injury or sudden trauma, Aligned Orthopedic Partners is your trusted source for expert care and lasting relief. Call today or schedule online to connect with a hand and wrist specialist near you.

Hand & Wrist Conditions & Treatments:

Understanding Carpal Tunnel Syndrome (CTS)

Carpal tunnel syndrome (CTS) occurs when the median nerve, a major nerve in your hand, gets squeezed as it passes through your wrist. This nerve is essential for controlling movement and sensation in your thumb and first three fingers. Imagine a narrow tunnel in your wrist – when the space inside gets too tight, the nerve gets pinched.

How to Manage Mild Carpal Tunnel Syndrome

If your CTS is mild, you can often manage it without surgery:

  • Home care: Rest your hand, do specific stretches, and avoid activities that worsen your symptoms. A wrist splint at night can also help.
  • Medications: Your doctor may recommend over-the-counter pain relievers or a corticosteroid injection for temporary relief.

When to Consider Surgery

When non-surgical treatments don’t work, carpal tunnel release (CTR) surgery may be necessary. This procedure cuts a ligament in your wrist, giving the nerve more room and relieving pressure. While traditional CTR surgery can be effective, it sometimes involves larger scars and a longer recovery period.

A New Option: Sonex Carpal Tunnel Release

The SX-One MicroKnife® with ultrasound guidance offers a minimally invasive CTR option. Here’s why it’s different:

  • Precision: Ultrasound helps the surgeon visualize the area, allowing for a smaller incision.
  • Faster recovery: Most patients experience immediate relief, can move their hand right away, and return to normal activity within a few days.
  • Minimal scarring: The smaller incision means less visible scarring and quicker healing.
  • Is Sonex CTR Right for You?

If you’re struggling with severe carpal tunnel syndrome, talk to your doctor about treatment options. They can help you determine if Sonex CTR is a good fit for  your individual needs.

Understanding Carpal Tunnel Release (CTR)

Carpal tunnel syndrome occurs when the median nerve, which runs through a narrow passageway in your wrist (the carpal tunnel), becomes compressed. This causes pain, numbness, tingling, and weakness in your hand and fingers.  If non-surgical options like rest, splinting, and medication don’t relieve your symptoms, carpal tunnel release surgery might be recommended.

Why is Carpal Tunnel Release Done?

The goal of CTR is to relieve pressure on the median nerve by cutting the ligament that forms the roof of the carpal tunnel. This creates more space for the nerve, reducing compression and improving symptoms.

Types of Carpal Tunnel Release

  • Open Release: This involves making a small incision in your palm to access the carpal tunnel and cut the ligament.
  • Endoscopic Release With this minimally invasive technique, tiny incisions are made, and the surgeon uses a camera and specialized tools to release the ligament.

The Carpal Tunnel Release Procedure

  • Anesthesia: You’ll likely receive local anesthesia to numb the area, or in some cases, regional or general anesthesia.
  • Surgery: The surgeon will make the incision(s) and carefully cut the ligament, relieving the nerve pressure.
  • Wound Closure: The incision(s) are closed with stitches.

Recovery After Carpal Tunnel Release

  • Pain and Soreness: You’ll likely experience some discomfort, but this usually subsides within a few days. Medication and ice can help.
  • Hand Therapy: Often recommended to improve hand strength and flexibility.
  • Timeframe: Most people see symptom improvement quickly, though full recovery can take weeks to months.

Important Considerations

  • CTR is highly successful: The majority of people experience significant symptom relief after surgery.
  • Discuss Technique: Talk to your surgeon about open vs. endoscopic release and which is best for your situation.
  • Follow Instructions: Proper post-surgical care is important for optimal healing.

Talk to Your Doctor

If you’re struggling with persistent carpal tunnel symptoms, your doctor can evaluate your condition and discuss whether carpal tunnel release surgery is right for you.

A New Option: Sonex Carpal Tunnel Release

The SX-One MicroKnife® with ultrasound guidance offers a minimally invasive CTR option.

Here’s Why It’s Different:

Precision: Ultrasound helps the surgeon visualize the area, allowing for a smaller incision.
Faster recovery: Most patients experience immediate relief, can move their hand right away, and return to normal activity within a few days.
Minimal scarring: The smaller incision means less visible scarring and quicker healing.

Is Sonex CTR Right for You?

If you’re struggling with severe carpal tunnel syndrome, talk to your doctor about treatment options. They can help you determine if Sonex CTR is a good fit for your individual needs.

Understanding Trigger Finger (Stenosing Tenosynovitis)

Trigger finger, sometimes called trigger thumb, is a condition where one of your fingers or thumb gets stuck in a bent position. It feels like it’s catching or locking, and you might hear a popping sound when you try to straighten it. This can be painful and make everyday tasks difficult.

What Causes Trigger Finger?

  • Tendon and Sheath: Your fingers have tendons (like cords) that allow them to bend. These tendons slide through a protective tunnel called a sheath.
  • Inflammation and Tightening: If a tendon becomes inflamed, it may form a nodule (bump). This makes it hard for the tendon to glide smoothly through the sheath, causing it to catch.

Trigger Finger Symptoms

  • Stiffness, especially in the morning.
  • A popping or clicking sensation when you bend or straighten your finger.
  • A tender bump at the base of the affected finger or thumb.
  • The finger locking in a bent position. In severe cases, it may need to be gently straightened with the other hand.

Treatment: From Conservative to Advanced

Treatment usually starts with:

  • Rest and Splinting: Avoiding activities that trigger the pain and potentially using a splint to keep the finger straight.
  • Medication: Over-the-counter or prescription anti-inflammatories to reduce pain and swelling.
  • Steroid Injections: A powerful anti-inflammatory injected near the tendon to provide temporary relief.

If these methods don’t help, your doctor may suggest:

  • Percutaneous Release: A minimally-invasive procedure where a needle is used to release the tight tendon sheath.
  • Surgery: A small incision is made to release the tendon sheath, allowing for smooth movement.

Important:

  • Early treatment helps prevent the condition from worsening.
  • Don’t hesitate to talk to your doctor if you experience symptoms of trigger finger.

Understanding Trigger Finger Release Surgery

Trigger finger (or trigger thumb) happens when the tendon that bends your finger gets inflamed and forms a nodule (or bump). This makes the tendon get stuck in its sheath (the tunnel it slides through), causing painful catching, locking, and popping sensations. Trigger finger release surgery is a procedure to fix this issue.

Why Consider Trigger Finger Release?

If other treatments like rest, medication, or steroid injections haven’t relieved your symptoms, release surgery might be recommended to:

  • Eliminate the Catching: Allow your finger to bend and straighten smoothly without painful locking.
  • Reduce Pain and Stiffness: Improve your hand function and ease discomfort.
  • Prevent Worsening: In severe cases, a finger stuck in a bent position can become permanent.

Types of Trigger Finger Release

  • Percutaneous Release: This minimally invasive procedure uses a needle inserted through the skin to cut the tight portion of the tendon sheath.
  • Open Release: This involves a small incision in your palm to directly access and release the tendon sheath.

The Procedure: What to Expect

  • Anesthesia: You’ll likely receive local anesthesia to numb the area.
  • Release: The surgeon will carefully release the constricted part of the tendon sheath, allowing the tendon to glide freely.
  • Closure: Any small incisions will be closed with stitches.

After Surgery

  • Pain Management: Some soreness is expected, but over-the-counter or prescription medication can help.
  • Hand Therapy: Exercises and therapy help regain full finger motion and strength.
  • Timing: Initial improvement might be quick, but full recovery may take several weeks.

Important Points

  • Success Rate: Trigger finger release is highly effective in providing long-term relief.
  • Technique Choice: Your surgeon will discuss the best procedure for your specific case.
  • Commitment to Recovery: Following your doctor’s instructions and engaging in hand exercises is crucial.

Understanding Thumb Arthritis

In a normal joint, bones are protected by cartilage, allowing for smooth and painless movement.
Osteoarthritis, also known as degenerative arthritis, occurs when cartilage wears down, leading to bone-to-bone contact.

Among hand joints, the thumb basal joint, or carpometacarpal (CMC) joint, is the second most affected by osteoarthritis.

This joint is formed by the trapezium bone in the wrist and the first metacarpal bone in the thumb, creating a saddle-shaped structure.

The unique shape of this joint enables a wide range of thumb movements, including up and down, across the palm, and the ability to pinch with the fingers.

Thumb arthritis is more common in women and typically develops after the age of 40.

The exact cause of thumb arthritis is often unknown, but previous joint injuries or general joint looseness may increase the risk, particularly at a younger age.

Thumb arthritis, the most common issue affecting the thumb joint, can impact range of motion and potentially cause discomfort in the wrist.

What Are The Symptoms of Thumb Arthritis?

Your primary indication of thumb basal joint arthritis is a deep, throbbing ache at the base of the thumb.
Pain worsens during gripping activities like opening jars, turning doorknobs, or writing.

As the condition progresses, you might experience discomfort even at rest, especially at night.
You may notice a decreased ability to pinch and grasp objects over time.

In severe cases, your joint may deteriorate and misalign, forming a noticeable “bump” at the base of the thumb.

This can lead to limited thumb mobility and a narrowing gap between your thumb and index finger.

Compensatory overextension of adjacent joint may occur.
Proactively managing your condition through orthopedic surgery or non-surgical interventions can alleviate pain, reduce inflammation, manage symptoms, and improve your overall well-being.

How Will My Doctor Diagnose Thumb Arthritis?

The appearance of your thumb and the location of pain are crucial for identifying this condition in your finger or wrist.

To reproduce symptoms, applying pressure along the entire length of the thumb and twisting or grinding the basal joint can aid in diagnosis.

X-rays can confirm the diagnosis, but the severity of symptoms may not always correspond to the joint’s appearance on the x-ray.

After assessing your symptoms, the surgeon will decide if surgery is necessary for your osteoarthritis.

Each patient is unique, so the surgeon will devise a personalized treatment plan based on the diagnosis.

Treatment

Treatment for Arthritis At the Base of The Thumb

Less severe thumb arthritis can be managed without surgery through various treatments:

  • Taking pain medication.
  • Using topical treatments.
  • Wearing splints.
  • Adjusting activities.

Occasionally receiving corticosteroid injections to relieve pain.

Hand physical therapists can offer different types of splints to support the thumb during activities.

Physical therapy is beneficial for improving thumb joint movement and function.

Physical therapists will provide exercises to do at home to enhance hand, finger, and joint function and reduce the effects of arthritis and osteoarthritis.

For patients with advanced thumb arthritis or those unresponsive to non-surgical treatments, surgery may be recommended.

Various surgical techniques can effectively reduce or eliminate pain and improve thumb position and function.

Common surgical procedures include removing arthritic bone and reconstructing the joint, fusing or realigning bones, and sometimes using arthroscopic procedures.

Consulting with your surgeon is crucial to determine the best treatment for your specific condition.

Thumb Arthritis Surgery

Patients who have advanced arthritis in their thumb, specifically rheumatoid arthritis, or those who do not respond to non-surgical treatments, may be considered for surgical reconstruction.

There are various surgical techniques available that can effectively alleviate or eliminate pain, as well as improve the position and function of the thumb.

Common surgical procedures include the removal of arthritic bone and joint reconstruction (known as joint arthroplasty), bone fusion or realignment methods, and occasionally arthroscopic procedures in specific cases.

By consulting with your treating doctor at Aligned Ortho, you can determine the most suitable options for addressing your thumb arthritis.

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