Hand & Wrist
Our team of orthopedic surgeons specializes in the diagnosis and treatment of hand and wrist conditions. Within your hand and wrist, there are multiple joints, muscles, tendons, and ligaments. We have the expertise to accurately diagnose your specific condition and provide effective treatment options that will help restore your mobility.
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.
Can It Help Ease Your Pain?
Thumb arthritis (also called CMC arthritis) occurs at the base of your thumb where it connects to your wrist. When the protective cartilage in this joint wears down, it causes pain, stiffness, and reduced hand function. While traditional treatments are often the first step, PRP therapy is a newer option offering potential benefits for those seeking an alternative to surgery.
What is PRP?
PRP (Platelet-Rich Plasma) is a concentrated solution made from your own blood. Platelets, tiny cells within your blood, are packed with growth factors that play a central role in your body’s healing processes.
How PRP Might Help Thumb Arthritis
When PRP is injected directly into your arthritic thumb joint, the idea is that the growth factors can:
- Reduce inflammation: Easing pain and making your thumb feel less stiff.
- Potentially promote cartilage repair: While more research is needed, PRP may help to slow the progression of arthritis or even stimulate new cartilage growth in mild to moderate cases.
- Enhance the effects of other treatments: PRP is often combined with physical therapy to optimize results.
Is PRP Therapy Right For You?
PRP could be a good option to consider if:
- You have mild to moderate thumb arthritis.
- Conservative treatments like rest, anti-inflammatories, and physical therapy haven’t brought enough relief.
- You’re not ready for surgery or want to explore less invasive options first.
The PRP Procedure in Thumb Arthritis
- Blood Draw: A small amount of your blood is taken.
- Preparation: The blood is processed in a centrifuge to concentrate the platelets.
- Injection: Using ultrasound guidance for precise delivery, your doctor injects the PRP into your affected thumb joint.
- Recovery: While there might be some temporary soreness, recovery is usually quick, and you’ll likely be encouraged to participate in hand therapy for the best possible outcome.
Important to Remember:
- PRP utilizes your own healing potential: This means minimal risk of side effects.
- Results can vary: PRP may provide long-lasting relief for many patients, but individual responses differ.
- Research is ongoing: More studies are needed, but existing evidence suggests PRP could be promising for thumb arthritis.
Discuss PRP with Your Doctor
If thumb arthritis is affecting your daily life, don’t hesitate to discuss all your treatment options with your doctor. They can assess your condition and help you determine if PRP is a worthwhile option to consider.
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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