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Month: November 2015

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General Hands

Nerve Injuries of the Hands

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If there were some sort of illustration that showed us how much of our brains functions went to operating the hands, it might astonish you. A huge amount of communication and activity between the hands and the brains occurs each day of your life, and when there are nerve injuries it can be tremendously disruptive to your ability to function completely.

As the American Society for the Surgery of the Hand indicates, the nerves are like a “telephone wiring” system in the body which sends and transports messages from the brain and out to every possible location. Just as in a real world setting, if those lines are damaged or downed in some way, communication ceases and messages cannot head back and forth as usual.

Nerves are also, physically, a lot like phone lines with their outer protection and their many inner lines and fibers. Additionally, the various inner lines have different tasks, too, and there are motor nerves for making your body move, sensory nerves that indicate everything from pain to temperature. Any nerve fiber can carry only one message – either sensory or motor, but all nerve tissue is made up of both types of nerves.

Should a nerve be harmed due to injury, pressure, crushing, or stretching, all of the messages stop, too. This can leave you unable to move a limb or experience sensation or feeling in the area where the nerve once communicated. Interestingly enough, the part of the damaged nerve that is closest to the brain does not die when injured. It remains alive and can continue to function and even grow. Though this can develop into a painful condition known as neuroma, it also means that a nerve that has been damaged does have a chance at being restored.

Can Damaged Nerves Come Back to Life?

If a nerve is severed, the various lines and connections can be reconnected through a surgical procedure. However, it is not as simple as it sounds, particularly when speaking about the nerves of the hand, which are thin strands no bigger than threads of yarn.

The good news is that it can be done, but it does have a lengthy recovery process. The initial goal is to get that outer sheath back together in order to encourage the inner nerves to reconnect and restore themselves. This is why any surgeries for nerve injuries demand at least three weeks of “downtime” after the procedure. Even then, the pace of regrowth is very slow, and to prevent any further damage, the patient is discouraged from using the digit or hand during the initial recovery period.

After that, however, there will be the need to use therapy to help the hand or fingers regain flexibility and function.

Your hand surgeon can review the options for nerve repair, and let you know your expected prognosis. With time and work, though, even severed nerves can be recovered or restored to at least partial function and health.

Source

ASSH.org. Nerve Injury. 2015. http://handcare.assh.org/SearchResults/tabid/145/SearchModuleID/1720/sites/1/Default.aspx?SearchTerm=damaged+nerves

Categories
General Hands

Hand Numbness and Tingling Is Not Always Carpal Tunnel

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There has been so much press about the condition known as carpal tunnel syndrome, or CTS, that many people automatically assume that any numbness or tingling in their hands or fingers must be this fairly common condition. However, there are several other issues that can just as easily lead to symptoms shared with CTS.

For example, the American Society for Surgery of the Hand indicates that the “potential conditions” leading to numbness in the hands include: vascular disorders, cold hand disease, Erbs palsy, CTS, Complex Regional Pain Syndrome, nerve injury, and cubital tunnel syndrome.

Are these the only reasons behind numbness and tingling in the hands or arms? No, there is a surprisingly long list of possibilities. Injury can be to blame, muscle thickening, blood vessel enlargement, and cysts and spurs can also be the cause of any loss of sensation or tingling.

However, one of the most common terms associated with the sensation of tingling or loss of feeling in the hands, though, is “nerves”. From compression of nerves in the arms, spine, and neck, to damage to the nerves, it seems that the greatest number of problems can begin with nerve related issues.

Compression neuropathy or pressure on a nerve can cause a sensation of numbness in the hands. Additionally, because some nerves in the hands have their sources in the area around the neck, any sort of compression or pressure on the neck can lead to numbness, as well.

When we start to look at the neck, though, we realize that the spine is also a major factor in nerves and how they affect the hands. Arthritis in the neck or spine, as an example, can be compressed due to bone spurs or disc problems, and these might impair nerves that relate to the hands and arms.

Diseases of the spinal cord can also cause problems if they manifest as tumors, swollen blood vessels or other things that can constrict or press on the nerves. These can lead to weakened muscles if compressed as well, and this can further complicate matters by making the source of the problem more difficult to detect.

Not all nerve activity is in the spine though and it is understood that some diseases that affect the nervous system can lead to symptoms that include numbness in the hands. Multiple sclerosis is a key example of this, but other issues may also present in this way. Peripheral neuropathy is yet another nerve-related issue that can be caused by disease and which presents in a glove-like pattern on the hands and arms. Diabetes is a common cause of this sort of hand numbness or tingling.

You may have numbness in a finger after an injury, and some medication and treatments can also have side effects that include numbness and tingling in the hands.

Diagnosis and Treatment of Hand Numbness and Tingling

Clearly, you must never just guess at what is causing you tingling or numbness in your hands, and you should never ignore it. Instead, the wisest course of action is to visit a physician or hand doctor who can take a full history, do an assessment of your condition and help you overcome whatever issue has led to your discomfort.

Categories
General

Osteoarthritis and Your Hands

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Arthritis appears in many different variations. Some types of arthritis can show up in any region of the body, some strike single joints are locations, and some appear only when a joint or limb has been damaged or injured. One of the most common types of arthritis is the variety known as osteoarthritis, and when it appears in the hands it usually does so in a limited number of places.

The most common spots for osteoarthritis to appear in your hands are the end joints closes to the tip of the finger (technically known as the DIP joint); the base of the thumb where it meets the wrist (known officially as the trapezio-metacarpal or basilar joints); and the joint in the middle of a finger (called the PIP joint).

Though it may show up in other areas, including the wrist, it is most likely to develop in the spots listed.

It is not like rheumatoid arthritis that attacks the synovium, but is instead a “wear and tear” type of arthritis that causes inflammation due to the loss of the cartilage between the different joints. In osteoarthritis, which is known as a degenerative condition, the pads of cartilage between bones wear down or are damaged and then begin to degrade. This leaves your bones actually rubbing against one another, and it can cause a long list of symptoms.

The Signs of Osteoarthritis

Obviously, the most common symptom associated with two bones rubbing together is pain, but many people with osteoarthritis in the hands will experience stiffness, an inability to flex or move the affected joint, tenderness in the joint, bone spurs, and an obvious sense of the two bones grating against one another (MayoClinic.org, 2015).

Bone spurs or bony nodules are very noticeable when you have osteoarthritis of the hands, and you will notice the unnatural swelling at the joints most commonly affected. The sense of pain is often described as aching, but many also complain of a loss in the ability to grip tightly or have much strength in the hands too.

Treating the Condition

As in other arthritis treatments, the focus of the treatment of osteoarthritis in the hands is to alleviate pain when present while also restoring or maintaining function. To do this requires a few different tactics, and it is only after a visit to your hand doctor that a full and proper regimen can be developed.

You may be given anti-inflammatory medications and instructed to use rest whenever any swelling occurs. Further modalities might include the use of heat and hot wax treatments, splints, and other therapies. It is also not unusual for steroid injections to be relied upon to help with movement and swelling. The only reason that a doctor may suggest surgery is when pain is not alleviated through more conservative treatments or when movement and function have been lost.

Osteoarthritis is not something you can easily avoid, but it is treatable. A visit to your hand doctor at the first signs of stiffness or swelling can put you on the track to protection of the joints and treatments that protect your hands function.

Source

MayoClinic.org. Osteoarthritis Symptoms. 2015. http://www.mayoclinic.org/diseases-conditions/osteoarthritis/basics/symptoms/con-20014749

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Dr. Aroras office from my first call to schedule my appointment was friendly. Walking in the first day, I felt like I was in a nice atmosphere. Dr. Arora was EXCELLENT in taking great care of my hand injury. He was gentle and very understanding to the concerns I had about my hand. His expertise was admirable and I would recommend anyone with an injury to their hand to his office to be under his care. Because of him, I have healed faster than expected and will make an 100% recovery! Thank you Dr.

Jackie S.

I first thought I was going to have to have painful injections or surgery, but Dr. Arora suggested physical therapy may do the trick. I was doubtful, but I agreed to do it. Now, my pain is gone, and with the help of an ergonomic keyboard at work to keep my hands in the correct position, I am virtually pain free. The therapy strengthened my wrists and shoulders, and built more flexibility into my wrists.

Jerry T.

My experience with this doctor was positive from the outset. Dr. Arora was kind and spent a great deal of time with me. Staff was friendly. The office was nice and bright.

Ariel G.

Very friendly and helpful Great staff!!! Doctor Arora was very professional and did great work. I was very happy with everything!

L B.