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Month: September 2020

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Conditions Wrists

Why Does Carpal Tunnel Syndrome Happen?

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Why does carpal tunnel syndrome happen?

It’s a question we hear often at our hand doctor’s offices in Howell, West Bloomfield, Warren, and Macomb Township. Carpal tunnel syndrome (CTS) is one of the most common conditions we treat.

In fact, more than 4 million people are affected by the syndrome. According to the Workers’ Compensation Institute, approximately 230,000 carpal tunnel release surgeries are performed every year

Determining the exact cause of CTS in order to prevent it can be challenging. Why carpal tunnel syndrome happens is based on a combination of many factors, and these factors range from gender to career choice.

CTS Defined

Before we get into the whys, here is a broad overview of what carpal tunnel syndrome is.

In general terms, CTS is a pinched nerve in the wrist. The phrase carpal tunnel itself refers to a space in the wrist where nine tendons and the median nerve pass from the arm into the hand.

When the median nerve, which runs from the forearm into the hand, becomes pressed, squeezed, or inflamed at the wrist, the result may be symptoms of carpal tunnel syndrome. They include numbness, pain, burning, tingling, and weakness in the wrist, palm of the hand, and along the fingers, especially the thumb and index finger, as well as a weaker grip and a tendency to drop things more often.

In other words, carpal tunnel syndrome is the result of pressure and swelling in this tunnel, which in turn increases pressure to the median nerve. It is typically not a problem with the median nerve itself.

Symptoms of carpal tunnel syndrome may increase gradually, and they often extend up into the arm.  These feelings may intensify to the point where it becomes difficult to hold small objects or to make a fist.

Frequent use of keyboards or power tools at work may cause carpal tunnel syndrome or lead to flareups.
Frequent use of keyboards or power tools at work may cause carpal tunnel syndrome or lead to flareups.

Why Does Carpal Tunnel Syndrome Happen?

Because a combination of factors may be involved, it can be difficult to determine the exact cause of CTS in each case. Causes of carpal tunnel syndrome and sources of flareups include current health conditions, gender, careers, hobbies, and a predisposition to the condition.

Current health conditions

Current health conditions may cause carpal tunnel syndrome or exacerbate symptoms of CTS in those who already have the condition. These include rheumatoid arthritis, pregnancy, thyroid conditions, diabetes, high blood pressure, and prior injuries. Diabetes and other metabolic disorders may directly affect the body’s nerves and make them more susceptible to compression.

Predisposition

Is carpal tunnel syndrome hereditary? It’s a controversial topic and one that requires further research. Historically, it was not believed to be hereditary, but more recent studies show some links. For that reason, some scientists and doctors believe some people may be more genetically predisposed to the condition than others.

Gender

Women are three times more likely to suffer from carpal tunnel syndrome than men are. In some cases, this may be due to pregnancy or menopause, which may cause swelling in the wrists.

Career and hobbies

Careers and hobbies are the most notorious culprits. Actions that can increase carpal tunnel syndrome symptoms include improper use of computer keyboards, regular use of power tools or hand tools, and repeated use of your wrist, such as playing a violin.

The risk of developing CTS is higher among assembly line workers, such as those in manufacturing, sewing, cleaning, and the restaurant industry. Carpal tunnel syndrome is also common among data entry personnel and others who use computers often.

CTS Treatment

Reducing or modifying certain actions may help alleviate the symptoms, such as taking frequent breaks, stretching out your wrists and fingers, wearing wrist protectors if possible, and investing in ergonomically designed furniture and equipment.

Symptoms of carpal tunnel syndrome may be present more at night than during the day based on how you sleep. For that reason, Dr. Arora may recommend that CTS patients wear wrist braces at night in order to support the wrist and keep it straight.

Other treatment options include steroid injections, the use of anti-inflammatory medications, and wrist surgery.

If you are experiencing wrist pain due to CTS, make an appointment to see Dr. Arora for carpal tunnel syndrome treatment at a southeast Michigan location near you.

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General

MRI, CT Scan, and Ultrasound Facts

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With the advancement of technology today, medical professionals are now more accurate to properly diagnose and treat a problem than ever before. Three of the most advanced means of examining a problematic area are through MRI, CT scans, and ultrasounds. These technologies provide Dr. Arora with utmost aid as he works to help enhance your day to day life.

What is MRI?

Magnetic resonance imaging, or MRI for short, is a means of assessing a problematic area. By utilizing a magnetic field and pulses of radio wave energy, an MRI can create digital imaging of the structures and systems within the body. MRI’s are commonly performed to locate and identify a variety of concerns such as an injury, tumor, infection, and more. One very distinctive quality of MRI’s is that they can reveal more information about your body than that of a standard x-ray.
A woman is guided into a CT scan.

What can I expect from an MRI Scan?

During an MRI scan, we strongly advise patients not to wear any metallic objects, including jewelry, piercings, or otherwise, as it may interfere with the scanning process. Please let Dr. Arora know if you have metallic devices or instruments implanted in your body such as a heart or blood vessel device, I.E. a pacemaker or a coronary artery stent, artificial limbs, dental work, etc. Please inform us prior to your scan of whether you experience sensations of claustrophobia, as MRI scans are performed occasionally in close quarters and require you to lie very still. An MRI scan can take approximately an hour to complete.

There are several differences between an MRI, CT scan, and ultrasound diagnostic tests.

What is a CT Scan?

A computerized tomography (CT) scan consolidates various images taken from a standard x-ray and utilizes computer processing to establish cross-sectional imaging of numerous structures within the body including the bones, blood vessels, and soft tissue. This type of imaging is often recommended to help:

  • Diagnose a disorder or fracture
  • Locate the problematic region
  • Guide surgical approaches and modes of therapy
  • Monitor a condition and the effectiveness of a treatment

CT scans can also provide greater details on any part of the body in contrast to an x-ray alone.

What can I expect from a CT Scan?

CT scans are generally a very quick test to complete. Patients will lie on a narrow, motorized table that will slide through what appears like the opening of a tunnel where the CT scanner itself will rotate around you. There may be points where Dr. Arora may ask you to hold your breath at specific periods to avoid blurry imagery creation.

An ultrasound is being performed in this image. There are several differences between MRIs, CAT scans, and this diagnostic test.

What is Ultrasound?

Ultrasound, also known as sonography, is a means of medical examination of the body. Live images are captured from the inside of your body through high-frequency sound waves. Comparable to that of a sonar and radar, the ultrasound technology creates a visualization of problems or concerns within tissues, organs, and vessels without the need for an incision. As opposed to other means of imaging, ultrasound does not use radiation, which is why it is commonly used for expectant mothers during their pregnancy.

What can I expect from an Ultrasound Scan?

The ultrasound scan examination is performed by a qualified technician that utilizes an ultrasound probe and machine. How you might go about preparing for an ultrasound scan will depend upon the part of the body that is being examined. Some areas that are receiving an ultrasound scan examination may require patients to refrain from eating or drinking for 8-12 hours before their assessment, as undigested food can obstruct sound waves from creating a lucid picture. You may still drink small amounts of water to keep hydrated and take prescribed medications as instructed. Be sure to inform Dr. Arora of any medications you may be taking prior to your examination. An ultrasound scan can take approximately 30 minutes to complete.

Contact us today to schedule an appointment at the location nearest you to learn more about MRI, CT scan, and ultrasound imaging.

Categories
General Treatments

Caring for Your Cast

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Hand, wrist, and arm injuries send many people of all ages to the Emergency Room, and they often walk out with a cast. A cast helps you heal and ease the pain while you do, but caring for your cast properly is important in order to avoid infection.

Cast Care Instructions

Once a cast or splint is in place, your pain should improve. However, due to your injury, you may have swelling. This can cause a build up of pressure inside the cast that can cause pain, numbness, tingling, cold fingers, or the inability to move your fingers. Slight discoloration can be normal, but if your fingers or toes become whitish or bluish it could indicate a problem.

If you develop any of the above symptoms, ELEVATE YOUR LIMB ABOVE THE LEVEL OF YOUR HEART. Ice packs also help to relieve swelling. This is good practice for the first few days after your injury regardless if you are having problems or not.

Do not put any items down your cast. Scratching can irritate and even cut the skin and an unseen infection can develop.

If the skin around the edges of the cast is becoming irritated, place a Band-Aid, tape, or moleskin around the edges of the cast to protect your skin from the rough surface. If the irritation persists, call our office.

Water and Casts:

If you are wearing a splint (plaster covered with an Ace bandage) or a fiberglass cast, DO NOT GET THE SPLINT OR CAST WET. This can lead to skin breakdown and infection (especially if it is covering a surgical incision). To protect your cast, we recommend two options. The first option is to wrap the arm with double plastic bags and then seal with duct tape. The second option is to use a purchased “Cast Protector” at a local chain drug store. Both these options have been found to be cost-effective reliable choices.

If your fiberglass/plaster splint/cast gets wet, please contact our doctor’s office in Howell, West Bloomfield, Macomb Township, or Warren right away.

 

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Categories
General Treatments

EMG Testing and Nerve Conduction Studies: Assessing Health of Muscles, Neurons

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Electromyography (EMG testing) and nerve conduction study (NCS) are diagnostic tests that are performed in order to assess the health of muscles and motor neurons.

Motor neurons are the nerves that are responsible for the muscles’ contractions, and damaged or dysfunctional motor neurons can cause health conditions like muscle and nerve disorders.

During the exam, we will monitor the electrical activity that occurs within the muscles at rest and when the muscles are slightly contracted. EMG testing measures the electrical activity within the muscles and can help physicians diagnose any potential problems with nerve-to-muscle signal transmission, nerve dysfunction, and/or muscle dysfunction.  

Why Should I Get an Electromyography?

EMG tests can be used to diagnose conditions like muscle disorders, disorders of the nerves, and conditions that affect the nerve root, motor neurons, and/or connections between the nerves and muscles.

Common symptoms that may indicate a muscle or nerve disorder can include:

  • Pain or cramping in the muscles
  • Tingling
  • Numbness
  • Muscle weakness
  • Some forms of limb pain

How is EMG Testing Performed?

This diagnostic procedure is formed by placing surface electrodes or inserting needle electrodes in various locations on your body. You may experience a mild twinge or spasm as the electrode delivers an electrical current to the designated area. You may be asked to contract your muscles during the procedure so the physician can monitor the electrical activity generated in your muscles during movement and at rest.

Where Will the Test be Performed?

If you have been given a prescription for an EMG/NCS test, please schedule your appointment at your earliest convenience. We recommend you return for a follow-up visit to Dr. Arora’s office at least one week after your EMG test to allow enough time for us to obtain the results. We recommend you confirm that we have received the results in our office before you return for your follow-up visit.

Dr. Arora works closely with a few select practices in the areas around each office to co-ordinate EMG testing.

Recommendations will be given at the time of your appointment.

Contact our doctor’s office in West Bloomfield, Howell, Warren, or Macomb today for further information or to schedule a consultation. We look forward to hearing from you!

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Patient

Stories

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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.