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Conditions

3 Home Remedies to Ease Discomfort from Carpal Tunnel Syndrome

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Are you feeling as if there is something “off” with your wrists? It’s not necessarily sharp pain yet, but there’s discomfort and perhaps a slight weakness or numbness when your wrists are in use? While it’s impossible to diagnose you in this blog, and we encourage you to see a hand specialist as soon as this persists over several weeks, there may be some home remedies to ease your pain. Here are 3 home remedies to ease discomfort from carpal tunnel syndrome.

 

What is carpal tunnel syndrome?

Carpal tunnel syndrome (CTS), also called median nerve compression, can occur when a nerve in your wrist is pinched, and the condition persists when the activity that is causing that pinched nerve is repeated daily. Here at Arora Hand Surgery, a hand, wrist, and elbow medical practice in southeast Michigan, we meet patients who have the onslaught of CTS due to activities such as gardening, bartending, and of course, excessive computer usage.

 

Some patients describe the beginning stages of carpal tunnel syndrome as feeling like tingling “pins and needles” are present in the fingers (usually the thumb and index fingers, the pinky is rarely affected), hands, wrists, and/or forearms. The tricky thing about CTS, though, is that it is frequently misdiagnosed because it shares symptoms with other conditions such as arthritis, wrist tendonitis, and repetitive strain injury (RSI).

 

If you do in fact have a mild case of carpal tunnel syndrome and want to try some home remedies before going to the doctor, some of your discomfort can be eased with lifestyle changes.

 

Here are a few home remedies that may ease carpal tunnel syndrome discomfort:

  1. Use wrist splints to help keep your hands aligned. This means at nighttime too, as we also tend to flex and overextend wrists during slumber. A wrist splint provides support to the wrist and/or thumb while you carry out your usual day-to-day activities. They make daily task easier by increasing grip strength and reducing overall pain.

 

  1. Alternating between applying ice and warm water dipping. Cold and heat remedies have been known to ease CTS discomfort. We recommend soaking your hands/wrists in an ice bath for 10 to 15 minutes up to twice daily. Alternately, for warm water treatment, you can dip your hands in water between 92 degrees and 100 degrees Fahrenheit up to four times daily. Be sure to break between cold and heat remedies for at least an hour.

 

  1. Make changes to your work style. As mentioned before, repetitive hand movements can worsen the pain. Think about the adjustments you can make in your day-to-day activities that would help ease discomfort. Some examples include adjusting your chair height so that there’s less strain on your wrists during typing, avoiding squeezing pliers aggressively, keeping wrist twists to a minimum, etc.

 

It’s important to point out that these 3 home remedies may ease discomfort from carpal tunnel syndrome but not cure the condition completely. If pain persists, the diagnosis and proper treatment of carpal tunnel syndrome is imperative for your quality of life and health. If you believe you may have carpal tunnel syndrome and you live in southeast Michigan, visit Dr. Avery Arora at one of his offices located in West Bloomfield, Warren, Macomb Township, or Howell. He is a hand surgeon that can and will help you.

 

 

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Conditions General Hands

What is the Difference Between Osteoarthritis and Rheumatoid Arthritis?

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The differences between osteoarthritis and rheumatoid arthritis are significant, but the ability to identify one over the other can be somewhat elusive to the general public. A proper diagnosis is crucial for effective arthritis treatment.

The symptoms of these two common forms of arthritis may be similar, but the conditions are actually very different.

The word “arthritis” itself isn’t as much of a diagnosis as a description of more than 100 different types of ailments that involve joint pain or inflammation. Osteoarthritis and rheumatoid arthritis are two of the most common forms. According to the Centers for Disease Control, more than 32.5 million U.S. adults suffer from osteoarthritis. Rheumatoid arthritis affects more than 1.3 million adults in the U.S.

To help you communicate your concerns to Dr. Arora, we offer the following comparison as a guide.

What is Osteoarthritis?

In very general terms, osteoarthritis occurs when cartilage in a joint wears out. It usually begins in one joint and may never affect other joints.

The pain can be mild, moderate, or severe. Moderate or severe osteoarthritis pain can make it difficult for patients to complete everyday activities, such as buttoning a shirt or tying their shoes.

It is most common among women and occurs more frequently as people get older. Other risk factors for osteoarthritis include obesity, genetics, and joint injury or overuse.

What is Rheumatoid Arthritis?

Rheumatoid arthritis is an autoimmune disease. When this occurs, the immune system essentially “malfunctions” and attacks the synovial membrane that encases and protects the joints. It frequently affect several joints at the same time.

Beyond the pain, inflammation, and swelling common in other forms of arthritis, rheumatoid arthritis symptoms may include fever, anemia, fatigue, and loss of appetite. Rheumatoid arthritis may also show signs in the skin, eyes, lungs, heart, kidneys, salivary glands, nerve tissue, bone marrow, and blood vessels. It tends to be symmetrical, so symptoms may occur on both sides of the body simultaneously.

This form of arthritis is a chronic condition. There is no cure, and it is likely to progress over time. However, treatment options can reduce pain, make the symptoms manageable, and prevent significant joint damage.

Women are more likely to develop RA than men are. RA can begin at any age but most commonly starts in middle age. Other risk factors for rheumatoid arthritis include family history, smoking, and excess weight.

4 Key Differences Between Osteoarthritis and Rheumatoid Arthritis

1. Number of Joints Affected

Osteoarthritis may only affect one joint. Rheumatoid arthritis may affect several at the same time.

2. Symmetry

Rheumatoid arthritis tends to be symmetrical, meaning it affects both elbows, for instance. Osteoarthritis is more centralized, so it might or might not affect both sides of the body.

However, both sides of the body may become affected due to the exertion of too much pressure on one side. For example, if you experience osteoarthritis pain in your left wrist, you may use your right wrist more often, eventually causing the right wrist to act up as well.

3. Duration of Symptoms

The duration and extent of the pain is different.

With RA, joint pain and swelling can come and go, but the disease never really goes away. The goal of rheumatoid arthritis treatment is to make you feel better and get your symptoms under control, known as “remission.”

Osteoarthritis is also permanent and the pain and swelling are similar, but the condition can improve over time.

4. Additional Symptoms

Rheumatoid arthritis may have symptoms such as fever, fatigue, anemia, and loss of appetite. Osteoarthritis is usually only pain, swelling, and some loss of flexibility in the particular joint that is affected at the time.

If you are experiencing arthritis pain in your hands, wrists, or elbows, it’s important to determine the type of arthritis in order to create the best treatment and prevention plan for you. For an evaluation, diagnosis, and arthritis treatment, make an appointment to see Dr. Arora in Warren, West Bloomfield, Howell, or Macomb Township.

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Conditions Hands

Looking for a West Bloomfield Hand Specialist? Why Experience Makes the Difference

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Are you betting that all hand specialists in the West Bloomfield, Michigan area are the same? We’ll take that bet!

Truly, we can see why you might think that. Typically, people who experience a hand injury go to the first local hand specialist they can find. If you need care for an injury, that makes sense. On the other hand, if you’re looking for effective recovery and long-term treatment, you need to find a local hand doctor who has many years of experience in treating traumatic injuries as well as various other hand conditions.

Why is experience so important when you’re looking for a hand specialist? Let us point out a handful of reasons experience makes the difference.

1. The doctor may have a greater wealth of knowledge regarding various hand conditions.

As you are looking for a hand doctor, it’s important to find one who can diagnose and treat a wide variety of hand conditions. In fact, that’s why it’s ideal to go to a specialist specifically rather than a general doctor. The hand is an intricate, complex system, and any number of issues can cause similar symptoms. An experienced doctor will be more skilled at identifying the exact source of the pain and the condition that’s causing it.

2. The recovery process and results are more optimal.

Our hand surgery team learns something new every day, and the longer we work, the more we learn. It’s as simple as that. We’ve come across stumbling blocks, unexpected excellent outcomes, tremendous successes, and even a few failures, and we’ve learned from them all. Experience leads to knowledge about what to do, what not to do, and how to do it. And nothing can replace “time” in order to gain that expertise.

3. An experienced hand specialist in West Bloomfield may provide more accurate diagnoses.

If a hand doctor has earned his or her title, he or she is likely very familiar with all the various hand conditions a person may experience. There are many great hand specialists in Michigan, it’s true. However, reading about it is much different than seeing it in person or hearing what the patient has to say.

An experienced hand specialist would dig deeper and look beyond the obvious to pinpoint conditions that may mask themselves as something else.

4. The fluctuating Michigan weather may have an effect.

Cold weather can cause conditions such as hand arthritis and Raynaud’s disease to flare up. A local hand specialist who has years of experience in treating patients in Michigan specifically may have a few more helpful tips that can relieve weather-related flareups.

It’s also not all about the winters. Dramatic changes in weather conditions can lead to hand pain, numbness, and tingling as well. If you’re looking for a hand specialist, it’s important to find one who understands what all four seasons in Michigan can do to your body — and maybe even your mind. It all goes together, after all.

5. You gain peace of mind with proper treatment.

When you choose the best hand specialist in the West Bloomfield area, you can have greater confidence in the diagnosis, treatments, and guidance. Skilled hand doctors have most likely successfully treated countless of patients who have your condition, so they are more familiar with its intricacies.

You can also feel free to ask as many questions as necessary and know that you’re getting the thorough answers you deserve.

If the condition is treated properly the first time, you are less likely to have to return to get it treated again, with the exception of basic follow-up appointments. A condition that is improperly diagnosed or treated will likely not go away on its own. You might get temporary relief, but eventually you will have to return for more permanent solutions.

As you are looking for a West Bloomfield hand specialist, you will find that Dr. Arora has the depth of knowledge, expertise, and experience you need for more effective recovery. Contact us to make an appointment to see Dr. Arora at his office on Orchard Lake Road.

 

Categories
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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Conditions General Hands

How to Reduce Hand Arthritis Symptoms

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Is numbness in your hands and fingers hindering your ability to complete everyday activities? You don’t have to simply accept recurring arthritis pain as a way of life. You will not be able to completely eliminate them, but you may be able to reduce hand arthritis symptoms.

When you live with arthritis, you need to stay active in order to alleviate pain and maintain dexterity. Even if you can’t make it to your physical therapy sessions, there are many exercises you can do at home.

5 Exercises that can Help Reduce Hand Arthritis Symptoms

1. Make Fists

Gently make a fist with your left hand and hold it for 30 seconds. Straighten your fingers and open them up wide. Then make the fist again and repeat this 10 times for each hand. Do not squeeze your fist closed.

2. Bend Fingers and Thumbs

Spread your fingers, and then bend your thumb toward the palm of your hand. Hold it there for a couple of seconds, and then release it. Repeat the motion with each of your fingers to the best of your ability.

Hand arthritis exercises can help you maintain dexterity in your fingers.
Bending your fingers and thumbs one at a time toward your palm is one way to try to maintain dexterity in your fingers.

3. Finger Lifts

Place your hand palm down on a table, and then lift one finger at a time and hold the lift for a couple of seconds.

4. Thumb to Pinky

With your palm up, try to touch your pinky with your thumb but don’t move the pinky. It’s ok if you can’t reach it; don’t force it. Instead, hold your thumb where you feel comfortable for several seconds, release, and repeat. Some days you may be able to touch your pinky, but on other days you might not.

5. Make an O or C Shape

Curve your fingers and thumbs into an “O” shape or “C” shape, like you’re holding a baseball. Hold the pose for a few seconds, release, and repeat.

Contact Dr. Arora’s Office for Additional Details

At-home physical therapy is only one way to reduce hand arthritis symptoms, but it can be especially effective when used with a combination of other remedies, such as the use of anti-inflammatory medications.  The best part is that you can do these exercises anywhere at any time. Just remember to stop if you feel pain, as you don’t want to injure yourself.

Consult with our hand surgeon before you begin this or any exercise routine. Call us at (248) 220-7747 if you want to know more!

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Conditions General Hands

Signs of Something More: 11 Health Conditions that Show Symptoms in the Hands and Arms

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A majority of our patients come in due to broken bones, carpal tunnel syndrome, trigger finger, nail bed injuries, cysts, arthritis, sprains, fractures, and similar concerns. In some cases, however, pain or numbness in the hands or arms may be indicators of underlying health conditions that require further treatment.

We’re not trying to scare anyone here. It’s important not to become overly concerned about the symptoms you’re feeling in your hands, as there likely is a relatively straight-forward explanation and effective solution.

However, you should always get examined by our hand surgeon or your family physician to evaluate the source of your pain. Arthritis, for example, is one condition commonly associated with numbness and pain, but there are many other health conditions that frequently show symptoms in the hands and arms. Following are some of these conditions.

1. Cardiovascular Disease

Diseases of the heart and arteries make it difficult for the heart to pump blood efficiently, possibly leading to weakness in the limbs. Cardiovascular diseases also may lead to blood clots in arteries anywhere in the body.

2. Parkinson’s Disease

If you’re not moving and have tremors in your hands, this could possibly be an early sign of Parkinson’s disease. There may be many other explanations for these tremors, but this is one possible reason. Your symptoms should be evaluated by a physician before you can rule out this possibility. In addition to tremors, symptoms of Parkinson’s disease include:

  • small handwriting
  • a diminished sense of smell
  • trouble sleeping
  • trouble walking or moving
  • masked face
  • soft or low voice
  • constipation
  • stooping or hunching over

3. Blood Clots Due to PVD or PAD

Peripheral venous disease or peripheral artery disease can lead to blood clots, poor circulation, and other symptoms that may be visible in the arms.

4. Impending Heart Attack

Pain from a heart attack may spread to the arms. If you experience pain in your chest and believe it’s due to a possible heart attack, call 911 for emergency care.

5. Impending Stroke

Remember the acronym FAST: Face, Arms, Speech, Time. Signs of a stroke include facial drooping, arm weakness, and speech difficulties. If you see this, Time is of the essence. Call 911 immediately; the sooner you get help, the less likely it is for the individual to experience permanent disability.

Conditions such as lymphedema show signs in the hands and arms. In this image, a medical care practitioner wraps a patient's hand and wrist as a form of lymphedema therapy.
Lymphedema is one of the many health conditions that shows signs in the hands and wrists. Therapy for lymphedema may include wrapping the arm.

6. Lymphedema

A very rare condition, lymphedema leads to swelling in the arms and legs due to a buildup of fluid.

7. Raynaud’s Phenomenon

Also known as Raynaud’s diseases, this condition is characterized by the discoloration of the fingers or toes in particular situations, such as being in the cold or having specific emotions. Despite its name, it’s a relatively common disease with approximately 200,000 cases being diagnosed per year.

8. Buerger’s Disease

Commonly associated with smokers, Buerger’s disease is a rare disorder characterized by narrowing or blockage of the veins and arteries of the extremities. This results in reduced blood flow to these areas, as well as pain, sores on the arms, discoloration of the hands, and leg cramping.

9. Hemiplegic Migraines

During an attack, individuals who have hemiplegic migraines experience weakness on one side of the body. This may involve a feeling of numbness or a pins-and-needles sensation in the face, arm, and leg.

A woman is shown in bed trying to fight off a headache. Individuals who have hemiplegic migraines experience weakness on one side of the body, including the arm.
Individuals who have hemiplegic migraines experience weakness on one side of the body.

10. Herniated Disk or Other Spine-Related Concerns

A herniated disk or other diseases of the spine can lead to pain or numbness in the arms due to pinched nerves.

11. Peripheral Neuropathy

A general term for several disorders, peripheral neuropathy results from damage to the body’s peripheral nervous system. The peripheral nervous system connects the nerves running from the brain and spinal cord (central nervous system) to the rest of the body, including the arms and hands. Peripheral neuropathy occurs when nerves are damaged and don’t function as they should, leading to numbness and pain in the extremities.

If you are experiencing pain in your hands, wrists, or arms, make an appointment to see Dr. Arora. We will evaluate your symptoms to determine the source of the discomfort.

If you experience an urgent medical concern, call 911 or go to your nearest emergency room.

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Conditions Elbows Treatments

Tennis Elbow Treatment, Causes and Prevention

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If you are experiencing pain in your elbow during exercise or routine activity, you may be suffering from tennis elbow. Fortunately, tennis elbow treatment can be very effective.

Tennis elbow, or lateral epicondylitis, is a painful condition involving the tendons that attach to the bone on the outside (lateral) part of the elbow. The tendon’s attachment to the bone degenerates, which places increased stress on the area. This, in turn, leads to pain when the muscle is active, such as during lifting or gripping actions.

Tennis elbow is a common overuse and muscle strain injury. In other words, people who repeatedly use their elbow and arm muscles may be susceptible to tennis elbow. Common causes of tennis elbow (besides playing tennis) include:

  • Work as a painter
  • Frequent use of plumbing tools
  • Driving screws in
  • Cutting up cooking ingredients, such as meat
  • Regular use of a computer mouse

The simplest tennis elbow treatment is rest, along with some pain medication if needed.

While it often gets better on its own, in some cases it may be advisable to explore physical therapy options for treatment. For instance, a physical therapist can coach you on ways to stretch and strengthen the muscles of your forearm, which can counteract the effects of tennis elbow and even help prevent it.

Other treatment options for tennis elbow include Botox or platelet-rich plasma injections into the affected tendon, the use of a brace, or, in extreme cases, surgery.

The best way to prevent tennis elbow in the first place is to avoid repetitive hand, arm, and wrist motions that could cause the deterioration of the elbow tendons. Ensuring the use of proper technique while gripping, lifting, rotating, or participating in any activity that involves your arm and hand should help as well.

If you’d like more information on tennis elbow treatment or would like to set up a consultation appointment, reach out to us at Arora Hand Surgery today.

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Conditions Elbows General Hands

Cellphone Overload: How to Avoid Hand and Elbow Pain

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Have you ever used your cellphone for so long that your hands became numb, your fingers stopped functioning properly, and you gave up on mentally blaming autocorrect? If so, it was probably slightly comical at the time. If this happens repeatedly, however, soon enough it won’t be funny anymore. If you do use your phone frequently, it’s important to know how to hold your phone to avoid hand and elbow pain.

If you don’t, eventually you could be dealing with something worse than just sore thumbs, uncooperative fingers, and a really hot ear.

Ways to Avoid Hand and Elbow Pain when Using Cellphones

1. Try using text-to-speak, at least every now and then.

2. Use a cellphone stand so you can set the phone on a table or desk instead of holding it. When you do, you can use any finger you want to play those games and give the other fingers a break.

3. Make a conscious effort to regularly stretch and flex your fingers, wrists, and elbows.

4. If you talk on the phone for long periods of time, holding the phone up to your ear can cause discomfort at your elbow. To avoid this problem, try using:

  • A headset
  • The speaker option
  • A video calling app like FaceTime
  • Internet calling options such as Skype

What Could Happen: Carpal Tunnel Syndrome and Cubital Tunnel Syndrome

You might believe that the tingling in your hands due to cellphone use is just a temporary sensation, and it probably is. But if you don’t make conscious efforts to avoid hand and elbow pain when using cellphones, you could end up facing some very real issues.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is the result of swelling and pressure in a “tunnel” in the wrist, which consists of nine tendons and a median nerve.

Causes of this very common condition are unclear, but improper use of keyboards, tools, and even cellphones can increase CTS. Other examples of activities that can increase carpal tunnel syndrome include driving a motorcycle and playing a violin.

Individuals with CTS can experience tingling, a weaker grip, numbness, a tendency to drop things, and pain in the hand and wrist.

Cubital Tunnel Syndrome

Ever wonder why it’s far from funny when something hits your “funny bone”? To the contrary, it’s extremely painful. The truth is that what you feel comes from a nerve that runs behind a bone in the elbow through the “cubital tunnel.”

Pressure on the nerve can affect the blood supply to the nerve, causing arm pain and weakness in the hand. Direct pressure, such as leaning on your elbow, can compress the nerve and cause some of your fingers to “fall asleep.”

Both cubital tunnel syndrome and carpal tunnel syndrome are painful conditions that may lead you to seek medical treatment.

Contact Arora Hand Surgery for More Information

For more information about how cellphone use affects your hands, fingers, wrists, and elbows, explore the Procedures & Conditions pages of our website to learn more about symptoms you may be experiencing. If you’re regularly feeling pain or numbness in your hands or arms, contact one of our Arora Hand Surgery offices by phone or request an appointment online.

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Conditions General

Can Dupuytren’s Contracture Be Cured?

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Dupuytren’s contracture is a disease of the hand resulting in a deformity of the finger. It may have originated with the Vikings in Scandinavia and spread across Europe and then the world, as Viking influence spread. Whatever its origins, it can be a disabling and distressing condition.

If you have the symptoms or have had a diagnosis of Dupuytren’s contracture you may be wondering if it is curable. Read on to learn more about the condition and the answer to your question.

What is Dupuytren’s Contracture?

The condition, Dupuytren’s contracture, affects the fingers and hands. One, or sometimes more, fingers bend towards the palm of the hand. It can affect either or both hands and, in some cases, it can affect the thumb.

It usually starts when a nodule or hard lump forms under the skin of the hand. This small lump can be around a quarter of an inch in diameter. It can feel tender although this usually passes.

More nodules may develop. These nodules are benign (non-cancerous) and generally do not pose a problem at this stage. Over time the nodules can form an extended cord that runs along a finger or the thumb.

The cord can tighten or shorten bending the finger or thumb. The contraction pulls the finger or thumb towards the palm. Although this is generally painless it is progressive.

As the Dupuytren’s contracture gets worse the finger or thumb bends ever more towards the palm and into a permanently bent position. This can make using the hand difficult, especially when extending the hand. Playing a musical instrument, swimming or even shaking someone’s hand can be problematic.

What Are the Causes?

Other than the genetic background to Dupuytren’s contracture, we know little about the causes. It does often run in families. If you have the gene for Dupuytren’s contracture there are some factors that make it more likely.

It tends to affect older men, over 50 years of age. People with diabetes, epilepsy or who drink heavily or smoke have an increased chance of developing the condition. However, lots of people with the condition don’t have these problems.

Who Is at Risk?

The condition is quite common and although most cases are men over 50, women are also affected and there have been cases of children with the condition. It is more common in people with a northern European ancestry.

Because there is a genetic aspect to the disease it may not be preventable but avoiding some of the risk factors such as heavy drinking and smoking may reduce the risk.

Getting a Diagnosis

The key symptoms are:

  • Nodules in the palm of the hand
  • Lumps or pitted skin surface
  • Thick skin
  • Fingers bent towards the palm

If you have any of the symptoms described here, the first step is to have your hand examined by a physician. An examination will include a discussion with you about your symptoms and how they affect your life. Different people find that daily activities are more or less affected by the condition.

If the diagnosis is Dupuytren’s Contracture, the physician will assess the severity. In many mild cases, the physician will recommend no treatment until the severity gets worse. In other cases where the condition is more advanced, there is a range of possible treatments.

What Are the Treatments?

Following a diagnosis, your physician may suggest non-surgical treatment or a minor procedure called needle fasciotomy. Surgery is the recommendation in severe cases. Surgery options include open fasciotomy or fasciectomy.

Non-Surgical Treatment

Non-surgical treatments include radiation therapy or an injection of collagenase clostridium histolyticum.

Radiation Therapy

Radiation therapy may delay or prevent the advancement of the condition and so avoid surgery.

The treatment is believed to reduce the production of collagen and therefore the development of the cords. The treatment does not lead to a reduction of symptoms in all cases. There are also some minor side effects including dry and flaking skin.

Collagenase Clostridium Histolyticum

Xiaflex or collagenase clostridium histolyticum is an enzyme. An injection into the cords in the hand weakens the cord. Follow up treatment involves physically extending the range of movement of the finger.

Your physician will advise on the exact post injection procedures. It’s important to follow these precisely. Further injections may be administered.

Some side effects may be swelling, itching and some bruising and pain. Less common side effects include feelings of sickness or dizziness.

The benefits of collagenase clostridium histolyticum may be to increase movement of the fingers and delay or avoid the need for surgery.

Surgical Treatments

There are several surgical options your physician may consider.

Needle Fasciotomy

This procedure does not need an overnight hospital stay. A local anesthetic means the patient remains conscious throughout.

During the procedure, the surgeon inserts a needle or fine blade into the problem fibrous cord. This weakens the cord and reduces the tendency to pull the finger towards the palm.

The benefits of this procedure are:

  • Less impact than major surgery
  • Quick recovery
  • Less risk of complications
  • Improved use of fingers

The treatment has some effect but many people will experience a return of the contracture.

Open Fasciotomy

More serious cases need more invasive surgery. The aim is to have a long-term benefit but as with any surgery, there are risks, as well as potential benefits.

The operation can be under a local anesthetic and does not usually require admission to hospital. After the surgeon makes an incision in the hand, they cut the fibrous cord, weakening it. This allows straightening of the fingers.

The wound in the hand is then stitched and dressed. There will be some post-operative care required including removal of the stitches. The healing process takes longer than a needle fasciotomy and there will be some scaring.

Fasciectomy

This procedure is the most invasive of the options available. There are three types of fasciectomy.

During a regional fasciectomy the surgeon removes the affected tissue through a large incision. This is either using a local anesthetic which numbs the whole arm or alternatively under a general anesthetic. This means the patient is unconscious during the operation.

This type of surgery is the most common type used. It is a more invasive operation than an open fasciotomy and so it comes with a higher risk of complications.

A segmental fasciectomy is where the surgeon makes small cuts in the hand and removes small pieces of affected tissue. A dermofasciectomy is where the skin is also removed along with the affected fibrous cord. A skin graft, taken from another part of the body, covers the wound.

The effectiveness of fasciectomy is greater than other procedures with longer lasting results. There are lower rates of the Dupuytren’s Contracture returning than for non-surgical or other surgical procedures. A physician will discuss the risks of surgery with you prior to making a decision to operate.

Recovery

Recovery after treatment can take some time. After surgery, you may need physiotherapy to improve the range of movement. This can take the form of manipulation and exercises.

The fingers may be bandaged to a plastic strip for all or part of the day and night. This splinting may help the position of the fingers as well as the formation of scar tissue.

After recovery from surgery, there is a chance that the process that causes Dupuytren’s contracture will continue. This means that the condition could return.

A return of the condition is most likely with needle fasciotomy and least likely with fasciectomy.

Can Dupuytren’s Contracture Be Cured?

As Dupuytren’s contracture is probably caused by a genetic pre-condition there is no simple cure. The treatments described here have different degrees of success and for different time spans. This depends on the degree of advancement and severity of the condition.

All individuals have different experiences of how debilitating the condition is and how beneficial any improvement is. Different people respond to treatment differently and also vary in their recovery and experience of complications.

Research indicates that while there is no cure for Dupuytren’s disease it is possible to achieve a beneficial outcome following treatment. A reduction in inconvenient and uncomfortable symptoms is desirable for most people. Slowing down the progression of the condition is also very welcome.

What Should You Do If You Have Symptoms?

Dupuytren’s contracture can interfere with your ability to do everyday tasks such as driving, washing or dressing. It can impact work if it makes using a keyboard or tools difficult. It can have a social impact if it stops you shaking hands comfortably.

There may not be a complete cure but there is a range of treatments that you can discuss with a physician. Understanding your condition and getting a professional diagnosis is key.

To talk to someone about your symptoms, call or fill out our form.

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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.