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Fingers General

Symptoms of Trigger Finger

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Trigger finger

Trigger finger, more formally known as stenosing tenosynovitis, is a condition in which a finger or the thumb gets locked in a bent position. The condition is more common in women than in men.

What are the Symptoms?

The affected finger may suddenly snap straight, like a trigger being pulled and released. Alternatively, the patient may not be able to straighten their finger at all. The patient may also feel discomfort or a lump at the base of the finger. Other symptoms can include limited mobility of the affected digit, a clicking or popping noise when the finger does move and pain.

What Causes Trigger Finger?

The fingers and thumbs have tendons that pass through sheaths or pulleys that keep the tendon close to the finger bone. If the sheath gets inflamed or irritated, it swells and thickens, which prevents the tendon from moving normally. If the condition isn’t treated, the sheath develops scars and nodules that make the sheath even more abnormally thick. This impairs the finger’s mobility even more.

Trigger finger is more common in people with certain health problems, such as diabetes or rheumatoid arthritis. Occupations and activities that require repeated strong gripping can increase the chances of developing trigger finger. For example, anybody who uses a screwdriver a lot might develop trigger finger.

How is Trigger Finger Treated?

There are many possible treatments for trigger finger. In a lot of cases, Dr. Arora will start by simply recommending that the patient rest the affected hand for at least four weeks. He may also recommend anti-inflammatory medication.

Our doctor may also splint the patient’s finger to keep it straight. In some cases, the patient will wear the splint only at night to avoid curling their fingers into a fist while sleeping. The patient may wear the splint for up to six weeks. Dr. Arora may also recommend gentle stretching exercises to improve the finger’s mobility.

If none of these methods prove helpful, our doctor may recommend a steroid injection near or directly into the affected sheath to reduce swelling and let the finger move freely again. Steroid injections are the most common treatment for trigger finger, and they work for about 90 percent of non-diabetic patients. The injection works for about 50 percent of the patients with diabetes.

An outpatient procedure in which the doctor breaks apart the constriction is often necessary if non-surgical treatments have failed. In severe or stubborn cases, our doctor may perform surgery on the affected tendon sheath.

Learn More During a Consultation

There is no one-size-fits-all treatment for trigger finger, as the best treatment option will depend on the unique situation. Make an appointment at Arora Hand Surgery in West Bloomfield, Howell, Warren, or Macomb so that our team can assess your condition and come up with a treatment plan for relieving you of your symptoms. Contact us today to schedule a consultation.

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Conditions General

What Causes Carpal Tunnel Syndrome?

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carpal tunnel syndrome

Surrounded by bones and ligaments, the carpel tunnel is the narrow space located on the palm side of your wrist. The main nerve and tendons that control the movement of your hand and fingers run through this tunnel. Affecting one or both hands, carpal tunnel syndrome causes pain and burning sensations that travel up your arm from the wrist. The symptoms typically affect the thumb, index finger and middle finger.

Women are more likely to be diagnosed with this condition, which is often more troublesome at night. The symptoms typically present themselves between the ages of 30 and 60. A number of factors can cause a pinched median nerve in your wrist.

Running from your forearm, the median nerve provides the sense of touch for your thumb and first three fingers. The numbness and tingling symptoms of carpel tunnel syndrome occur when the nerve is compressed. Chronic inflammation associated with an underlying medical condition is the most common reason for the swelling and compression.

Ailments typically related to the condition include diabetes, thyroid dysfunction and autoimmune diseases like rheumatoid arthritis. High blood pressure and fluid retention associated with pregnancy or menopause can also cause inflammation in your wrist. Fractures or other trauma can cause carpal tunnel syndrome as well. Detrimental lifestyle choices like smoking, an increased body mass index and a high salt intake may increase the risk for developing carpal tunnel syndrome.

Repeated motions of your wrist can contribute to inflammation and swelling. Regularly overextending your wrist can make the symptoms worse. This type of physical stress occurs in occupations like assembly line work, construction and professions requiring constant keyboarding.

If you are experiencing the symptoms of carpal tunnel syndrome, schedule an appointment at Arora Hand Surgery so that a comprehensive assessment can be conducted. Treatment options will depend on the severity of your condition. Typically, the earlier the syndrome is diagnosed and treated, the more favorable the outcome.

During a consultation at our office in West Bloomfield, Howell, Warren, or Macomb, our team may also provide information on helpful lifestyle changes. These measures can reduce the risk of developing carpal tunnel syndrome in the future or provide significant long-term improvement or elimination of symptoms if you are already afflicted with the disorder.

You do not have to live with the debilitating effects of carpal tunnel syndrome. With the right treatment options and lifestyle changes, you can experience a significant improvement in your quality of life with help from Avery Arora, MD and his team at Arora Hand Surgery. Contact us today to book your appointment.

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General

The Best — Without the Boast

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MI hand surgeon Dr. Avery Arora smiles in a headshot taken outside of his office.

“As long as I can remember, I have always wanted to be a physician,” says Dr. Avery Arora.

With that goal in mind — and a lot of hard work — this quiet, studious young man accomplished his dream. Now a board-certified shining star in his field, Dr. Arora was selected by local physicians as a Top Doc of 2013 in the field of Hand Surgery.

Practicing medicine since 2005, Dr. Arora’s medical journey started at the Medical College of Wisconsin. He completed his residency and internship in general surgery at William Beaumont Hospital in Royal Oak. During his residency, Dr. Arora had the good fortune to meet some surgeons who were pursuing hand surgery training. Exploring the specialty further, he knew this was the right path for his career. Technical and functional aspects of a hand surgery specialty suited him exceptionally well.

“I enjoyed the concrete, mechanical nature of the hand. Hands are an integral part of the body, and their form, function, and anatomy are interesting and challenging,” Dr. Arora explains.

He was accepted into fellowship training in the department of orthopaedics at the University of Colorado in Denver, where he honed his skills as a hand surgeon — treating a spectrum of hand problems associated with veterans, and children through adults. He excelled in advanced hand trauma, microsurgery, and common problems with the hand, wrist, and elbow.

Dr. Arora conveys that many of us take for granted how much we need our hands for the activities of daily living. When there is something wrong with your hand, there is a lot riding on the outcome — and, therefore, on whom you choose to help you recover. Because he has seen such a range of challenges associated with hands during his career, Dr. Arora is sensitive to a patient’s situation, and meticulous and vigilant with regard to procedures.

“I am not a salesperson,” Dr. Arora says. “I enjoy one-on-one interaction with my patients, learning about their lives, their work, their struggles, and what makes them tick. There’s always a uniquely personal aspect to each case.”

He conveys this with genuine sincerity. Introspective and respectful, this doctor and father of two young boys brings a big heart and impressive professional competence to bear when dealing with his patients.

There is no cookie-cutter routine to Dr. Arora’s method. He is adamant about practicing a patientcentered approach to his work, and involves his patients in all aspects of the decision-making process. He presents a menu of options as patients move forward with their care, and they are encouraged when he guides the process and helps them choose the clinical path that makes sense for them.

“Patient and surgeon must be on the same page,” Dr. Arora says. “I like to take the time to talk through all the options with patients — imaging, surgery, therapy, follow-up care; and educate them and make it easy for my patients to make decisions that suit them best for their circumstances.”

Practicing medicine is not the same today as it was a few decades ago. There are patients who are uninsured, and the risk of medical malpractice has increased tremendously. Unlike some in his field of expertise, Dr. Arora will take calls and see patients in the emergency room and hospital, as well as in his office. He enjoys the variety of patients and interesting cases, and this keeps his array of skills polished.

Dr. Arora maintains membership in a number of professional organizations, including the American Society for Surgery of the Hand, the American Association of Hand Surgery, the Arthroscopy Association of North America, and the American Board of Surgery. Emphasizing his work, Dr. Arora says, “I am grateful and happy, and although I might appear a little reserved to some, in truth I care very deeply about what I do and the outcome for my patients.”

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Conditions General

What is Dupuytren’s Contracture?

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What is Dupuytren’s Contracture?

Dupuytren’s Contracture is a rare type of hand disorder that tends to take a number of years to develop. It causes the layers of tissues that lay beneath the skin on the palm of the hand to begin to form knots. These knots thicken and can actually cause one or more of the fingers to bend. Once they are bent into this position, it will no longer be possible to straighten them. Since it is impossible to bend the fingers, it will make it difficult to do many normal activities and actions. You would not even be capable of putting on a pair of gloves. Eventually, it will become difficult to grasp large objects.

In most cases, only the ring finger and the pinky will be affected. In very rare cases, it can also affect the thumb and the index finger. The contracture tends to affect older men who have a Northern European heritage.

What Are the Causes?

Currently, the cause of Dupuytren’s Contracture is unknown. Researchers have not been able to find any evidence that it is related to hand injuries or any occupations that could cause repetitive stress issues or injuries due to vibration. However, they have found a number of factors that can increase the risk of developing the condition.

Men, as mentioned are the most likely to develop the contracture, and it typically affects those who are 50 and over. The condition also tends to run in families. Those who have diabetes are also at an elevated risk. In addition, smoking can increase the risk of developing Dupuytren’s Contracture, as can alcohol.

What Are the Treatments?

Doctors can help to treat the condition in a number of different ways. They may use a needle technique, in which the doctor will insert a needle into the affected area to break up the hardened tissues that is causing the finger to contract. They may also utilize enzyme injections. Those who have advanced stages of the disease can also have surgery to help remove the hardened tissue.

If you suffer from Dupuytren’s Contracture, speak with a doctor about your condition to find the best treatment options.

Talking With a Doctor

Chances are good that you will want to speak with a specialist about this condition. Your primary care physician can refer you to a specialist, who will want to know more about your medical history and how you have been dealing with the condition. For example, they want to know whether there is a history of Dupuytren’s Contracture in your family, if you’ve tried any treatments, and what medications you are taking.

The doctor will also want to know when the symptoms first started. Since this condition comes on slowly, it can be difficult to pinpoint when it began. Let them know if you are in pain, if the condition has been getting worse, and how it currently affects your daily life.

Most of the time, your doctor will be able to diagnose you based on examining your hands. The signs of Dupuytren’s Contracture are very obvious.

If you have any specific questions, contact us at our hand and wrist surgery offices in West Bloomfield, Howell, Warren, or Macomb or click here to request an appointment with Dr. Arora.

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Conditions General

Syndactyly Causes and Treatment

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Everyone has a little web of flesh between their thumb and their forefinger. If there are fleshy webs between your fingers as well, though, you may have a condition known as syndactyly.

What Is Syndactyly?

Simply stated, syndactyly is a condition in which adjacent fingers have grown together and appear webbed. If the fingers are completely joined, the condition is known as “complete syndactyly.” If only part of the fingers are involved, this is “incomplete syndactyly.” If both the flesh and the skin are involved, the condition is referred to as “simple syndactyly,” although sufferers would probably argue that there is nothing simple about it. Complete syndactyly is a joining of the bones. Fingers may also be joined at the tips, but have separate bones. This is complete simple syndactyly.

Causes

Syndactyly is a birth defect. The condition is sometimes genetic, passed down from one generation to the next. Other times, it occurs for no apparent reason. What is known, though, is that syndactyly has nothing to do with anything the mother may have done or neglected to do throughout her pregnancy. There is no need for a mother to feel guilty if her child is born with syndactyly.

Treatment

If it appears that syndactyly may interfere with function, it can be surgically corrected. Otherwise, parents can make the decision based on aesthetics. Most cases of syndactyly actually will not impair function. If surgery is done, though, therapy will be required post-surgery. Usually this involves wearing spacers between the fingers while the child is sleeping, in order to prevent the fingers from growing together again. The hand will also need to be bandaged for some time – perhaps even months. There may also be a need for follow-up surgery in years to come.

Success of Treatment

The goal of the surgery for syndactyly is to improve appearance, and also prevent the deformity from progressing. Usually, this is successful, although the appearance of the hand may not be completely what we would consider to be “normal.” It is important to remember that unless the appearance of the hand is extremely abnormal, what most people notice about the hand is not how it looks, but how it works. As long as a person is using their hand in a natural manner, deformities will usually be overlooked by the casual observer.

Refusing Treatment

If you have a child who has syndactyly, treatment is generally optional. Syndactyly does not usually present a health risk unless the fingers are joined toward the tips – in that case, they will bend in undesirable directions over the course of time. In such situations, surgery should be performed in the early years so the child can adapt to the changes in his or her hand. If delayed beyond the early childhood years, the results of syndactyly surgery are usually less than satisfactory.

If the condition is likely to result only in aesthetic issues, then surgery can be foregone without fear of complications down the road.

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Elbows General Treatments

How To Treat A Broken Elbow

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How a broken elbow is treated depends largely on the type of injury. Treatment could involve nothing more than applying a splint to the arm and keeping it elevated as much as possible. On the other hand, it could involve surgery to repair not only damaged bones, but damaged blood vessels and nerves.

Treatment will also depend on your age. As an example, children and adults usually injure their elbows in different ways, and they also heal differently.

Medication

If you have broken your elbow, at some point you will almost certainly require medication. Oral medications are frequently used for mild pain, whereas injections may be needed for pain that is moderate to severe – this type of medication can be delivered directly into the joint. If the elbow needs to be re-set, you will probably require a sedative to help you relax while the doctor re-sets the bone.

Re-setting the bone not only puts it back into its correct position, but it will also go a long way toward relieving pain. Frequently, broken bones can cut blood vessels and nerves, or press on them. Re-setting the bones stops this sort of damage. Medications can be provided during the re-setting process, as well as afterward to help with pain relief as healing progresses.

Surgery

If you have a compound injury (an injury in which at least one of the bones at your elbow is protruding through the skin), you may need an operation. With this type of injury, there is a good chance that blood vessels and nerves have been damaged. Additionally, the bone and surrounding tissue will need to be cleaned before the bone is put back in place, in order to prevent infection.

Draining

If the elbow joint is filled with fluid, it can be drained. This will relieve pain and pressure.

Splints, Slings and Casts

Splints are used for a variety of elbow injuries. They are usually made from plaster, and placed on the back of your arm in order to hold your elbow in a fixed position. Usually, the splint will extend from your hand to your shoulder, so that the hand cannot turn and the elbow will not bend, possibly preventing a fracture from healing or further dislocating the elbow.

You may also require a sling so that your arm can rest. You may be asked to remove it when you are at home, and elevate your arm in order to alleviate the swelling.

In most cases, you will not be fitted with a cast. This is because casts cover the arm completely, and if there is swelling under the cast, it could damage blood vessels and nerves.

Follow Up

Some joints can be fairly “forgiving” as they heal. The elbow, however, will not forgive and could heal badly, causing you to experience discomfort down the road. So make sure to follow your doctors advice to the letter if you are diagnosed with a broken elbow, and also be sure to keep any follow up appointments that are scheduled.

If you have any specific questions, please visit one of our offices or contact us at our offices in West Bloomfield, Howell, Warren, or Macomb.

Categories
Fingers General

The Facts About Nail Psoriasis

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When you hear the term “psoriasis,” you no doubt think about your skin or your scalp. You know about itching, flaking and discomfort in other areas, but probably the very last thing you think about is your fingernails. The fact is, though, psoriasis can also affect your nails. It changes the way that your nails look, often causing thickening or a change in shape or color, and it can also be painful. Fortunately, nail psoriasis is very treatable.

Symptoms

If you have nail psoriasis, your nails may become very unsightly, turning brown, yellow or green, or developing white or red spots. You may also notice grooves or ridges, or little holes on the surface of the nail. You might also find that there is a buildup of white, chalky material under the nail that could even cause it to become detached from the skin. Needless to say, this is painful. Brittle or broken nails are also a symptom of nail psoriasis. In its advanced stages, nail psoriasis may make it difficult for you to move your fingers. This loss of functionality can impair your ability to work and to socialize effectively.

Preventing Nail Psoriasis

As is the case with many illnesses and disorders, prevention is far better than a cure. In order to prevent nail psoriasis, you should do the following:

  • Keep your nails short.
  • Wear gloves when you are working with your hands.
  • Use a nail file to make sure that your nails are always smooth.
  • Moisturize your hands morning and evening, and whenever they have been in water.
  • Use clear nail polish to protect the surface of your nails, but be sure that you are not allergic to any of the chemicals in the polish.

Remember that taking care of your nails is part of your daily hygiene, just the same as washing your face or brushing your teeth.

Treating Nail Psoriasis

Generally speaking, the same treatments that work on scalp and skin psoriasis can also work on nail psoriasis. However, because nails grow slowly, you may not see improvement right away. Treatments for nail psoriasis include:

  • Medication that is either taken orally or applied directly to the nails
  • Phototherapy using ultraviolet light
  • Protective lacquers to strengthen and hydrate your nails – used in the same way as nail polish
  • Antibiotic creams that work to ease the discomfort of nail psoriasis and cure any infection that may have resulted from the condition
  • Coricosteroid injections applied under the nails every few months, under local anesthetic

The Final Word

Nail psoriasis is unsightly, and can also be very painful. Fortunately, there are remedies available that can ease the discomfort and correct the condition. If you have symptoms of nail psoriasis, you should see your doctor immediately. The condition will not get better on its own, and if left untreated, it can cause significant and permanent damage to your nail bed.

If you have any specific questions, please visit or contact our office in West Bloomfield, Howell, Warren, or Macomb.

Categories
General

Top Questions to Ask Your Hand Surgeon

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If you are in need of hand surgery, you will need to set up a consultation with the hand surgeon. During the consultation, they will provide you with information about the procedure, and you will have the opportunity to ask a number of questions to get a better understanding of the entire process. Lets look at some of the questions you should be asking.

Why Is the Doctor Choosing This Procedure?

There are many different types of hand surgery, and the doctor will choose the one thats best for your particular condition. However, you can still ask for clarification as to why they feel it is the best option. In addition, you can ask the doctor if there are any alternatives to the procedure.

Ask the doctor what benefits the procedure offers over the other options, and what you can reasonably expect after surgery. How much of your pain will it relieve? Will it help to return mobility and flexibility to your hand? You will also want to ask the doctor if this is the only procedure you will need, or if it might need to be repeated later.

What Happens During the Procedure?

How is the procedure performed and what is involved with it? Does it require a large incision or will the doctor be using arthroscopic tools that only require small incisions? The doctor should ask you whether you have any allergies to medication or have had any allergies to anesthesia. Always be forthcoming with your medical history so there are no unexpected complications.

What Are the Risks?

While it is certainly important to know the benefits that the surgery can provide, you also need to make sure you understand the risks. Even safe surgeries will have some element of risk, and you need the doctor to be very clear about the potential risks and issues associated with the surgery.

How Do I Get Ready for Surgery?

Before the day of your surgery, you need to ask the doctor about what procedures you need to follow before you arrive. Depending on the type of surgery, and your particular case, they might have different requirements, so talk with the pre-op nurse so you understand what you will have to do.

How Long Is the Healing Process?

While patients will heal at different rates, even those who have the same procedure, your doctor should be able to give you a good estimate of how much time it will take to heal. Understand the doctors orders when it comes to recovery and follow them. If they are unclear, ask them about what you can and cant do during the recovery time. Will you need to have help at home after the surgery? The discharge instructions should be clear, and if they are not, have them clarified before you head home.

Will I Need Therapy?

Some patients may find that they need to have therapy after surgery so they can improve the mobility and flexibility of their hands. Get instructions from the doctor on what types of therapy you need.

If you have any specific questions, please visit or contact our office in West Bloomfield, Howell, Warren, or Macomb.

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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.