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Treatments Wrists

Can Carpal Tunnel Syndrome Be Cured?

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Can carpal tunnel syndrome be cured? While there is no official cure, there are many remedies. In this image, a man at his desk is holding his painful wrist.

Can carpal tunnel syndrome be cured?

It’s a question wrist doctors and scientists have been trying to answer for decades. The simple answer is “yes and no.” …

OK, so that’s not so simple. Allow us to explain.

Carpal tunnel syndrome can be alleviated for a certain amount of time, but it might flare up days, weeks, or months later. In other words, many types of carpal tunnel syndrome treatments are very effective, but they may be temporary.

A more permanent solution to cure the symptoms of carpal tunnel syndrome is surgery, but this option is typically reserved for situations where self-help or medication do not alleviate the symptoms.

On the other hand, you may experience carpal tunnel syndrome pain only once in your life and never again depending on your lifestyle.

Self-Care for Carpal Tunnel Syndrome

Even though there might not be a true cure for carpal tunnel syndrome, the good news is that you have many options for self-care. Dr. Arora will go over these treatments with you, but here is an overview of some of the most common remedies.

Wearing wrist braces while you sleep

It’s hard to figure out how to rest your wrists while you sleep. Sometimes you lean your head on them. Other times they’re under a pillow. Every now and then they’re over your head or under another part of your body. All of these positions could lead to pain or numbness in the wrists.

Wearing wrist braces at night can help protect your wrists and keep them straight, thereby alleviating the symptoms.

Investing in ergonomic equipment and furniture

If your job requires extensive use of your wrists, you or your employer may wish to obtain ergonomically designed chairs, keyboards, and other equipment. For jobs that require the use of manual or power tools, consider wearing wrist support if possible.

Watching your posture

Your mama told you not to slouch as you were walking. Now, your wrist doctor is telling you not to slouch as you’re sitting.

If you use a computer throughout the day, you may be tempted to roll your shoulders forward, but don’t do that. Your body wasn’t made that way, so unnaturally slouching will only make wrist pain come on faster.

Sit up straight with your shoulders back and comfortably aligned as often as possible.

Taking frequent breaks

We’re not trying to get you fired here. When we say “frequent breaks,” we simply mean taking 20 seconds to stop what you’re doing and then stretch your hand and shoulder muscles before getting back to work.

Carpal tunnel syndrome is caused by tension in your wrists, so loosening up that area every now and then should help.

Medication & Surgical Options

When combined with self-care, anti-inflammatory medications can be effective in relieving the symptoms. Some patients may find relief with steroid injections as well, so ask Dr. Arora about that option.

For those with lingering symptoms, wrist surgery may provide a more long-term cure for carpal tunnel syndrome. The surgery entails cutting the ligament that forms of the top of the tunnel on the palm side of the hand. The goal is to enlarge the carpal tunnel in order to decrease pressure on the median nerve.

For carpal tunnel syndrome treatment in Howell, Warren, West Bloomfield, or Macomb Township, make an appointment with Dr. Arora through our website or by calling (248) 220-7747. He will analyze your symptoms in order to determine the cause of your wrist pain and then work with you to create a treatment regimen that’s right for you.

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General Treatments

Caring for Your Cast

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A broken wrist is shown in a closeup image. The man has a cast and sling.

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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General Treatments

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

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EMG tests and nerve conduction studies assess the health of muscles and motor neurons.

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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General Treatments Wrists

How is Carpal Tunnel Syndrome Treated?

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How is carpal tunnel syndrome treated? It depends on the extend of the wrist pain, health factors, and more, but treatments can be effective in minimizing CTS symptoms.

Between 3 percent and 6 percent of the adult population has carpal tunnel syndrome (CTS), making it undoubtedly the most common nerve disorder today. How carpal tunnel syndrome is treated depends on a variety of factors, such as the intensity of the condition. Fortunately, treatment can be very effective in reducing the pain, numbness, and tingling associated with CTS.

CTS occurs when there is pressure or swelling in the carpal tunnel, which is a space in your wrist where nine tendons and the median nerve pass from the arm into the hand. The condition is usually associated with repetitive use of the wrists, such as regularly using a keyboard or hand tools, but research indicates that it is likely related to a genetic predisposition as well.

How Carpal Tunnel Syndrome is Treated

Methods of treating carpal tunnel syndrome or reducing its effects range from self-care to surgical procedures in more serious cases. Following are several common solutions.

Oral Medications

Nonsteroidal anti-inflammatory drugs, known as NSAIDs, may help relieve pain and reduce swelling. Brand names of such medications available over-the-counter or in prescription form include:

  • Advil and Motrin (ibuprofen)
  • Aleve (naproxen sodium)
  • Mobic (meloxicam)

The use of anti-inflammatory medications to treat carpal tunnel syndrome may be especially ideal if the patient has arthritis symptoms as well.

Some doctors may prescribe a short course of oral steroids as well to reduce swelling. Such medications include prednisone or methylprednisone.

Discuss side effects of medication use with Dr. Arora or your primary care physician.

One way to treat carpal tunnel syndrome is through the use of anti-inflammatory medications.
Anti-inflammatory medications may reduce swelling in the carpal tunnel.

Steroid Injections

A more effective way to use steroids to treat carpal tunnel syndrome is to inject it into the carpal tunnel. Doing so may help decrease inflammation and swelling, thereby reducing pressure on the median nerve.

Protect Your Wrists

A key to reducing CTS pain is to keep your wrists relatively straight, which is somewhat possible during the day but not so much at night. For that reason, some doctors may prescribe wrist braces that you can wear while you sleep.

To prevent pain, you should also wear a brace if possible when participating in games and sports that strain your wrists, such as bowling.

If your job requires repetitive use of the wrists – such as in manufacturing, construction, or the auto repair fields – wear protective gear if possible to keep them stable.

Self-Care

Self-care is probably one of the easiest and most effective ways to prevent flareups. Take an active role in your CTS treatment plan with the following measures whenever and wherever possible:

  • Use ergonomically designed furniture and computer equipment.
  • Use proper posture when typing.
  • Sleep with your wrists straight, even if you’re not wearing a brace.
  • Take frequent breaks at work or when participating in hobbies.

Gently stretch your arms, flex your wrists, and wiggle your fingers regularly to reduce tension and increase blood flow. Dr. Arora can provide you with more specific at-home exercise tips that may reduce CTS symptoms.

Repetitive use of the wrists can be painful. Ergonomically designed furniture and equipment may help reduce carpal tunnel syndrome symptoms.
Repetitive use of the wrists can be painful. Ergonomically designed furniture and equipment may help reduce carpal tunnel syndrome symptoms.

Wrist Surgery

In cases where pain is not alleviated with the above treatments, surgeries can be helpful. The two most common surgeries for carpal tunnel syndrome are known as open carpal tunnel release and endoscopic carpal tunnel release, both of which can be handled on an outpatient basis.

  • Open carpal tunnel release surgery: In very simple terms, the surgeon makes a 1-inch incision on the wrist and then divides the carpal ligament to enlarge the carpal tunnel.
  • Endoscopic carpal tunnel release surgery: This is an alternate option with a similar goal. The surgeon typically makes two half-inch incisions, one on the wrist and one on the palm. A camera attached to a narrow tube is inserted into one incision, and the camera guides the doctor as he uses instruments to cut the carpal ligament through the other incision.
  • Laser carpal tunnel surgery: People often ask, but sorry to say, there is no such thing!

Get It Checked Out

How carpal tunnel syndrome is treated depends on the effectiveness of prior treatments, the extent of the condition, your ability to follow other remedies, and more. It’s also possible that your wrist pain is not CTS at all, but a different condition altogether.

The first step is to schedule an appointment to see Dr. Arora in West Bloomfield, Howell, Warren, or Macomb for an evaluation of your condition. If it is carpal tunnel syndrome, we will work with you to find a solution you’re comfortable with. Call us for more information.

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Fingers General Treatments

Mallet Finger: Definitions, Symptoms, and Treatment

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As shown here, a splint can be used to correct mallet finger if a hand doctor is seen soon after the finger injury.

Mallet finger is common in many individuals, especially because issues that occur regularly can lead to it. Slamming a finger into a door, injuring it with a baseball, falling, or any number of mishaps can all lead to this finger deformity.

What is Mallet Finger?

A mallet finger is a deformity of the finger caused when the tendon that straightens your finger (the extensor tendon) is damaged.

Such injuries are very common among athletes. When a ball or other object strikes the tip of the finger or thumb and forcibly bends it, the force tears the tendon that straightens out the finger. It may even pull away a piece of bone along with the tendon. As a result, the tip of the finger or thumb is no longer able to straighten.  In fact, mallet finger is also known as baseball finger for this reason.

In a mallet finger, the fingertip droops. If the injury is recent, the finger may be painful, swollen, and bruised. These effects will be especially pronounced if there is an associated fracture. These symptoms may decrease over time, but mild discomfort in the finger and tendons may persist.

Occasionally, blood collects beneath the nail, and the nail can even become detached from beneath the skin fold at the base of the nail.

Mallet Finger Treatment

The majority of mallet finger injuries can be treated without surgery. Ice should be applied immediately, and the hand should be elevated with the fingers toward the ceiling. Medical attention should be sought within a week after injury, or the finger could heal improperly, leading to more permanent damage. It is especially important to seek immediate attention if there is blood beneath the nail or if the nail is detached. This may be a sign of a nail bed laceration or an open fracture.

Mallet fingers can also be treated with splints or casts that keep the fingertip straight until the tendon heals. This usually lasts about eight weeks. The good news is that the finger usually regains acceptable function and appearance with this treatment, although some inability to fully extend the finger may continue.  Once the finger has healed, a hand surgeon or hand therapist will teach you exercises to regain motion in the fingertip.

Seeing a hand doctor for children with mallet finger is especially crucial. Because their fingers are still growing, a doctor can aim to ensure that the finger or fingers do not become stunted or deformed.

Surgery may be required to treat mallet finger if:

  • The condition is severe
  • There are large bone fragments
  • Joints are misaligned.
  • Using a split is not ideal or possible
  • Other treatments are not successful.

Surgical treatments may include tightening the tendon, using tendon grafts, or fusing the joint straight. Pins, wires, or small screws may be used to aid healing.

If you have a new finger injury or have been coping with the symptoms of mallet finger for years, make an appointment to see our hand surgeon in West Bloomfield, Howell, Warren, or Macomb. Dr. Avery Arora can help determine the right treatment options for you.

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General Treatments

Treating Common Basketball Injuries to Arms and Hands

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Basketball injuries to the fingers, hand, wrist, or elbow are common during the summertime.

The swish of a perfect basketball shot is a classic sound during hot summer days. From youths to adults, most everyone enjoys a game of basketball. Whether your hoop of choice is in the park or over the garage, you want to focus on improving your game this season while having fun. Naturally, you may be concerned about possible twisted ankles or concussions. However, basketball injuries involving your arm, elbow, wrist, and hand are also common, as well as preventable and treatable.

Common Arm and Hand Basketball Injuries

As with any sport, basketball injuries can and will occur, especially with your hands, elbows, wrists, and hands. Unfortunately, basketball injuries can get in the way of developing your technique.

You see more arm, hand and finger injuries in contact sports like basketball. Catching the ball incorrectly can bend your fingers unnaturally and cause injuries in other areas. Collisions during offensive and defensive plays also cause mild, moderate, and serious injuries.

Here are a few common arm and hand basketball injuries and how to treat them.

1. Bruises

You receive a bruise due to a collision with another player or a direct blow by the ball or another object. A bruise that takes too long to fade can indicate a more serious injury.

You can use the R.I.C.E. method to treat many injuries, especially bruises and swelling. Rest the area. Ice it every two hours, for 20 minutes total. Apply compression, such as an Ace bandage, to reduce the swelling. Elevate the area over the heart.

2. Shoulder Injuries

The repetitive motions associated with shooting from the socket can lead to shoulder injuries of the ligaments, tendons, and muscles therein. You may inflame the tendon or tear a rotator cuff. Overuse can lead to both, but an acute injury can also lead to tears. R.I.C.E. can help with the swelling, but tears need medical attention, such as cortisone injections.

3. Jammed Fingers

It’s common to jam a finger when playing basketball. Soak the injury in cold water for at least 20 minutes. Protect your jammed finger from further damage by “buddy taping” it to the next finger with medical tape.

4. Muscle strains

You can strain a muscle due to lack of flexibility or overuse. For overuse, try light stretching. You may also see an indent, bruising, and swelling, so it’s best to treat these injuries with the R.I.C.E. method.

5. Wrist Sprains

Many mild to moderate wrist sprains may be treated similarly to an ankle sprain with home remedies, but you should still pay us a visit for proper analysis. The ligaments may only be minorly damaged. However, they could also be torn and causing severe pain.

Try resting your wrist for 48 hours, and over-the-counter anti-inflammatory medicine may help. Consult with your doctor before taking any medications.

If the pain persists, you may have a more serious tear or a broken wrist. In the case of fractures or dislocations, do visit our offices to allow us to properly diagnose your case. An injury may seem minor, but the degree of pain and its longevity may worry you. Don’t hide an injury, or your injury may require surgery down the road due to lack of proper treatment.

Prevention is Key

A good coach is key to learning proper techniques with shooting, dribbling, passing, offense, and defense. Aside from practice, you should always take preventative measures against basketball injuries by stretching before you go out on the court.

Taking just five minutes of your time to warm-up each time you play may keep you playing all summer and help prevent injury.

Contact us at Dr. Avery Arora’s offices in West Bloomfield, Howell, Warren, or Macomb Township for assistance with any injuries regarding your arm, wrist, or hand.

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Conditions Elbows Treatments

Tennis Elbow Treatment, Causes and Prevention

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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.

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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General Treatments Wrists

Carpal Tunnel Syndrome: What It Is and How to Prevent It

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As depicted here, poor wrist placement while working at a computer might be one of the factors involved in the onset of carpal tunnel syndrome.

We’ve all heard about carpal tunnel syndrome (CTS) all our lives, and most of us realize it has something to do with painful wrists.

But why does it happen, really? And is there a way to prevent it?

What is Carpal Tunnel Syndrome?

The general public tends to speak about it casually, but for people who are experiencing carpal tunnel, it can mean extreme pain.

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. Carpal tunnel syndrome is the result of pressure and swelling in this tunnel, which in turn increases pressure to the median nerve, located at the wrist.

Signs of CTS include tingling, numbness, a weaker grip, a tendency to drop things, and pain in the hand, fingers, and arm.

Because a combination of factors may be involved, it can be difficult to determine the exact cause of CTS in each case. Some of these factors may include rheumatoid arthritis, thyroid conditions, pregnancy, diabetes, high blood pressure, and prior injuries.

Activities that can increase carpal tunnel syndrome symptoms include improper use of computer keyboards, regular use of power tools or hand tools, driving a motorcycle, and repeated use of your wrist, such as playing a violin or guitar.

How to Prevent It

Without a definite cause, it can be challenging to completely prevent carpal tunnel syndrome. But you can definitely try to be proactive by using:

  • Proper posture when typing.
  • Adjusting sitting height to allow for a natural angle to the wrist.
  • Ergonomic keyboards.
  • Braces when participating in activities that strain your wrists, such as bowling.
  • Proper protection as possible if you work in the manufacturing, automobile, assembly line, or construction industry.

You should also remember to give your wrists a break from whatever you are doing for a few minutes every couple of hours. During that time, stretch and bend your wrists and hands.

CTS Treatment

CTS symptoms can be relieved by changing patterns of hand use or temporarily splinting the wrist during sleep. A steroid injection that can relieve symptoms around the nerve may be helpful as well.

In more serious cases, surgery may be required to cut the ligament that forms the top of the tunnel on the palm side of the hand. The result is an enlarging of the tunnel and therefore a decrease of pressure on the nerve.

If you are experiencing carpal tunnel syndrome symptoms that cannot be relieved by home remedies, schedule an appointment to see Dr. Avery Arora in West Bloomfield, Howell, Macomb, or Warren.

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Fingers General Treatments

Surgical Reconstruction For A Nail Bed Injury

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Surgical reconstruction is an option for a nail bed injury.

Nail bed injuries are caused when the nail bed is pinched or crushed. This painful injury is commonly caused by the fingertips being shut in a door or struck with a hard object moving at a high rate of speed. It may feel like you are left to deal with the repercussions of your nail bed injury forever, but an option is surgical reconstruction.

A nail bed injury can include damage to the tissue, tendons, nerve ending, bone, skin, pulp and other structures that are around the nail bed. Common signs of a nail bed injury include a painful collection of blood under the fingernail, a cracked fingernail, or a fingernail that falls off. Once a nail bed injury is diagnosed, surgical reconstruction is one of the most effective ways to treat it.

Should the nail bed be destroyed or lost due to injury, a surgeon can reconstruct part of it or the entire thing by surgically grafting parts taken from the other fingers or toes. This can prevent future problems or deformities as the nail bed heals. A split-thickness graft is the type of graft most commonly used to repair a damaged nail bed through surgical reconstruction. This procedure is often used by surgeons when repairing a nail bed that is missing. This process can help to restore the use of a finger that is badly damaged.

Prior to the nail bed reconstruction surgical procedure being performed, it’s important to have a consultation with a member of our staff. An x-ray will likely be taken to determine how much damage has been done to the nail bed. This will help determine what the best next step for you is.

In most cases, all minor injuries are fully repaired, leaving the finger looking and functioning normally. Our team will help you understand what you should be able to expect from your surgical reconstruction for a nail bed injury.

If you are concerned about a possible nail bed injury, contact us today at Arora Hand Surgery and schedule your consultation. We proudly serve Michigan with offices in Warren, Macomb, Howell, and West Bloomfield. Contact us today and let us give you a hand!

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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.