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General Treatments Wrists

How is Carpal Tunnel Syndrome Treated?

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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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General Wrists

Who is at Risk of Getting Carpal Tunnel Syndrome (CTS)?

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Between 4 million and 10 million Americans have carpal tunnel syndrome. Characterized by numbness or tingling in the fingers and pain in the wrists, it can affect virtually anyone.

According to the National Institute of Neurological Disorders and Stroke, women are three times more likely than men to develop carpal tunnel syndrome. It usually occurs only in adults, and middle-aged adults and seniors are more likely to develop the syndrome than younger adults.

The structure of an individual’s wrist also may have an impact on the potential for CTS. The carpal tunnel is a space in the wrist where nine tendons and a median nerve pass from the arm into the hand. It’s typically about an inch wide. However, people who have more space in this tunnel are possibly less likely to get carpal tunnel syndrome, and individuals whose tunnels are tighter may be at higher risk.

Lifestyle factors, however, may be the most significant regarding who is at risk of getting carpal tunnel syndrome.

What Places Some People at Risk of Getting Carpal Tunnel Syndrome

1. Body Structure & Pre-Existing Medical Conditions

Individuals who have pre-existing medical conditions like diabetes, high blood pressure, arthritis, obesity, or nerve disorders are among those who are at risk of getting carpal tunnel syndrome. Other conditions that may be related to CTS include an overactive pituitary gland or an underactive thyroid gland. These health concerns may lead to fluid retention in the wrists, which places stress on the carpal tunnel.

Individuals who have jobs that demand strenuous or repetitive use of the wrists, such as painters, may be at higher risk of getting carpal tunnel syndrome.
Individuals who have jobs that demand strenuous or repetitive use of the wrists, such as painting, may be at higher risk of getting carpal tunnel syndrome.

2. Workplace Demands

Jobs that require repetitive or strenuous use of the wrists may be associated with CTS. These workers include:

  • Assembly line workers
  • Manufacturing employees, especially those who frequently use manual or vibrating hand tools
  • Tailors
  • Carpenters/woodworkers
  • Janitors/cleaning service personnel
  • Chefs/cooks
  • Data entry clerks/office workers
  • Painters

3. Hobbies

Many games, sports, and other hobbies may cause or increase the effects of carpal tunnel syndrome. Examples of these are bowling, playing the piano, playing basketball, and knitting.

4. Injuries

Wrist injuries that cause swelling may increase the effects of CTS as well.

5. Heredity

Some people are simply biologically or physically more prone to carpal tunnel syndrome than others are.

6. Cysts or Tumors

Cysts or tumors that develop in the wrists could lead to swelling and discomfort, leading to CTS symptoms such as tingling, numbness, and pain.

Possible Reasons Why Women Get CTS More Often

As noted above, research shows that women are three times more likely to get CTS than men are. The reasons for that are threefold.

  • Menopause may cause fluid retention in the wrists, which would add pressure to the tunnel.
  • Women who are pregnant may be more susceptible to CTS for similar reasons.
  • Women are more likely to have some of the underlying factors that contribute to carpal tunnel syndrome, such as arthritis, obesity, and thyroid issues.

Is it CTS?

Because it is so common, the general public tends to associate any wrist pain with carpal tunnel syndrome. However, many other conditions could cause pain and numbness in the hands and wrists.

If you believe you may have carpal tunnel syndrome, make an appointment with Dr. Arora for an evaluation. You may do so online or by calling one of our offices, located in West Bloomfield, Howell, Warren, and Macomb Township.

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General Wrists

What is the Carpal Tunnel?

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The phrase “carpal tunnel syndrome” is well-known but often misunderstood. If you have been experiencing pain in your wrists and have been diagnosed with CTS, chances are you asked: What does that mean? What is the carpal tunnel? Is having a carpal tunnel bad?

Before we go any further, let’s get this straight first: You are supposed to have a carpal tunnel. You were born with it.

But it’s not supposed to hurt.

What is the Carpal Tunnel?

The carpal tunnel is literally a tunnel found in your wrists. It is a space in the wrist where nine tendons and the median nerve pass from the arm into the hand. About an inch wide, it protects the median nerve and flexor tendons that bend the fingers and thumb.

It is formed by two layers: a deep carpal arch and a superficial flexor retinaculum.  The bottom and sides of this tunnel are formed by small wrist bones called carpal bones. The top, located on the palm side, is a strong band of connective tissue called the transverse carpal ligament.

The nine tendons in this area of the wrist are:

  • One flexor pollicis longus
  • Four tendons of flexor digitorum profundus
  • Four tendons of flexor digitorum superficialis

Why Do My Wrists Hurt Sometimes?

Pain in the wrists may be caused by carpal tunnel syndrome, which occurs when there is pressure and swelling in this tunnel. Possible causes of CTS include arthritis, thyroid conditions, pregnancy, diabetes, high blood pressure, and injury.

A significant factor believed to cause or exacerbate the pain is repetitive use of the wrists, especially without taking proper precautions. Examples include participating in sports, games, or other hobbies, as well as use of a computer keyboard or tools at work.

Dr. Arora will perform ultrasound testing or order an electromyography (EMG) study to confirm the diagnosis prior to proceeding with any significant treatments.

Prevention and self-care tips may help alleviate the pain associated with this syndrome. They include using ergonomically designed furniture and equipment; using proper form and protective gear while operating tools; and wearing a wrist guard while participating in activities that strain your wrists.

In some cases, more significant remedies may be advised, such as wearing a brace on the wrists when you sleep, using oral steroid medications, or undergoing steroid injections.  For persistent pain, you may elect to undergo a surgical procedure that enlarges the tunnel in order to decrease pressure.

For more information about what the carpal tunnel is, what it is comprised of, and how to alleviate wrist pain, visit the Arora Hand Surgery website or call us to make an appointment.

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General Hands Wrists

Hand or Wrist Tumors: Should You Be Worried?

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If you have a sudden growth or lump on your hand or wrist, the sight can be unsettling. Your mind may immediately go to a dark place, where you worry about serious conditions like cancer. It’s important to know, however, that hand or wrist tumors are usually not as bad as they look.

What You Need to Know About Hand or Wrist Tumors

A tumor can be defined as swelling on a part of the body due to the abnormal growth of tissue.

The word “tumor” is not synonymous with cancer. In fact, the vast majority of hand or wrist tumors are non-cancerous and painless.

Types of tumors that can develop on the hands and wrists include:

  • Giant Cell Tumor of the Tendon Sheath: This usually benign tumor most often occurs in patients older than 30. It grows slowly and is painless, and most often is found on the fingers.
  • Lipomas: Lipomas are the most common type of tumor, but they do not appear on the hands or wrists as frequently as on other areas of the body, such as the back or thigh. The benign fatty tissue growth usually affects adults ages 50 or older. They are soft to the touch and grow slowly.
  • Nerve Sheath Tumors: The nerve sheath is tissue that insulates the peripheral nerves, and a nerve sheath tumor grows within the cells of this covering. It can cause symptoms of shooting sharp pain in the affected area.
  • Neuromas: The growths are found along nerves and are caused by a traumatic event, such as a cut to the nerve. They are often very painful.

Other common types of tumors and other growths, such as cysts, that appear on the hands or wrists include ganglion cysts and epidermal inclusion cysts.

Treatment for Hand or Wrist Tumors

Occasionally an ultrasound will be performed or an MRI ordered to help distinguish the mass. If it is believed to be non-cancerous and is not troublesome, no action is necessary. Most people, however, do not want to live with the growth, so they elect to have them surgically removed.

Patients who are experiencing pain associated with these masses may be prescribed anti-inflammatory medications or given splints.

Individuals who are concerned about hand or wrist tumors should make an appointment with our hand surgeon, Dr. Arora. A proper examination can give you peace of mind if the growth is harmless, or help protect you if it isn’t.

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General Wrists

Carpal Tunnel Syndrome: Condition Often Comes with Serious Consequences

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If you are experiencing carpal tunnel syndrome, like Al Roker has, schedule an appointment to see our hand surgeon.
Al Roker is among the celebrities who have experienced carpal tunnel syndrome.

Playing video games, typing on a keyboard, driving a motorcycle, and playing a musical instrument can all make the symptoms of carpal tunnel syndrome worse, and anyone who has experienced it will tell you it’s serious business.

Carpal tunnel syndrome, which is a pinched nerve that results from pressure and swelling in a “tunnel” in the wrist, can be much more painful than the general public realizes.

In fact, in October Al Roker of “The Today Show” was forced to undergo emergency carpal tunnel surgery when he lost use of his thumb during rehearsals for a Broadway show.

But he is far from the only star who has experienced CTS.

  • When Jessica Alba woke up to a numb arm, she worried that she had experienced a stroke. As it turns out, she was experiencing carpal tunnel syndrome, which women are three times more susceptible to than men are.
  • Online gaming and video games are often the culprits when it comes to irritating existing carpal tunnel issues, as “Friends” star Matthew Perry and Boston Red Sox Pitcher David Price might possibly tell you.
  • In 2015, Brooke Shields underwent carpal tunnel surgery on both of her wrists.
Jessica Alba is one of the celebrities who has experienced carpal tunnel syndrome.
Jessica Alba worried that she had experienced a stroke when she felt the effects of carpal tunnel syndrome, which women are more susceptible to than men are. (Photo courtesy of PMK)

The exact causes of CTS are unclear, so that means it can essentially affect anyone at any time. Some activities, like those mentioned above, can exacerbate the condition, which includes pain, swelling, and numbness in the hands.

Although you might not be able to avoid CTS completely, you can be proactive by:

  • Using proper posture as you’re typing and also using ergonomic keyboards
  • Using wrist braces during activities like bowling
  • Using protection as you’re working in the construction, automobile, and manufacturing industry.

Bending and stretching your wrists every now and then during certain activities can help as well.

In some cases, surgery may be necessary to address the issue. The surgery usually entails cutting a ligament within the carpal tunnel on the palm side of your hand.

If you’re experiencing CTS symptoms, make an appointment to see our hand surgeon for an exam.

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General Treatments Wrists

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

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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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General Wrists

The Most Common Sprained Wrist Symptoms

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A sprained wrist is one of the most common injuries among athletes. All it takes is one momentary loss of balance, and the force of the fall bends the wrist back toward the forearm. This action stretches the ligaments that connect the wrist and hand bones a little too far, causing tiny tears or a complete break in the ligament. Exerting too much pressure, twisting it too far, or being hit in the wrist can also cause a sprain. These injuries are associated with injuries which are common in basketball, baseball, gymnastics, diving, skiing, skating, skateboarding, and inline skating. If you are experiencing sprained wrist symptoms, call Aurora Hand Surgery in Michigan to schedule a consultation.

Sprained Wrist Symptoms

A sprained wrist will feel tender and warm around the injury, along with some pain and swelling, as well as bruising. Some patients can feel a popping or tearing sensation along with the other sprained wrist symptoms. There are three grades of a wrist sprain:

  • Grade I involves pain with some minor damage to the ligament.
  • Grade II involves loss of function to the wrist with more severe ligament damage and pain, as well as a feeling of looseness to the joint.
  • Garde III involves severe pain, and a completely torn ligament with loss of function and looseness of the joint.

A diagnosis can be made using an x-ray, MRI, an arthrogram (a special x-ray or MRI done after the dye is injected into the wrist), or an arthroscopy (a minimally-invasive surgery in which a tiny camera is inserted into the wrist.

Treatment

With a sprained wrist, it’s best to start with the R.I.C.E. method:

  • Rest the sprained limb for at least 48 hours.
  • Ice it to reduce pain and swelling.
  • Compress the injury with a bandage.
  • Elevate the wrist above your heart.

For severe sprains, like Grades II or III, it’s best to contact a doctor, as they might recommend surgery to repair the torn ligament. The length of treatment and recovery depends on the individual and the severity of the injury. Recovery times vary as well.

For more information regarding sprained wrist symptoms and treatment, contact us today at Arora Hand Surgery and book an appointment in West Bloomfield, Warren, Macomb, or Howell.

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General Wrists

Wrist Pain with No Swelling – Possible Causes

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Injuries like fractures and sprains are most often the sources of wrist pain. However, long-term conditions like arthritis, repetitive stress and carpal tunnel syndrome can also cause wrist pain with no swelling. Since there are other factors that can cause wrist pain besides obvious causes like fractures, an accurate diagnosis is needed to get the proper treatment and healing approach. Arora Hand Surgery offers superior diagnostic services to determine the actual cause of the pain.

Arthritis

Arthritis occurs in two forms: rheumatoid arthritis and osteoarthritis. Rheumatoid arthritis is a condition where the body’s immune system attacks its tissues. The wrist is often the first target, and when one wrist is affected, the other is too. Osteoarthritis occurs when the cartilage cushioning the bones at the joints deteriorates with time. This condition is uncommon, and when it happens, it is often because the wrist in question has had an injury in the past.

Injuries

Injuries occur due to sudden impact and when repetitive stress is applied to a particular part of the body. Sudden impacts involve an immediate application of force, such as when you fall on your knee and injure it or when you land on an outstretched hand and injure your wrist joint. This kind of fall can result in fractures, sprains, and strains. Injuries like these, even fractures like the scaphoid fracture that occurs on the thumb, may not be visible on X-rays immediately after the injury. Oftentimes, the patient complains of wrist pain with no swelling.

Ganglion Cysts

With a tendency to occur on the part opposite the palm, these soft tissue cysts can be painful. Surprisingly, an activity may worsen the pain or improve it. Patients should look out for pain that shifts by either reducing or increasing when they take part in an activity that involves the wrist.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition that develops when a lot of pressure is applied to the median nerve as it passes through a passageway on the palm side of the wrist called the carpal tunnel.

Kienbock’s Disease

Common among young adults, this disorder is the progressive collapse of one of the small bones in the wrist when the blood supply to the bone is interrupted. The ‘dead’ bone makes the wrist tender and painful.

Wrist Pain with No Swelling? Come and See Us

While there are many causes of wrist pain with no swelling, the location of the pain will help Dr. Arora at Arora Hand Surgery perform a proper diagnosis to determine the exact cause of the wrist pain. Contact us today to book an appointment at our office in West Bloomfield, Howell, Warren, or Macomb!

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General Wrists

Common Broken Wrist Symptoms

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At Arora Hand Surgery, we treat a variety of conditions and injuries of the hands and wrists.  Broken wrists are a common injury.  They are usually caused by falls.  People tend to try and catch themselves with their open hands when falling.  The delicate wrist bones can fracture or crack under the pressure.  If you are not aware of what the broken wrist symptoms are, it is easy to not realize the severity of your injury.
 
 

Risk Factors for Wrist Injury

People who play certain sports are more susceptible to injury of the wrist.  High-risk sporting activities include:

  • Soccer
  • Football
  • Equestrian sports
  • Rugby
  • Roller and inline skating
  • Hockey
  • Trampolining

Those with osteoporosis, which is a condition causing thinning of the bones, are at higher risk of injury.

It is important that fractured or broken wrists be treated as soon as possible.  When the injury heals without proper care, the bones can fuse together misaligned.  Improperly aligned bones, in a crucial area such as the wrist, can make even simple activities difficult. Daily tasks like writing or using buttons can become very difficult.

Potential complications can include:

  • Osteoarthritis
  • Perpetual stiffness of the wrist
  • Aching
  • Disability
  • Nerve damage
  • Damage to blood vessels
  • Decreased range of motion
  • Decreased grip strength

The earlier you seek treatment, the more likely serious conditions can be avoided.

A Closer Look at Broken Wrist Symptoms

The first step in preventing further injury or disability to your wrist is identifying the symptoms of a fracture or break.  The first and most obvious signs often occur immediately following the injury.  You may experience severe pain that is exasperated by trying to move your wrist or hand.  You may also have pain when trying to grip things, squeeze or clench your fists.  Additional signs you should look for include:

  • Tenderness in the area
  • Swelling of the hand or wrist
  • Bruising
  • Stiffness of the fingers or thumb
  • Inability to move the fingers or thumb
  • Numbness in your fingers
  • Numbness in your hand

Whenever there is a deformity in the area such as a bent wrist or crooked finger, it is a clear indication of damage.

If there is any question about the possibility of a fracture or break of the wrist, you should see our doctor as soon as possible.  A loss of regular motor control, numbness, or swelling are serious signs that should never be ignored.  Failing to do so could lead to long-term consequences.

If you are experiencing any of the broken wrist symptoms that were discussed here, or other unexplained symptoms, we urge you to call us at Arora Hand Surgery in West Bloomfield, Howell, Warren, or Macomb. Contact us today to schedule your appointment.

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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.