Hand Surgery

Could Texting Cause Carpal Tunnel Syndrome?

Have you ever felt a numbness, tingling or shooting pain in your hands? If so you might be one of millions of people worldwide who suffer with Carpal Tunnel syndrome. The causes of Carpal Tunnel have long been contested, and previously doctors argues that it might be caused by “overuse” of the wrist – ie people sat still at a desk typing all day. New research points the finger at our smartphone addiction, with a possible link between smartphone use and Carpal tunnel recently being reported by the DailyMail and CNN after research in Hong Kong found a link.

 

Carpal Tunnel Syndrome Due to textingWhat is Carpal Tunnel Syndrome?

 

The carpal tunnel is a small passageway in your wrist that the median nerve travels through. It is thought that this passageway can become compressed and in turn compress the median nerve. This results in a number of symptoms such as:

 

  • Pins and needles in your hand (known to medical professionals as paresthesia)
  • Thumb Weakness (the median nerve controls your thumb)
  • A dull ache in your hand

 

Could Carpal Tunnel Be Linked with texting?

 

The study, published in the Journal Muscle and Nerve asked a small number of patients (48_ to fill out questionnaires on their wrist pain before taking tests to see whether they has numbness and tingling – the classic symptoms of carpal tunnel. They found that patients who used their devices for 4-5 hours a day or more often had enlarged median nerves (seen in carpal tunnel) and had more pain in their wrists.

 

The director of Arthritis Research UK talked to the DailyMail, and said of the results

 

‘Previously we only saw this type of repetitive strain injury in people using a mouse and keyboard at work.

‘Now we have these new repetitive movements, swiping and tapping, in our leisure time, as people are barely ever without their smartphones and tablets.

‘This is a real new challenge for the 21st century and I would encourage anyone suffering symptoms of burning and tingling to contact their GP promptly.”

 

He also noted that the sample size of the study was small – and more research is needed.

 

What Can Be Done About Carpal Tunnel?

 

A number of specialist clinics across the united states can provide excellent care if you think you are suffering from carpal tunnel syndrome. The treatments usually include the following:

 

  • Self Care: Take it easy – rest up! If you are over using a keyboard then stop!
  • Medication: Drugs like Ibuprofen can reduce swelling and inflammation in the nerve and reduce pain
  • A splint or brace: These can be bought cheaply online and keep the wrist in a position that doesn’t hurt.
  • Steroid injection: Corticosteroids can be injected right into the wrist – these are much more powerful than simple painkillers.
  • Surgery: Some clinics will offer a surgery that opens up the roof of the passageway (the carpal tunnel) and reduces pressure on the median nerve.

 

If you or someone you know are suffering from carpal tunnel, contact a specialist clinic today.

Conditions That Affect Hand Function

The hands are vital parts of the human body and without them, very little essential and social activities can be performed such as feeding, being productive to be able to make a living and support dependents, and interactions with others. Losing the ability to use one’s hand can be a very emotional and debilitating problem that can lead to increased stress and anxiety that may result in the development of mental health issues such as depression. Therefore, the proper diagnosis and management of conditions affecting hands is extremely important.

The following are conditions that can result in the hands becoming unable to function properly and how they are managed.

Dupuytren’s contracture Hand SurgeryDupuytren’s contracture

  • Progressive thickening of the tissue in the palm of the hand results in shortening of this tissue and causes flexing contractures of the fingers (makes the fingers close).
  • The most commonly affected fingers are the fourth and fifth digits and this can be quite a disabling condition.
  • Management includes physical and occupational therapy and surgical intervention in severe cases.

Trigger finger

  • Referred to in medicine as stenosing tenosynovitis.
  • Trigger finger causes a similar issue to Dupuytren’s contracture. The difference though is that where the latter involves pathology of the tissue covering the palm of the hand, trigger finger is caused by thickening of the tissue that covers the tendons which allow the fingers to close.
  • The condition is characterized by the affected finger seeming like it is stuck in a trigger-pulling position. Since it is difficult for the finger to be straightened, when it becomes unlocked it resembles the pulling of a trigger.
  • Management includes trigger finger surgery and when the thumb is involved is referred to as trigger thumb surgery.
  • These surgeries may be performed through minimally invasive access or open procedures if the cases are severe.

Carpal tunnel syndrome

  • This condition is associated with compression of the median nerve through the carpal bones in the wrist.
  • Compression of the median nerve results in the decreased sensation of the thumb and first two fingers which can complicate and lead to decreased power in the hand with an inability to use the limb.
  • Management of this condition involves initial conservative therapy with pain relieving measure and the use of splints to help take pressure off the median nerve.
  • If these therapies are ineffective, or the case is severe, then carpal release surgery is performed.

Rheumatoid arthritis

  • An autoimmune condition where antibodies are produced by the immune system that attacks and damages the synovial tissue around joints, especially of the wrists and fingers.
  • This process results in damage to the joints leading to deformities of the fingers making them stiff and difficult to use.
  • Management of this condition includes using medications such as steroids and non-steroidal anti-inflammatories such as ibuprofen or naproxen. Early therapy may also include medications such as disease-modifying anti-rheumatic drugs (DMARDs) like azathioprine, sulfasalazine, and methotrexate to help reduce disease progression as well as induce more remissions.
  • Surgical interventions may be warranted in cases where the medications are not working and the patient’s use of their hands has becomes severely debilitating.

Recovery after Carpal Tunnel Surgery

carpal tunnel syndrome2

One of the most common operations done today is carpal tunnel surgery. The goal of surgery is to relieve pressure on the median nerve. For many patients, improvement is noticed right away. For other patients, the pain stops, but full recovery of sensation is not always possible.

What will my sensation and strength be like after surgery?

Most patients describe a tingling or numbness after the carpal tunnel procedure. The return of sensation depends on severity of nerve compression, duration of symptoms, general health, age, and circulation. In severe cases, decompressing the nerve may not help gain full recovery of sensation. There are many reasons why the hand with carpal tunnel does not feel as strong as the other hand. This is often related to decreased sensation, which improves after carpal tunnel release. While some muscle recovery is likely after surgery, it is not always possible to regain full function.

What can I expect immediately after surgery?

After carpal tunnel surgery, you will be in a small surgical dressing with a piece of plaster splint in place along the wrist. Most of the palm and fingers are free, however. A nurse monitors you in the recovery room before you are discharged home. You will feel some soreness and numbness of the affected region. You will return to the doctor’s office in 4-7 days to have the surgical dressing removed. If sutures are present, they are also removed.

What happens to the cut ligament after surgery?

After carpal tunnel surgery, the cut ligament heals, filing in the gap with new tissue. By preserving normal palmar tissue, less new growth of tissue fills in, which makes your palm feel normal.

Can I use my hand right away?

After your carpal tunnel surgery, you are encouraged to use your hand immediately, especially your fingers. You will have a dressing on the area, which must be kept clean and dry. For showers, you should cover the area with a plastic bag.

How long does it take to heal?

The time of healing varies from patient to patient, as no two people are alike. However, most people can perform light activities in 1-2 weeks, and heavy activities within 4-6 weeks. Most people only are off from work for 5-10 days. While you may feel better early on, it is advisable not to overdo it, as this may delay a full recovery.

Will I be in a lot of pain?

Many people report that recovery from carpal tunnel surgery is not painful, and they get by taking only over-the-counter pain medicine, such as Advil or Aleve. However, the surgeon will give you a prescription for pain medicine to ease your discomfort. If you take care of your hand and wrist, your pain will be minimal.

Will I need physical therapy?

Physical therapy is used to relieve palm stiffness and discomfort. The therapist works with you through range of motion exercises and helps you perform flexibility and strengthening activities.

What can I expect immediately after surgery?

After carpal tunnel surgery, you will be in a small surgical dressing with a piece of plaster splint in place along the wrist. Most of the palm and fingers are free, however. A nurse monitors you in the recovery room before you are discharged home. You will feel some soreness and numbness of the affected region. You will return to the doctor’s office in 4-7 days to have the surgical dressing removed. If sutures are present, they are also removed.

What can I do to relieve pain and recover sooner?

Hand exercises with a stress ball are important in the first few days after surgery. Be careful to not overdo this, however. Gradually increase your tolerance for squeezing and gripping, and move your finger often to avoid stiffness and tendonitis. You may benefit from use of a cool splint, which protects the area while providing reduction of swelling.

OSPI offers top orthopedic surgeons in Gilbert AZ who offer all types of general orthopedics, carpal tunnel release, joint replacement and more. Call us today!

Overview of Mallet Finger (Baseball Finger)

A mallet finger is a deformity caused when the tendon that straightens the finger is damaged. Called the extensor tendon, this structure can become injured from an object (like a ball) striking the tip of the finger or thumb, forcibly bending it.

How common is mallet finger?

Around 85% of mallet finger cases are the result of minimal trauma or they arise spontaneously. In a study involving three generations of family, researchers noted a genetic predisposition for the condition. According to a recent study, 28% of injuries seen in the emergency room are hand injuries. On average, tendon injuries affect around 2% of the general population.Mallet_finger

What causes mallet finger?

Mallet finger is caused from a ball or other object hitting the tip of a finger. The force of the blow pulls away a piece of bone with the tendon in some cases. Because the finger and thumb cannot straighten, it decreases finger function. Any forced flexion of the finger risks the integrity of the distal intraphalangeal phalanx (DIP) joint. The injury is common among players of soccer, baseball, volleyball, and basketball.

Mallet deformity is also associated with fracture of the dorsal articular surface of the DIP, which occurs in three patterns:

  • A small fleck of bone that involves 25% or less of the articular surface.
  • A large bony fragment that involves 30% or more of the articular surface.
  • An avulsion of any size associated with palmar subluxation of the DIP.

What symptoms are associated with mallet finger?

The main characteristic of mallet finger is a drooping fingertip. This means the person cannot straighten the finger without using the other hand. The finger may be bruised, swollen, or painful, usually if there is a fracture along with the injury.

How is mallet finger diagnosed?

The diagnosis can be made by viewing the finger. However, the doctor will inquire about the injury, take a medical history, and perform x-rays.

What is the treatment for mallet finger?

The majority of mallet finger injuries are treated without surgery. Options include:

  • Ice – Ice should be applied as soon as the injury occurs, and the hand should be elevated with the fingers toward the ceiling.Mallet_Finger_Splint_s__05609.1344611002.1280.1280
  • Splinting – There are many splints and casts used for mallet finger. The goal is to keep the fingertip straight while the tendon heals. For most patients, the splint is worn around 8 weeks.
  • Physical therapy – A therapist will instruct on when to remove the splint for exercise of the fingertip. Exercises are used to maintain motion of the middle joint so the finger does not get stiff.
  • Surgical repair – This is considered when the injury involves large bone fragments or joint malalignment. For these cases, wires, pins, and screws are used to secure the bony fragment and to realign the joint. Surgery is used when nonsurgical measures are not successful.

What is the prognosis for mallet finger?

An untreated mallet finger can have functional consequence if there is a swan-neck deformity. Frequently, an extension lag is present, which is mild. It usually takes several months for the swelling and redness to subside, but the finger’s mobility and appearance will return to normal.

Resources

Angermann P, Lohmann M. Injuries to the hand and wrist. A study of 50,272 injuries. J Hand Surg Br. 1993;18:642-644.

Jones NF & Peterson J (1998). Epidemiologyy study of the mallet finger deformity. Journal of Hand Surgery, 13(3), 334-338.

Carpal Tunnel Release Surgery with a Gilbert Hand Surgeon

Carpal tunnel release surgery is only considered for patients who do not get relief of symptoms from nonsurgical measures. This procedure is done on an outpatient basis for most patients.

Why is carpal tunnel release surgery done?

Carpal tunnel syndrome (CTS) occurs when the tissues (synovium) around the flexor tendons and median nerve swell and cause pressure. These synovial tissues lubricate the tendons so the fingers can move easily. Over time, this swelling narrows the small space of the carpal tunnel and crowds the nerve.carpal tunnel horizontal wrist photo

Who is a candidate for carpal tunnel release surgery?

Candidates for carpal tunnel release surgery include those who:

  • Do not respond to conservative treatment (physical therapy and medications).
  • Have constant numbness and wasting of the thumb muscles.

How do I prepare for the surgery?

Before you undergo carpal tunnel release surgery, notify the doctor of all medicines you are taking. Certain blood-thinning agents must be held for 7 days before the scheduled procedure. Arrange for someone to drive you from the hospital, and do not eat or drink for 8 hours before the surgery.

Will I be given anesthesia?

The outpatient procedure only takes around 60 minutes. Before the surgery, you are given general anesthesia (put to sleep), which prevents pain and movement during the surgery.

How is carpal tunnel release performed?

There are two ways to perform the procedure:

  • Open carpal tunnel release – The surgeon will use a needle to administer a local anesthetic. A small cut icarpal tunnel anatomy pictures made in your palm, and the surgeon divides the transverse carpal ligament (roof of the carpal tunnel). A ligament is also cut from inside the carpal tunnel to speed up recovery, and tissue around the nerve is removed.
  • Endoscopic carpal tunnel release – With this procedure, the surgeon makes a small cut in the palm region of the hand, and inserts a small endoscope into the wrist. This tube has an attached camera and light so the surgeon can view images on a monitor. Small tools are inserted so the surgeon can cut the carpal ligament.

What is involved in the recovery process?

Immediately after surgery, you must frequently elevate your hand on pillows to reduce swelling and prevent stiffness. Some pain, stiffness, and swelling can be expected after the procedure. You are required to wear a wrist brace for 2-3 weeks, and you can use your hand normally.

Expect some soreness of the palm for several weeks, as well as pinching and griping weakness (will last for around 6 months). In addition, light gripping and lifting, self-care activities, and driving are permitted soon after the procedure.

What are the long-term outcomes of the procedure?

The majority of people’s symptoms improve after carpal tunnel release surgery. However, recovery is gradual. On the average, pinch and grip strength returns by the second month following the procedure. For optional recovery, physical therapy is prescribed.

What are the home care instructions?

It will take around 4 weeks to fully recover. For a full recovery, the patient should:

  • Take medications as prescribed.
  • Apply ice packs to the wrist and hand every few hours.
  • Avoid lifting heavy objects.
  • Elevate the hand and wrist frequently.

What are the risks and complications of the carpal tunnel release procedure?

All surgeries carry some risks. With carpal tunnel release surgery, risks include infection, nerve damage, bleeding, and allergic reaction to solutions and medications. Be sure to notify the Gilbert orthopedic doctor if you experience intense pain, fever, chills, unusual redness or swelling, chest pain, and/or shortness of breath.

At OSPI, top hand surgeons offer carpal tunnel release procedures for the entire East Valley including Chandler, Gilbert, Mesa and surrounding areas. Most insurance is accepted, and appointments are readily available. Call today for the top hand surgeons Arizona trusts!

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