Let’s Talk About: Hand and Upper Extremity Pain

What are some of the most common hand, wrist, upper extremity, and shoulder pain issues that you regularly see?

Jung Park, MD (Orthopedic Surgeon, specializing in hand/wrist): The most common diagnoses that I see are carpal tunnel syndrome, trigger finger, tendinitis and trauma related conditions, such as fractures and ligament injuries.

Kieran Cody, MD (Orthopedic Surgeon, specializing in shoulders): I see a lot of shoulder arthritis, rotator cuff tears, and impingement syndrome. Other common diagnoses are frozen shoulder and shoulder instability. My older patients tend to have more problems with arthritis and rotator cuff tears, while my younger patients more frequently come in with instability or a frozen shoulder.

Kraig Bano, MPT, CHT (Physical Therapist/Certified Hand Therapist):  One of the most common things I see is that patients are not sure of the origin of their pain. They will often say, “I just woke up with it.”  However, pain is often caused by an underlying condition.  For example, pain in the upper extremity (shoulder, arm, elbow, forearm, wrist and hand) can be could be caused by conditions such as arthritis, tendinitis or nerve related issues such as carpal tunnel syndrome, cubital tunnel syndrome or the cervical spine.

Are there any issues that you’ve seen exacerbated during COVID-19 because so many people are now working from home and are finding themselves spending far more hours during the day sitting and typing on keyboards?

Cody: COVID-19 and social distancing has changed everything in so many ways!

Some people are becoming deconditioned because they are not able to get to the gym like they used to, while others have taken this opportunity to work out like crazy, even though their bodies might not be prepared.  As a result, I’m seeing patients who haven’t been working out enough, and others who did too much and ended up with overuse injury issues

Bano: COVID-19 has also changed the way many of us complete our work duties.   People have switched from using their ergonomically designed desks at work to a home work station that may be a laptop on the dining room table or a seat on the sofa.

For most people, a high table coupled with a low or un-adjustable chair causes them to have to raise their arms and flex their wrists to reach the keyboard.  Essentially, they are holding their arms out to their sides at 45 degree angles for an entire work day!  Over time, this can lead to shoulder, elbow, wrist and/or hand pain.

Park: I agree. Typing for extended periods of time at the kitchen counter, on the sofa or on the bed can lead to tendinitis around the forearm, elbow and wrist.  Many people also experience neck spasms and overuse syndrome.

At the same time, I find that some patients are taking advantage of the home quarantine to tackle extensive house projects. While I applaud the initiative, I have seen some traumatic injuries caused by doing tasks that are outside of patient’s regular routines.

For each of these common issues, what do you typically recommend to patients to alleviate the pain?

Cody: These problems can often be treated with conservative, non-surgical care. I always like to start with a combination of relative rest, anti-inflammatory medications or cortisone shots, and physical therapy. I would say the majority of patients get better with nonsurgical management.

Bano: Physical therapy can go a long way towards alleviating pain. After a very thorough evaluation, we can design a customized plan that may include manual therapy, stretching, strengthening exercises, and pain relieving modalities such as heat, ice and/or electrical stimulation. We also look at the activities that worsen the pain or increase dysfunction, and work with the patient to find ways to modify them such as ergonomic changes, assistive devices or changes in duration or intensity.

Park: I agree with Dr. Cody and Kraig. Conservative treatment along with physical therapy is often highly effective. I also find that if the condition is particularly isolated to one tendon for instance, steroid injection can be very helpful.  Sometimes, if the issue is due to trauma, surgery may ultimately be needed.

What are the best exercises to help with common hand, wrist, or shoulder pain issues?

Park: There is not one exercise that helps for all conditions.  However, I generally recommend stretching all muscle groups from the neck down to the fingertip.  I recommend doing these exercises in front of a mirror to make sure that both sides are symmetrical.  A physical therapist can also help create an exercise regimen that is designed specifically for the diagnosis.

Cody: I often find that for the shoulder, exercises that emphasize shoulder blade positioning are usually the most helpful. I often tell my patients that pulling exercises are better than pushing for the shoulder. For example, a row is more beneficial than a bench press, and a lat pulldown is better than a military press.

Bano: There are many exercises that are designed to alleviate pain but ultimately, it is not a “one size fits all” situation. At Fitness Physical Therapy (part of Bucks County Orthopedic Specialists), we use years of experience and knowledge to determine the most appropriate exercises for each patient’s unique situation in order to get maximal results with pain reduction and return to all activities.

Let’s Focus on Carpal Tunnel Syndrome

Carpal tunnel syndrome is a very common issue that many patients have.  What causes this condition and how can patients tell if they have it?

Park: Although there are some risk factors to developing carpal tunnel syndrome, there is no one reason why the patient gets this condition.  It can lead to numbness and tingling on the thumb, index and middle finger.   Symptoms are usually aggravated at night and by keeping the hand and wrist in a flexed position.

What are the different levels of severity with carpal tunnel syndrome and how does a patient know when to see a specialist?

Park: I recommend seeing a specialist when symptoms are becoming more frequent and ideally, before they become too severe. As the syndrome progresses, patients can experience more severe or frequent numbness or tingling that can become almost constant.  When the condition becomes severe, the patient may also notice weakness, particularly in the thumb. Through examination and imaging studies, a specialist can determine the severity of the carpal tunnel syndrome.

What treatments for carpal tunnel syndrome do you recommend for pain management and symptom relief?

Park: Conservative measures, such as stretches, exercises, and wrist braces work best in the early stages of carpal tunnel syndrome.   I only recommend surgery in severe cases. For example, if patients find no relief with conservative treatments or their imaging studies show severe compression, surgery to release the carpal tunnel may be needed.

Bano: In some cases, when the carpal tunnel syndrome symptoms are intermittent or mild, conservative treatment including stretching, nerve gliding and bracing to prevent extremes of wrist motion can help alleviate pain and numbness. However, when the symptoms (such as pain, tingling or numbness) progress to be more constant or significant weakness develops with pinching or squeezing, further options need to be explored with a hand surgeon to prevent permanent deficits, such as loss of sensation or strength. If surgery becomes the treatment of choice, physical therapy will help with scar management to prevent a thick and painful scar and to regain range of motion, strength and overall function.

What are some of the newer approaches in anesthesia for carpal tunnel surgery?

Park: Because of advances in local anesthesia, I am now able to perform carpal tunnel surgery without sedation (putting a patient to sleep).  Benefits of this approach mean that there is no need for fasting and none of the risks associated with anesthetic drugs.  Patients can even drive themselves to and from surgery.

Let’s Focus on Shoulders

What are the common causes of shoulder pain?

Cody: Rotator cuff tears and shoulder arthritis are two common causes of shoulder pain.

Rotator cuff tears can occur either from a sudden injury, or more gradually over time. The rotator cuff is composed of four muscles and tendons that help elevate the arm overhead. When there is a tear, the patient will notice both weakness and pain with overhead activity.

Shoulder arthritis is typically a gradually progressive problem in which patients will notice both pain and limited range of motion. They may even notice a grinding sensation as the cartilage wears out and the bones start rubbing against each other.

What treatments for shoulder pain do you recommend for pain management and symptom relief?

Cody: This is a great question, because patients are often surprised at how incredibly effective conservative treatments can be. For example, I frequently have patients who come to my office with acute and severe shoulder pain that is often related to bursitis. Patients are sometimes apprehensive about trying physical therapy for a pain that is so severe, but ultimately they are able to return to normal without needing any surgery at all. I love hearing their stories down the road when they tell me they were unsure that physical therapy was going to help them and yet, it truly did.

So, in terms of managing shoulder pain, beyond rest, ice, and anti-inflammatory medications, working with a physical therapist can be extremely beneficial. With PT, a patient will have an exercise program aimed at regaining range of motion and gradually strengthening the area, with an emphasis on shoulder blade position and stability.

Bano: I agree with Dr. Cody. In many cases, people are able to return to their normal activities with minimal to no pain following skilled physical therapy and continuing with their prescribed home exercise program.   Following a thorough examination by the physical therapist, a plan of care will be developed that may include manual therapy (soft tissue mobilization, joint mobilization, stretching, strengthening, stabilization of the shoulder blade) and return to activity training.  In the past, I have seen people with severe rotator cuff injuries or arthritis return to their activities of daily living following physical therapy.

What are the different levels of severity with shoulder pain and how does a patient know when to see a specialist?

Cody: We are frequently asked when is the correct time to see a specialist? I would say the time to get it checked out is when pain interferes with your life, sleep, activities of daily living, enjoyment of recreational activities, and/or it has not gone away after trying a week or two of rest and over-the-counter anti-inflammatory medication.  Minor problems often resolve on their own, but if a pain persists, it could be a more serious problem that will require a trip to the doctor’s office.

What are some of the newer approaches with anesthesia for shoulder surgery?

Cody: For shoulder surgery there have been tremendous improvements in anesthesia and pain control. The biggest improvement has been a nerve block with a long-acting, delayed release anesthetic. Patients can typically get 2 to 3 days of excellent pain control from just the nerve block alone. Most of my patients use very little narcotic medication and depend primarily on Tylenol with an anti-inflammatory medicine after surgery.

The doctors and therapists at Bucks County Orthopedic Specialists and Fitness Physical Therapy have extensive training and experience with all hand, shoulder, and upper extremity issues. If you’re struggling with pain and are looking for either surgical and non-surgical solutions, call (215) 348-7000 to schedule an appointment with Dr. Jung Park, hand specialist or Dr. Kieran Cody, shoulder specialist, or call (215) 918-5610 to schedule with Kraig Bano, CHT.

Pain in Hand: 10 Possible Causes

Hand pain can result from injury, arthritis, and other health conditions, including autoimmune disease.

The human hands are complex and delicate structures that contain 27 bones. The muscles and joints in the hand allow for strong, precise, and dexterous movements, but they are vulnerable to injury.

There are many different causes and types of hand pain. Hand pain can originate in different parts of the complex skeletal structure, including the:

• bones
• joints
• connective tissues
• tendons
• nerves

Hand pain can stem from:

• inflammation
• nerve damage
• repetitive motion injuries
• sprains and fractures
• several chronic health conditions

Many conditions contributing to hand pain can be treated. Depending on the cause of your hand pain, you may benefit from medications, exercises, or lifestyle changes.

Arthritis (the inflammation of one or more joints) is the leading cause of hand pain. It can occur anywhere in the body but is particularly common in the hands and wrist. There are more than 100 different types of arthritis, but the most common are osteoarthritis and rheumatoid arthritis.

Osteoarthritis typically affects older adults. Over the years, joints in the hands experience a lot of wear and tear. Articular cartilage is a slippery tissue that covers the ends of bones, allowing joints to move smoothly. As it gradually decreases, painful symptoms may begin to appear.

Rheumatoid arthritis is a chronic disease that can affect many parts of the body. It causes the joints to become inflamed, which leads to pain and stiffness. It often begins in the hands or feet, affecting the same joints on both sides of your body. Learn how to naturally relieve arthritis pain.

Arthritis symptoms include:

• dull or burning pain in joints of fingers or wrist
• pain after overuse (such as heavy gripping or repetitive motion)
• morning pain and stiffness in joints
• swelling around joints
• changes in surrounding thumb joints (overextension)
• warmth at site of the affected joint (resulting from inflammation)
• sensations of grinding, grating, or looseness around finger joints
• small cysts on the end of fingers

Common arthritis treatments include:

• medications to treat symptoms of pain and swelling
• injections of long-lasting anesthetics or steroids
• splinting of joints during times of overuse
• surgery
• occupational therapy/physical therapy modalities

The carpal tunnel is a narrow passageway of ligament and bone located at the base of your hand. It contains the median nerve (a nerve running from your forearm to the palm of your hand) and the tendons responsible for moving your fingers.

Carpal tunnel syndrome occurs when the median nerve gets squeezed by a narrowing carpal tunnel. This narrowing can be caused by the thickening of irritated tendons, inflammation, or anything that might cause swelling in this area.

Symptoms of carpal tunnel syndrome begin gradually and can reach varying degrees of severity. Symptoms include frequent burning, tingling, or itching numbness in the palm of the hand and the fingers. Pain is often felt around the thumb, index finger, and middle finger.

Other carpal tunnel symptoms include:

• feeling like fingers are swollen even when no swelling is present
• pain during the night
• pain and stiffness of hand or wrist in the morning
• decreased grip strength
• trouble grasping small objects or preforming certain tasks
• wasting away of the muscles at the base of thumb (severe cases)
• difficulty feeling the difference between hot and cold

Common treatments:

• splinting
• avoiding uncomfortable activities
• using ice or cool packs
• taking over-the-counter (OTC) pain medications
• getting injections of anesthetic or steroids
• taking oral steroids
• exercising and stretching
• having acupuncture
• having surgery

De Quervain’s tenosynovitis is a painful condition affecting the tendons around your thumb. Swelling in the two tendons around the base of your thumb causes the area around your tendons to become inflamed. This inflammation puts pressure on nearby nerves, causing pain and numbness around the base of your thumb.

Other symptoms of de Quervain’s tenosynovitis include:

• pain around the thumb-side of your wrist
• swelling near the base of your thumb
• trouble grasping something or making a pinching motion
• a sticking or popping feeling when moving your thumb

Common treatments for De Quervain’s tenosynovitis include:

• splinting
• applying ice or cold packs
• taking OTC pain relievers, like ibuprofen or aspirin
• avoiding painful tasks and pinching motions
• having physical therapy or occupational therapy
• having surgery
• injecting the area with a steroid

Ganglion cysts of the wrist and hand are not typically painful, but they can be unsightly. They most often appear as a large mass or lump coming out of the back of the wrist. They can also appear in varying sizes on the underside of the wrist, the end joint of the finger, or the base of the finger.

These cysts are filled with fluid and can quickly appear, disappear, or change size. If your ganglion cyst becomes large enough to put pressure on nearby nerves, you may experience pain, tingling, or numbness around the wrist or hand.

Ganglion cysts can often go without treatment. Rest and splinting can reduce the size of the cyst and it may go away with time. If it’s causing pain, your doctor may choose to drain the fluid from the cyst or remove it entirely.

Gout, which is a complex form of arthritis, is an extremely painful condition that can affect anyone. People with gout experience sudden, severe attacks of pain in their joints. Gout most often affects the joint at the base of the big toe, but it can occur anywhere in the feet, knees, hands, and wrists.

If you have gout in your hands or wrists, you’ll experience intense attacks of pain, burning, redness, and tenderness. Gout often wakes people in the night. You may feel like your hand is on fire. The weight of a bed sheet can feel intolerable.

There are several medications available to treat painful gout attacks, including nonsteroidal anti-inflammatories (NSAIDs) and colchicine. There are also medications that help prevent future attacks and complications. Learn more about managing gout with both traditional and alternative treatments.

Lupus is an autoimmune disease, which means your immune system mistakenly attacks healthy cells and damages healthy tissue. Joint pain and stiffness are often the first signs of lupus.

When lupus flares, there is inflammation throughout the body. This inflammation causes a thin lining around the joints to thicken, leading to pain and swelling in the hands, wrists, and feet.

Other symptoms of lupus include:

• muscle pain
• an unexplained fever
• red rashes, often on the face
• hair loss
• pale or purple fingers or toes
• pain when taking deep breaths
• fatigue
• swelling in the legs or around eyes

There is no cure for lupus, but there are many treatments available that can help you manage symptoms. For pain and stiffness in the hand and wrist joints, try:

• a warm or cold compress
• OTC pain medications
• NSAIDs
• physical or occupational therapy
• resting painful joints and avoiding painful activities

Peripheral neuropathy is a condition that causes numbness, pain, and weakness in your hands and feet. Peripheral neuropathy in your hands occurs when your peripheral nerves are damaged.

There are a number of things that can cause peripheral nerve damage, including diabetes, traumatic injuries, infections, and metabolic problems.

Peripheral neuropathy can affect one nerve or many different nerves throughout the body. Your hands and wrists have different types of nerves, including sensory nerves that feel things like touch, temperature, and pain, and motor nerves that control muscle movement.

The type and location of your neuropathic pain will depend on which nerves are affected.

Common symptoms of peripheral neuropathy include:

• numbness, prickling, or tingling in your feet or hands that comes on gradually
• sharp, jabbing, throbbing, freezing, or burning pain in hands or feet
• extreme sensitivity in hands or feet
• muscle weakness or paralysis
• lack of coordination; falling

Common treatments for peripheral neuropathy include:

• prescription medications that treat nerve pain
• OTC pain relievers
• prescription painkillers
• anti-seizure medication
• antidepressants

Raynaud’s phenomenon, also known as Raynaud’s disease, causes certain areas (particularly the fingers and toes) to become numb and cold when you’re stressed or exposed to cold temperatures.

When you get cold, it’s normal for your body to save heat by slowing the supply of blood to the skin. It achieves this by narrowing the blood vessels.

For people with Raynaud’s, the body’s reaction to cold or stress is more intense. Blood vessels in the hands can narrow much faster and tighter than normal.

The symptoms of a Raynaud’s attack might include:

• cold fingers and toes
• fingers and toes changing colors (red, white, blue)
• numbness or a tingling, throbbing, prickly feeling
• sores, gangrene, ulcers, and tissue damage (in severe cases)

Primary Raynaud’s is usually so mild that no treatment is required. But secondary Raynaud’s, which results from another health condition, can be more severe and may require surgery.

Treatment focuses on preventing further attacks and reducing the likelihood of tissue damage.

This primarily means keeping hands and feet warm in cold temperatures with gloves, socks, boots, and chemical heaters.

Trigger finger, also known as stenosing tenosynovitis, is a painful condition that occurs when your finger or thumb gets stuck in a bent position.

When you move your fingers, your tendons slide through tunnels called tendon sheaths. When these tunnels swell, the tendon can no longer slide through, and it gets stuck.

If you have trigger finger, you may feel a tender bump and heat on the top of your palm, at the base of your finger, where the tendon sheath is located. Other symptoms include:

• a popping or snapping feeling as you straighten and bend your finger
• one or more fingers stuck in a bent position
• stiffness and inability to straighten your finger in the morning
• severe pain at the base of the finger

Common treatments for trigger finger include:

• NSAIDs
• a steroid injection directly into the tendon sheath
• surgery to release the tendon sheath

Hand injuries are extremely common. The complex structure of the hand is delicate and vulnerable. Your hands are constantly exposed to danger. Hand injuries are common in sports, construction, and falls.

There are 27 small bones in each hand that can be broken in a number of different ways. Fractures in the hand can heal poorly when not treated properly. A poorly healed fracture can permanently change the structure and dexterity of your hand.

There are also muscles in the hand that can be sprained or strained. Always go to your doctor for an X-ray to ensure there are no fractures. Physical or occupational therapy is an essential component of treating any serious hand injury.

Treatments for fractures and sprains will vary depending on the type and location of the injury. Splinting is a common treatment option. Here’s how to make a temporary splint from materials you have.

In severe cases, surgery may be necessary to prevent long-term damage.

There are a few strategies you can use to relieve hand pain:

Was this helpful?

There are many different causes of hand pain. Generally, you should see your doctor when you have any new pain or when pain suddenly worsens.

Some hand problems develop gradually. Talk to your doctor if gradually worsening pain has been bothering you for some time. In the event of a traumatic injury, go to your local emergency room or critical care center for an X-ray.

You can connect with a primary care doctor in your area using the Healthline FindCare tool.

Pain in the fingers – General information, Causes. Tomsk

Symptoms and diseases

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General information

Pain in the fingers is quite common, especially in old age. Considering that the fingers of the hands consist of several bones (phalanges) connected by very mobile joints, and it is with our hands that we most often interact with the outside world, the probability of injuring them is extremely high. Of course, not only injuries can provoke pain in the fingers. There are many diseases that can cause pain in the joints of the fingers. Most of them are systemic and require a responsible approach, qualified diagnosis and timely treatment. In addition, many diseases of the fingers are accompanied by swelling of the joints and limited mobility, which affects performance. If you experience pain in the fingers, you should consult a doctor without delay (for a timely diagnosis and to prevent the development of serious consequences).

Causes of occurrence

The occurrence of pain in the fingers may be the result of an injury (bruise, dislocation, fracture) or overwork from long work associated with monotonous small movements of the fingers. However, in addition, pain in the fingers may be a symptom of one of the following diseases:

• Rheumatoid arthritis. A characteristic feature of this disease is the symmetry of pain on both hands (the same joints hurt). The manifestations of rheumatoid arthritis are also the appearance of characteristic nodules on the hands, morning stiffness of movements in the affected joints, and deformity of the phalanges of the fingers.

• Gouty arthritis. Gout develops when there are disturbances in purine metabolism and, as a result, the deposition of a large amount of uric acid salts in the joints. Pain in the fingers with gout can occur spontaneously and be very severe. The skin over the affected joint swells and turns purple. It also increases the sensitivity of the finger.

• Psoriatic arthritis. Although psoriasis is a skin condition, it often affects the joints as well. As a rule, it is the distal phalanges (the latter) that are affected. The joints may swell and take the form of “sausages”. It is also possible to darken the nail plate and form small dotted depressions on it.

• Osteoarthritis. This disease is characterized by dystrophic changes in cartilage tissue. Occurs more often in old age.

• Stenosing ligamentitis of the transverse carpal ligament. This disease is also called carpal tunnel syndrome. The pain is felt in impulse from the base of the palm towards the fingertips.

Other causes of pain in the fingers can be damage to the cervical spine or elbow joint, as well as burns or frostbite of the hands.

Tingling and pain in the hands

Tingling and pain in the hands can be caused by compression neuropathy. With advanced compression of the nerve, pain is experienced, and damage to the nerve can cause paralysis of the hand, loss of working capacity and disability.

Neurosurgeon Medicīnas centrs ARS says Dr. med. Janis Slesins

Why do my hands go numb and hurt?

Loss of sensation, tingling and pain in the hands can be caused by various reasons, so a thorough examination is required first. The most common cause is compressive neuropathy, or nerve compression. There are over 20 types of neuropathy. The two most common disorders are carpal and cubital tunnel syndrome

Why is it called carpal tunnel?

The name of the disease compression neuropathy indicates the essence of the disease – a compressed nerve. It usually occurs at the narrowest points along the path of the nerve, which is why this disease is called canal (tunnel) disease. The nerve is compressed in the carpal tunnel – in the wrist or in the cubital tunnel – in a narrow channel in the middle of the elbow. Carpal tunnel syndrome is more common than cubital tunnel syndrome

What causes carpal tunnel syndrome?

The most common cause of nerve compression is heavy, repetitive manual work. This disease is more common in people who overwork their hands and fingers every day, performing the same movements, working with their hands up or when their hands are in a tense position. In addition, this disease is more common in people with metabolic or hormonal disorders, in patients with diabetes mellitus, with weakened thyroid function, and with rheumatoid arthritis.

Who is more likely to develop carpal tunnel syndrome?

Historically, carpal tunnel syndrome was called the disease of milkmaids, because it was most common in women who milked cows with their hands all their lives. Modern work has become easier, heavy manual labor has been replaced by technology, computers and modern devices, but the prevalence of this disease has not changed. Carpal tunnel syndrome in the modern world is a typical problem of computer specialists , this disease can often be found in warehouse and office workers, as well as those who work a lot at a computer or on an assembly line, as well as teachers, hairdressers, dentists, electricians, gardeners, rural workers, and those who work hard needlework, etc. However, people who do not overload their hands with daily work are not immune from the disease. In women, carpal tunnel syndrome occurs 4 times more often than in men.

What are the first symptoms?

It all starts with tingling in the fingers, palms hurt, especially at night. The tingling and pain progresses and soon the fingers are swollen and insensitive in the morning. Gradually develops impaired mobility in the hand. An untreated nerve in the wrist for a long time drastically worsens the quality of life – sensory disturbances in the fingers become more pronounced, the muscles of the wrist wear out over time, the hand loses strength. It becomes impossible to grasp and hold small objects, and performing even simple routine work .

Is it possible to develop a diseased hand?

The development of the hand in this disease does not help, since the disease appears with excessive movements, from too much load. Additional movements or exercises create even more stress.

When to see a doctor?

When something tingles or hurts a little, it often goes away quickly on its own or with pain medication. You should go to the doctor when the complaints become constant and do not go away within 2-3 weeks. It is important to find out the cause of the complaints and, if necessary, to perform various examinations in order to decide on the appropriate treatment tactic – wait or treat. The good news for all patients is that this disease is quite treatable.

In a mild case of compressive neuropathy, when symptoms have just begun to appear, it is usually recommended to protect and not stress the affected arm . This is not always possible, since it is necessary to abandon the usual rhythm of life and work. However, in the arsenal of doctors there are various methods for helping. There are various possibilities and means of how to reduce painful symptoms, however, it must be understood that only surgery is the only way to treat this disease, since all other methods serve to reduce symptoms . Blockades, medications and orthoses alleviate the existing condition, but in the long run only surgery can help with this disease. It helps to get rid of this disease and completely forget about discomfort. Fully cured and / or achieve a noticeable improvement in the condition is obtained in 90% of patients

What examinations are needed?

A visit to a neurosurgeon is required to determine the cause and initiate appropriate treatment. First of all, it is necessary to clarify the location and degree of nerve damage in order to choose the appropriate treatment method that will reduce pressure on the nerve and help restore damaged fibers. Diagnosis is important, as treatment depends on it, which will be different in each case . First, the neurosurgeon visually and manually assesses the condition of the hand, then the most important examination is neurography, which helps to determine the nature and level of damage to the nerve fibers. When there is something suspicious near the nerve, for example, an enlarged articular bag or a formation of an unclear nature, and additional information is required about changes in adjacent tissues – tendons, joints and bones, then an ultrasound is done. If there are suspicions that some other disease causes pain and tingling in the arm, then X-ray, electromyography, computed tomography, magnetic resonance, laboratory tests, etc. are used to clarify the diagnosis.

How to treat compression neuropathy?

In order to reduce or completely eliminate nerve compression, doctors at Medicīnas centrs ARS have at their disposal various methods and means that will help eliminate discomfort and alleviate the painful condition for a while or completely. There are several possibilities depending on the degree of nerve damage. In mild cases, drug therapy with local injections is used. For this, both painkillers and steroid injections or blockades are used. Sometimes physical therapy helps for a while – ultrasound with a healing ointment, magnetic therapy, electrophoresis and other procedures that relieve swelling of the hand, releasing the pinched nerve. At night, it is worth using a special orthosis, which keeps the hand in the correct condition and reduces pain. However, all these methods have a short-term effect. Surgery is required to completely relieve the pinched nerve. She gives long-term result – the ability to work normally again and sleep peacefully .

Medicīnas centrs ARS, following the latest global trends in neurosurgery, offers increasingly gentle methods of treating compression neuropathy, replacing traditional surgical methods with modern endoscopy. This significantly speeds up recovery and restoration of the quality of life.

How is the operation performed?

Endoscopic surgery is performed at the ARS Day Hospital using local anesthesia. To release the nerve, either traditional surgical methods or is a newer and less traumatic endoscopic method . The patient can return home on the same day immediately after the operation. In a traditional operation, a small incision is made at the base of the palm or on the inner surface of the elbow, the canal is opened, and the nerve is released from compression. After the operation, it is necessary to observe a careful regimen for a month. The endoscopic method is much more gentle for the patient – through a small skin incision, a miniature endoscope is inserted into the carpal (cubital) canal – a video camera and microscopic surgical instruments, with which the compressed nerve is released. In this way, surrounding tissues are preserved, a less painful postoperative period is provided, faster recovery and restoration of working capacity, as well as a minimal cosmetic defect .