Carpal Tunnel Syndrome:
Carpal tunnel syndrome can present in multiple ways. Patients often say they are woken up multiple times at night with pain or tingling in their hand. Sometimes the hand feels cold, heavy, or weak when trying to do certain activities. Carpal tunnel syndrome is a condition where increased pressure is placed on the median nerve at the wrist. Although CTS can be treated without surgery with splinting, sometimes a nerve study is required to evaluate the presence or extent of compression of the nerve, and at times a small incision is required to release the compressive tissue on the nerve and alleviate symptoms.
Thumb arthritis is the most common form of osteoarthritis affecting the hand. Also called basal joint arthritis, CMC arthritis occurs more commonly in women than men, and can make the easiest task painful. It can cause severe hand pain, swelling, and decreased strength and range of motion of the thumb, making it difficult to do simple household tasks, such as grasping objects, pinching, turning doorknobs and opening jars. Treatment for thumb arthritis may include activity modifications splints, or corticosteroid injections. Severe thumb arthritis may require surgery. With his research collaborator, Dr. Michael Rainbow, Dr. Kamal has studied the effects of the surgical treatment of CMC arthritis on wrist stability, and applies this knowledge to improve management of patients in his clinic. Reade Dr. Kamal’s article on CMC Arthritis below:
Patients with trigger fingers often wake up in the morning and find they can’t straighten their finger out. Sometimes the finger must be manually straightened, which can cause pain and discomfort. Stenosing tenosynovitis, commonly known as “trigger finger” or “trigger thumb”, involves the pulleys and tendons in the hand that bend the fingers. In the finger, the pulleys are a series of rings that form a tunnel through which the tendons can glide. Trigger finger/thumb occurs when the pulley at the base of the finger becomes inflamed, constricting the tendon and making it difficult for the tendon to glide. Because of this increased resistance you can feel pain, popping, or a catching feeling in the finger or thumb. When the tendon catches, it produces irritation and more swelling of the pulley. This causes a vicious cycle of triggering and thickening of the pulley. Sometimes the finger becomes stuck or locked, and is hard to straighten or bend. The problem can often be treated with different non-operative methods, including splinting or corticosteroid injection. At times, it requires an outpatient surgical procedure to release the pulley and allow the tendon to glide freely.
Ulnar Impaction Syndrome (Ulnar Sided Wrist Pain):
In ulnar impaction syndrome, motions of the wrist, such as swinging a racket or golf club, or even lifting a gallon of milk, can cause excruciating and debilitating wrist pain. In this problem repeat impaction of the ulna bone against the wrist (or carpus) creates cumulative damage to the bones and soft tissues about the distal radio-ulnar joint, the triangular fibrocartilage, and the carpal bones. Dr. Kamal always attempts to treat this problem without surgery, often with splinting and anti-inflammatory medications. At times, an MRI is required and shows the extent of involvement of the damage, which directs potential surgical options including arthroscopy and ulnar shortening osteotomy. For more information, see Dr. Kamal’s article on ulnar shortening osteotomy here.
Dr. Kamal treats a wide range of hand conditions. If you do not see yours listed, please call his office to discuss your individual needs. Other common conditions treated by Dr. Kamal include:
- Distal Radio-Ulnar Instability
- Basal Joint / Thumb Arthritis
- Trigger Fingers
- Dequervain’s Syndrome
- Tendon Lacerations
- Knife and Puncture Wounds
- Nerve Injuries and Lacerations
- Lumps and Bumps on the hand or fingers