Frequently Asked Questions
I have been diagnosed with carpal tunnel syndrome. What does that mean?
Carpal tunnel syndrome is a painful progressive condition caused by compression of a key nerve in the wrist. It occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. Symptoms usually start gradually, with pain, weakness or numbness in the hand and wrist, radiating up the arm. As symptoms worsen, people might feel tingling during the day and decreased grip strength may make it difficult to form a fist, grasp small objects or perform other manual tasks. In some cases, no direct cause of the syndrome can be identified. Most likely the disorder is due to a congenital predisposition--the carpal tunnel is simply smaller in some people than in others. However, the risk of developing carpal tunnel syndrome is especially common in those performing assembly-line work.
What type of therapy is involved after a carpal tunnel release?
Not everyone requires therapy after surgery. However, active movement of the fingers is recommended after surgery to reduce swelling and decrease pain. Occupational therapy techniques may include splinting, soft tissue mobilization, wound management, scar tissue management, tendon and nerve gliding exercises, strengthening exercises and education about joint protection and ergonomics.
What is a ganglion cyst? How is it removed?
A ganglion cyst is a synovial cyst that arises from the lining of a tendon sheath. The most common location for this type of cyst is on the wrist near the base of your thumb. The cyst may be aspirated or excised depending on the problems it is causing. Physician evaluation is warranted if the cyst is causing pain and/or dysfunction of your hand.
My thumb hurts when I pinch objects or turn doorknobs. What is the problem?
There may be more than one problem, but pain at the base of the thumb (also known as the carpometacarpal or CMC joint) may indicate arthritis. This occurs when muscles around the thumb reinforce abnormal movement patterns at the base of the thumb. The thumb experiences subluxation (falls out of the joint) at the base and causes discomfort with daily tasks such as gripping objects, turning a doorknob or key, fastening small buttons on clothing and opening jars. Avoid pinching with your thumb on top of the index finger (similar to holding a key). Instead, try to pinch by touching your thumb to the index and little fingers. This reinforces a stable position of the carpometacarpal joint. If the problem persists, make an appointment with a hand surgeon for an evaluation and to discuss treatment.
I have been diagnosed with "tennis elbow." Please explain what this means. I don't play tennis.
Tennis elbow, also known as lateral epicondylitis, involves pain and fatigue of the muscles that extend your wrist and/or fingers at the point of origin for these muscles (the outside of the elbow). Symptoms often begin with inflammation after overuse or repetitive motion and persist because the cells, which normally heal soft tissue, are not able to function properly in this area due to a lack of blood flow. It is called "tennis elbow" because it is very common in tennis players due to the repetitive motion of the tennis swing.
My doctor has diagnosed a scaphoid fracture and says I will be in a cast for three to four months. Why will I have to be in a cast so long?
The scaphoid bone, also called the navicular bone, is a small, canoe-shaped bone at the base of the thumb near your wrist. Under normal circumstances, the blood supply to the proximal portion (closest to the forearm) of the scaphoid is relatively poor. Therefore, when this bone is fractured, it often does not receive enough nutrient-rich blood to heal in the typical four to six weeks. Rather, it may take up to 20 weeks to heal. In some cases, surgical intervention is required to properly resolve the fracture.
I fractured my wrist three months ago. When can I expect the swelling to resolve?
It may take up to a year for swelling to resolve after an injury. Your physician or therapist may recommend compression garments to be worn during the day or night to make you more comfortable.
How long will it take for my strength to return to "normal?"
The nature of your injury, the immobilization period after your injury and your commitment to the rehabilitation process are all significant factors that contribute to the length of time needed for recovery. Some patients regain peak strength at six months, others at 12 months.
My child has been diagnosed with syndactyly. What does this mean and what treatment is available?
Syndactyly is a common congenital anomaly. It occurs when the web space-the area between the fingers-extends up the fingers, keeping them from spreading apart. The most common location is between the middle and ring fingers. After an evaluation of joint surfaces and soft tissues, surgical reconstruction is often the treatment option. Therapy may be recommended after surgery for soft tissue and scar management.
I just had ulnar collateral ligament reconstruction surgery. When will I be able to return to work?
When you return to work depends on the physical requirements of your job and your physician's evaluation of your progress in therapy.