To learn more about these services, please select one of the links below:
Athletic Injuries Back to top
Carpal Tunnel Syndrome and Surgical Release
Carpal Tunnel Syndrome is a common, painful, progressive condition that is caused by compression of the median nerve at the wrist area. Common symptoms of carpal tunnel syndrome include numbness and tingling sensation in all the fingers except little finger; pain and burning sensation in hand and wrist that may radiate up the arm and elbow; and weakness in hand with diminished grip strength. Exact causes of the condition are not known. However certain factors increase the risk of developing carpal tunnel syndrome and they include congenital abnormalities, repetitive motion of hand and wrists, fractures and sprains, hormonal imbalance, and other medical conditions such as hypothyroidism, rheumatoid arthritis, diabetes, obesity, gout, overactive pituitary gland, or the presence of a cyst or tumor in the canal.
Carpal tunnel syndrome may be treated using conservative approaches or surgery. The conservative treatments include:
- Treating underlying medical conditions
- Immobilization of the hand and wrist with a splint or wrist brace for 4-6 weeks
- Rest the hand for 2 weeks or more
- Ice packs to avoid swelling
- Avoid activities that tend to worsen the symptoms
- Medications such as nonsteroidal anti-inflammatory drugs, diuretics, and steroid injections
- Strengthening and stretching exercises once symptoms diminish
If conservative treatment options fail to resolve the condition your surgeon may recommend surgical procedure.
Carpal Tunnel Release Surgery
Carpal tunnel syndrome can be treated with carpal tunnel release surgery. Traditional surgery involves up to a 2- inch incision in the palm and wrist area, whereas endoscopic surgery involves one or two half-an-inch incisions and the use of an endoscope. During the surgery, the transverse carpal ligament will be dissected to release the pressure on the median nerve and enlarge the carpal tunnel. Your surgeon will decide which options are best for you based on your general and medical conditions.
Your surgeon may suggest you to practice certain post-operative procedures for better recovery and to avoid further complications.
- Elevate the hand above heart level to reduce swelling
- A splint may be worn
- Ice packs to the surgical area to reduce swelling
- Keep the surgical incision clean and dry. Cover the area with plastic wrap when bathing or showering
- Physical therapy may be ordered to restore wrist strength
- Eating a healthy diet and not smoking will promote healing
The majority of patients suffer no complications following carpal tunnel release surgery. However some patients may suffer from pain, infections, scarring, and nerve damage causing weakness, paralysis, or loss of sensation and stiffness in the hand and wrist area.
Fractures and Trauma Back to top
A bone fracture is a medical condition in which a bone is cracked or broken. It is a break in the continuity of the bone. While many fractures are the result of high force impact or stress, bone fracture can also occur as a result of certain medical conditions that weaken the bones, such as osteoporosis.
To learn more, please click on the links below from the American Academy of Orthopaedic Surgeons AAOS website.
Foot and Ankle
- Ankle Fractures
- Heel Fractures
- Lisfranc (Midfoot) Fracture
- Stress Fractures of the Foot and Ankle
- Talus Fractures
- Toe and Forefoot Fractures
Knee and Leg
- Fractures of the Proximal Tibia
- Pediatric Thighbone (Femur) Fracture
- Shinbone Fractures
- Thighbone (Femur) Fracture
Shoulder, Arm, Elbow
Muscle Sprains / Strains Back to top
Sprain is an injury or tear of the ligaments and strain is injury to the muscle or tendons. Sprains and strains are common in ankle, spine, knee, thigh, hip, elbow, and wrist joints.
Sprain is caused by trauma, overstretching of the joints during sports activities such as basketball and swimming. Strain is caused due to overuse of the muscles, inadequate rest during breaks while playing sports. Some sports such as gymnastics, basketball, football, hockey, and running causes the muscles and ligament tear.
The muscles injured during sports include hamstring and quadriceps muscles of the thigh, calf and knee muscles, and flexor muscles of the joints. The commonly observed symptom is pain and inflammation. In addition to these symptoms muscle spasm, muscle weakness, and cramping may be observed.
Immediately following an injury and before being evaluated by a medical doctor, you should initiate the R.I.C.E. method of treatment
- Rest: Rest the knee as more damage could result from putting pressure on the injury
- Ice: Ice packs applied to the injury will help diminish swelling and pain. Ice should be applied over a towel to the affected area for 15-20 minutes four times a day for several days. Never place ice directly over the skin
- Compression: Wrapping the knee with an elastic bandage or compression stocking can help to minimize the swelling and support your knee
- Elevation: Elevating the knee above heart level will also help with swelling and pain
Your doctor may prescribe nonsteroidal anti-inflammatory drugs to reduce the pain and inflammation. Rehabilitation program is recommended for people injured by sports which help to regain strength and allow fast recovery. Rehabilitation program includes massages and various strengthening, stability, and stretching exercises which should be carried out on a regular basis.
Spinal Disorders Back to top
Spinal injuries are the most common injuries that may occur while playing, performing normal activities, operating heavy machines, lifting heavy objects, driving automobiles, or when you suffer a fall.
Common spinal injuries you may suffer include:
- Dislocation of adjacent bones
- Partial misalignment (subluxation) of adjacent bones
- Disc compression (herniated disc)
- Hematoma (accumulation of blood)
- Partial or complete tears of ligaments
The most common symptom of spinal injuries is pain. Some injuries may damage spinal nerves that may cause inflammation, loss of muscle control and loss of sensation. Symptoms may proceed to paralysis, limited movement, and immobility. Workplace injuries are diagnosed using X-rays, computed tomography (CT) scans, and magnetic-resonance imaging (MRI) scans.
Depending on the type and severity of injury, you may be treated with pain medications, epidural injections (injecting into spine), physiotherapy, and surgery. Surgery is recommended when other treatments are a failure or inappropriate. Surgery for spinal condition depends on the type and severity of injury.
Some of the Common Spinal Surgeries Include:
Coccygectomy is a surgical procedure which involves removal of part or entire portion of tailbone (coccyx) present at the end of your spine. It is performed in patients who have persistent tailbone pain due to injury, fall or contact sports and when all other conservative treatments are a failure.
During the surgery, an incision will be made on your lower back, a few inches above the anus following which the muscles will be retracted to find the damaged or broken coccyx. Then a part or the entire coccyx is removed.
Spinal decompression is a procedure of relieving pressure on one or many “pinched nerves” of the backbone. It can be achieved either by surgical or non-surgical method. It is used to treat conditions that cause chronic backache like herniated disc, disc bulge, sciatica, spinal stenosis.
Non-surgical spinal decompression is performed using decompression machine, a safe and non-invasive method.
Surgical Spinal Decompression is Performed by Two Procedures:
- Microdiscectomy: A minimally invasive procedure which involves removal of a portion of a slipped disc by a surgical instrument or LASER.
- Laminectomy: This is a procedure in which a small portion of the roof of the spinal bone is removed to relieve pressure on pinched nerve. This is performed as a last resort, when conservative treatment fails to provide relief from back pain.
Posterior and Anterior Spinal Fusions
Spinal fusion is a surgical procedure done for the treatment of upper and lower spine problems. It is mostly done in the lower back (lumbar region) joining two or more spinal bones to avoid the motion between them. This prevents the stretching of nerves and surrounding ligaments and muscles.
Anterior spinal fusion is a procedure where the surgeon makes an incision on the patient’s front part of the body; and posterior spinal fusion is a procedure where the incision is made on the patient’s back exposing the spine.
Laminectomy is a surgical procedure to remove the portion of the lamina (roof) of the spinal bone. It helps to relieve the pain associated with narrowing of spinal column. The procedure removes bones and damaged disks and makes space for spinal nerves and column.
In a traditional laminectomy the incision made is large and the overlying muscles must be cut.
In a minimal invasive technique very tiny incisions are made, the back muscles are moved aside and the lamina is removed.
It is a surgical procedure performed on the spine for the removal of the fragment of slipped disc. Slipped disc is also known as bulging disc or herniated disc.
Slipped disc occurs when the inner core of the spinal disc bulges out through the outer layer of the disc. This fragment may press the spinal cord and the nerves that surround the spinal cord. This pressure causes the symptoms of slipped disc. Here the surgeon uses the small incision to look at the actual herniated disc, to remove the disc and relieve the pressure on the nerve. It is also called as open discectomy.
Transforaminal Lumbar Interbody Fusions
Transforaminal lumbar interbody fusion is a surgical procedure of the lower back where the damaged disc which is located between the two spinal bones (vertebrae) is removed and the vertebrae are fused together.
In transforaminal procedure, the damaged disc is removed from the side and is replaced with artificial device (prosthesis) made of bone, plastic or ceramic. Space around the prosthesis is filled with milled bone and then stabilized with titanium screws and rods. The prosthesis and the milled bone will fuse with other vertebrae over the time and provide more stability to the spinal column.
This surgery is performed for various conditions such as degenerative disc disease, low grade spondylolisthesis, spinal instability and others.
Anterior Cervical Decompression Fusions
Decompression fusion is a surgical procedure to remove the pressure from the spinal cord and/or nerve roots by reconstructing the upper part of the spinal cord. This procedure is performed to reduce deformity and stabilization, minimizing neurological injury and early rehabilitation of the spine.
Cervical decompression is performed by making a small incision in front part of the neck. The fusion can be done by replacing the damaged part with new bone where the bone is collected either from different body part of the same patient, from a donor or an artificial bone. Spine surgeons prefer anterior procedure because it provides a better access to site of injury.
Your spine surgeon may recommend for rehabilitation that includes both physiotherapy and occupational therapy to promote complete and faster healing.
Sports Medicine Back to top
To learn more, please click this link to be directed to our Sports Medicine section inside Patient Education.
Or can click on the topics below to find out more from the Orthopaedic connection website of American Academy of Orthopaedic Surgeons.
- ACL Injury: Should it be fixed?
- ACL Reconstruction
- Activities After a Knee Replacement
- Additional Resources on the Knee
- Adolescent Anterior Knee Pain
- Arthritis of the Knee
- Care of the Aging Knee: Baby Boomers May Need Lifestyle Changes
- Cemented and Cementless Knee Replacement
- Deep Vein Thrombosis
- Frequently Asked Questions about Osteoarthritis of the Knee
- Goosefoot (Pes Anserine) Bursitis of the Knee
- Knee Arthroscopy
- Knee Arthroscopy Exercise Guide
- Knee Implants
- Knee Ligament Injuries
- Knee Replacement Exercise Guide
- Kneecap (Prepatellar) Bursitis
- Meniscal Tear
- Meniscal Transplants
- Minimally Invasive Total Knee Replacement
- Nonsurgical Treatment Options for Osteoarthritis of the Knee
- Orthopaedists Research Female Knee Problems
- Osgood-Schlatter Disease (Knee Pain)
- Osteonecrosis of the Knee
- Osteotomy and Unicompartmental Knee Arthroplasty
- Posterior Cruciate Ligament (PCL) Tear
- Rotating Platform/Mobile-bearing Knees
- Runner's Knee (Patellofemoral Pain)
- Surgical Treatment of Osteoarthritis of the Knee
- The Impact of Osteoarthritis of the Knee
- The Knee
- Total Knee Replacement
- Unstable Kneecap
- Viscosupplementation Treatment for Arthritis
Sports Medicine Topics
- Exercises for Young Athletes
- Heat Injury
- Muscle contusion (bruise)
- Muscle cramp
- Playing it Safe on the Tennis Court
- Prevent Golf Injuries
- Prevent Inline Skating Injuries
- Prevent Scooter-Related Injuries
- Return To Play
- Shin splints
- Skateboarding Safety
- Sports Nutrition
- Sprains and Strains
- Stress Fractures
- Women and ACL Injuries