Carpal Tunnel Syndrome

You may have heard of carpal tunnel syndrome, but do you know what causes it? Contrary to popular belief, it’s not caused just from repetitive motions like typing, though these actions do contribute to the pain associated with the condition.

Carpal tunnel is actually caused when the synovium (tissues surrounding tendons in the wrist) swells and puts pressure on the median nerve in the wrist. All this occurs in the carpal tunnel region of the body, hence the syndrome’s name.

Some factors that may contribute to developing carpal tunnel syndrome include:

  • Heredity – if members of your family experienced carpal tunnel syndrome, this may increase your chances of facing the same condition
  • Hormonal changes – these changes can occur during pregnancy and cause carpal tunnel syndrome
  • Age – the older a person is, the more likely they are to experience carpal tunnel syndrome
  • Medical conditions – diabetes and rheumatoid arthritis are just a few of the diseases that can contribute to carpal tunnel syndrome

Treatment

Your doctor may perform a series of tests to diagnose you with carpal tunnel syndrome. In some cases, carpal tunnel syndrome can be treated or relieved without surgery, by using a brace or splint, taking medications, changing activities/behavior or receiving steroid injections.

Surgical measures may be taken if no relief is seen from the nonsurgical options. For the most part, the procedure is outpatient with local anesthesia. Some pain and swelling are common after the surgery, and complete recovery may take up to a year.

Physical therapy may be recommended to assist in regaining grip and pinch strength.

If you think you might have carpal tunnel syndrome, visit http://www.neorthohospital.com to schedule an appointment with one of our physicians.

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Carpal Tunnel Syndrome

Avoiding “FOOSH” Injuries

Being prepared this winter can prevent slip and fall injuries

Nebraska winters provide a perfect climate for injuries related to slips and falls. Just as predictable as the arrival of snow and ice is the significant increase in fall related injuries seen at Nebraska Orthopaedic Hospital. Of these incidents, a majority are classified by what are called “FOOSH” injuries.

The term “FOOSH” stands for a Fall On Outstretched Hand. It is a reflexive instinct to extend an arm when one slips and begins to fall. Unfortunately, this protective maneuver often results in an injury, most commonly a fractured wrist that many times requires surgery. While complete prevention of these accidents is impossible, the hand therapy department here at Nebraska Orthopaedic Hospital has several recommendations to consider in keeping you safer on your feet this winter.

  • Match your footwear to outside conditions.
  • Pay attention to the weather and be more aware of your surroundings. Assume that areas where you will be walking have not been properly treated for slick conditions. Areas of high traffic such as entrances to buildings commonly accumulate slush and standing water.
  • Slow down and plan ahead. Rushing and/or running late increases the likelihood of falls.Being prepared this winter can prevent slip and fall injuries
  • Carry less in your hands and move at a slower pace.
  • Properly treat problematic areas around your home or workspace.
  • Use common sense. In other words, think twice about wearing sandals to retrieve the newspaper on a cold, icy morning.

The physical and occupational therapists at Nebraska Orthopaedic Hospital specialize in treating orthopaedic injuries. Where it involves aquatic therapy, rehabilitation from a recent surgery or nagging sports injury, our therapists dedicate each day to getting you back on your feet – no matter the season.

For more information on the services provided by the Nebraska Orthopaedic Hospital Physical Therapy Department, please visit www.neorthohospital.com/our-services/physical-therapy.

Avoiding “FOOSH” Injuries

What is Physiatry?

Physiatry, or physical medicine and rehabilitation, is a branch of medicine recognized by the American Board of Medical Specialties. This relatively new field emphasizes prevention, diagnosis, and non-surgical treatment of injuries or ailments that may affect movement. Physiatry focuses on healing the whole patient, not just one part. It’s often called “the quality of life profession.”

Dr. Hahn counsels a patient

A physiatrist (also called a physical medicine and rehabilitation physician) may work with a team of healthcare professionals to provide the best possible care for each individual patient. The main goal is to restore function after a traumatic injury or event, like a stroke. Surgery is such a big undertaking both physically and mentally.  Of course, some conditions do require surgery, but for most spine related injuries, physiatry offers a less-invasive, conservative approach to treatment, often with less rehabilitation time. Often, physiatry treatment entails a combination of multiple therapies, like medications, physical therapy, injections and other procedures.

Here at Nebraska Orthopaedic Hospital, my passion is interventional spine treatments and recovery. I specialize in non-surgical techniques to relieve pain and avoid surgery in some cases. Some of the most common spine injuries I see include:

  • Disk herniation
  • Sciatica
  • Arthritis
  • Spinal stenosis

By working together with our team, we can provide a treatment plan to keep you as active as possible at any age. To learn more about physiatry or interventional spine treatments, or to schedule an appointment, please visit www.neorthohospital.com.

Dr. Matthew Hahn recently returned to Omaha after completing a fellowship in Interventional Spine and Sports Medicine at the University of Pennsylvania Medical Center. He was previously Academic and Chief Resident at Kansas University Medical Center, and received his Doctorate of Medicine from the University of Nebraska Medical Center.

What is Physiatry?

Articular Cartilage Restoration

This illustration from the American Academy of Orthopaedic Surgeons shows the damage on a knee joint needing articular cartilage restoration

What is Articular Cartilage?

Articular cartilage covers the ends of bones where they meet to form joints. This covering allows joints to move smoothly with little friction, and enables us to move about freely. However, cartilage does break down over time, or can be damaged from injuries. Unfortunately, cartilage cannot repair itself, and the areas where it is worn down may become painful and lead to arthritis. The knees, shoulders and ankles are common areas for articular cartilage replacements.

Treatments

Many restorative procedures use arthroscopy to repair the affected area. This technique allows for quicker recovery than open procedures. However, your doctor should discuss procedure options with you when determining the best treatment route.

The most common cartilage restoration procedures include:

  • Microfracture – multiple holes are made in the joint surface to promote new blood supply and a healing response in the subchondral bone
  • Drilling – similar to microfracture, a small drill creates the holes to promote a healing response in the subchrondral bone. However, the holes are made using an arthroscope, which can be less precise than a microfracture
  • Abrasion arthroplasty – small burrs are used to cause small areas of bleeding from the bone in the affected area to promote production of new fibro-cartilage. In this procedure, high speed burrs are used instead of wires or drills
  • Autologous Chondryte Implantation – new cartilage cells are grown from healthy cartilage, and implanted in the affected area
  • Osteochondral Autograft Transplantation – healthy cartilage is transferred from one part of the joint to the area requiring repair
  • Osteochondral Allograft Transplantion – considered when the defect is too large for an autograft, an allograft consists of using cadaver donor tissue to replace the missing cartilage

Rehabilitation

Because of the regenerative nature of most cartilage replacements, great care must be taken to protect the joint surface during recovery. Walking aids like crutches may be necessary to move around for a few weeks after surgery.

Physical therapy may be recommended to help restore mobility and strengthen the joint and muscles around it.

For more information on articular cartilage restoration or to schedule an appointment, please visit www.neorthohospital.com.

Articular Cartilage Restoration