Ultrasound Guidance Following Surgery Leads to Quicker Relief

Faster and longer-term relief from carpal tunnel can be achieved by using ultrasound-guided release. This treatment makes carpal tunnel release surgery safer and less-invasive than conventional open or endoscopic surgeries. Improvements in hand function and comfortability are also possible with ultrasound-guided carpal tunnel release (UGCTR.)

Researchers from Thomas Jefferson University Hospital investigated the long-term implications of UGCTR. They found patients had sustained improvements due to the smaller incisions and faster recovery up to one-year post-surgery.

Sarah I. Kamel, M.D., Assistant Professor of Radiology, said, “Our study demonstrates that ultrasound-guided carpal tunnel release can be performed safely, with high patient satisfaction and significant long-term relief. The rapid post-operative recovery and longstanding relief of symptoms suggest that ultrasound-guided carpal tunnel release may be advantageous to traditional surgical methods of transverse carpal ligament transection.”

Patients were required to fill out three questionnaires designed to assess their hand’s pain and function levels. Researchers used this data as a tool to measure and judge the outcomes. The patients provided answers pre-procedure, two-weeks post-procedure, and 1.7 years later. 

While two patients required follow-up surgery within eight to ten days following the first procedure, no patients experienced immediate complications. The team made two adjustments to avoid these outcomes in the future. They now include more extensive pre-procedural cleaning that extends around the forearm prior to draping. They perform two passes of the ligament transection to potentially decrease the risk of remnant tissue that may contribute to incomplete release.

These results point to the UGCTR procedure’s efficacy, but future investigations into follow-up and cost analysis are necessary. “Ultrasound-guided carpal tunnel release quickly improves hand function and reduces hand discomfort, with persistent improvement at one year. Ultrasound-guided carpal tunnel release may be a safe, effective, and less-invasive alternative to traditional open or endoscopic surgery, particularly in patients for whom traditional surgery may be high-risk or contraindicated,” said the team.

For more information on ultrasound guidance following carpal tunnel surgery, read the full journal report by the American Journal of Roentgenology. For carpal tunnel guidance, contact the professionals at Michigan Hand & Wrist today.

Michigan Hand & Wrist was founded in 2001 with the mission to provide the highest-quality care for patients seeking surgical or non-surgical hand or upper extremity relief. Our goal is to exhaust all non-operative measures before discussing or moving on to surgical interventions. We offer on-site physical therapy from therapists committed to improving your quality of life. Our individualized treatments are modern, progressive, and exceptional. Contact us today at www.michiganhandandwrist.com or call 248-596-0412.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

Five Ways to Help Prevent Carpal Tunnel Syndrome

Carpal Tunnel is prevalent in today’s society; people typically associate the syndrome with years of heavy typing, computer use, and other office tasks. However, Carpal Tunnel can affect anyone who performs repetitive hand movements. Approximately 500,000 people undergo surgery each year; it is one of the most common hand operations. Thankfully, there are ways to prevent Carpal Tunnel by reducing the amount of pressure on your hands and wrists.

  1. Stretch Often
    A few hand stretches per day helps to loosen up ligaments and tendons. Make a fist with your hand, then extend your fingers until they point straight out. Repeat this process ten times. To modify this stretch, you can also fan your fingers out horizontally as far as you can.
  2. Be Ambidextrous
    Try to use your non-dominant hand to pick up or transfer objects, open doors, hold drinking cups, etc. This helps reduce pressure on your dominant hand due to repetitive movements.
  3. Loosen Grip
    Most people don’t realize they are over-exerting their hands when they write/hold a pen or pencil, type on a keyboard, hold a steering wheel, use tools, and other everyday tasks. Try to loosen your grip on these objects.
  4. Stay Warm
    Cold climates or environments can contribute to pain and stiffness. If necessary, warm up your surroundings by turning up the thermostat, use a space heater, or wear fingerless gloves while working. The heat will help stimulate blood flow, thus improving circulation and keeping hands and wrists loose.
  5. Maintain Posture
    One of the simplest ways to prevent Carpal Tunnel is to maintain proper posture. When slouching, your shoulders pull your neck and shoulder muscles forward, which causes the nerves to tighten. This domino-effect also affects your hands and wrists.

Are you or a loved one experiencing symptoms of Carpal Tunnel? Michigan Hand and Wrist specializes in assessing and consulting patients dealing with hand and other upper extremity issues. Check out our previous blog post to learn more about Carpal Tunnel.

Michigan Hand & Wrist was founded in 2001 with the mission to provide the highest-quality care for patients seeking surgical or non-surgical hand and upper extremity relief. Our goal is to exhaust all non-operative measures before discussing or moving on to surgical interventions. We offer on-site physical therapy with therapists committed to improving your quality of life. Our individualized treatments are modern, progressive, and exceptional. Contact us today at www.michiganhandandwrist.com or call 248-596-0412.

Written by the digital marketing staff at Creative Programs & Systems: www.cpsmi.com.

Carpal Tunnel Syndrome FAQ

What is carpal tunnel syndrome?It is a condition in which there is excessive pressure on the median nerve in the wrist that stimulates feeling and movement to parts of the hand. Carpal tunnel syndrome can lead to tingling, numbness, and muscle damage to the hand and fingers. What are the causes?Making the same hand and wrist movements repeatedly may cause the condition. It hasn’t been proven that typing on keyboards or using a mouse causes the condition, but these activities can contribute to tendonitis or bursitis. What are the symptoms?

  • Difficulty gripping objects
  • Numbness or tingling in the thumb, fingers, or palm
  • Pain in the wrist or hand
  • Pain extending to elbow 

 As the disease progresses, patients can develop a burning sensation or shooting pains in the forearm. Chronic carpal tunnel syndrome can also lead to atrophy of the hand muscles. How is it diagnosed?Often carpal tunnel takes the wrap for a myriad of conditions or diseases that involve pain of the hand and arm. The term is so well known but only 1 in 5 people with these symptoms actually have carpal tunnel syndrome. To establish a diagnosis, a clinician will evaluate your elbows, wrists, and arms for strength and flexibility imbalances, tissue adhesions, and muscle dysfunction. What are the treatment options?Current research supports the use of physical therapy to restore normal movements to the elbow, hand, and wrist. You can make changes in your home or at work to alleviate pain and pressure. Some medications, like Ibuprofen and Naproxen, are used to relieve symptoms temporarily. Corticosteroid injections can also be given in the carpal tunnel area to relieve pain. Surgery is usually a last resort option for those with chronic carpal tunnel syndrome, but has a very high success rate. If you are experiencing symptoms of carpal tunnel syndrome, the experts at Michigan Hand and Wrist offers comprehensive adult and pediatric care to treat this condition. Live your life pain-free and contact the experienced medical team at Michigan Hand and Wrist to begin your treatment.

Do I Have Wrist Tendonitis?

Are you experiencing difficulty and pain when moving your wrist? One of the most common causes of wrist pain is a condition called wrist tendonitis, also known as tenosynovitis. It’s characterized by irritation and inflammation of the tendons around the wrist joint, and is a fairly common condition. So, how do you know if you are experiencing wrist tendonitis?


  • difficulty moving wrist
  • pain in area of inflammation
  • swelling of surrounding soft tissue

How to Diagnose

Wrist tendonitis is most often diagnosed by looking for the characteristic symptoms. Symptoms are universal, but a more specific analysis is required to determine the precise location of the inflammation. A trained physician can perform stretch tests to determine exactly which tendon is the source of discomfort. One form of wrist tendonitis, called ‘DeQuervain’s tenosynovitis’, is the inflammation of the tendon at the base of the thumb. This form of tendonitis most commonly afflicts new mothers and is diagnosed using a specific test called ‘Finkelstein’s’ test’. This is just one example of the many forms of wrist tendonitis. Depending on the specific source of pain, there are a number of different treatment options available.



Splinting the wrist is the first step towards treating wrist tendonitis. By restricting the tendon and allowing it to rest, inflammation and pain should decrease. 

Anti-inflammatory Medications

Anti-inflammatory medications are effective at decreasing inflammation and swelling in the soft tissue, which is the primary cause of the pain. This treatment, however effective, is not a permanent solution to an ongoing problem. 

Cortisone Injection

Cortisone is a powerful anti-inflammatory that is administered through injection directly at the source of pain. Again, this treatment may be only temporary and can weaken the tendons over time. 


If the previously listed methods of treatment were deemed ineffective and the problem is recurring a doctor might recommend a surgical procedure. Through surgery, areas of the tendon and inflammatory tissue can be removed, allowing the tendon to move freely. If you are experiencing wrist pain it is highly recommended that you visit an orthopedic surgeon immediately. They can correctly diagnose your condition and recommend the correct treatment plan for your specific issue. For the most respected orthopedic surgeons in Michigan contact Michigan Hand and Wrist, P.C. and discuss with them your individualized treatment plan.

How to Find the Best Michigan Hand Doctor

You should never consider settling for anything less than the best medical services. Who wouldn’t want the most experienced and qualified medical professionals to deal with their healthcare matters? Here are some suggestions for finding a trustworthy medical professional.

It’s best to want a medical professional that graduated from a prestigious university, but that isn’t the only factor to consider. It is also a good idea to look into their experience. While you’re waiting at the physician’s office, look around at his or her diplomas and certificates and notice the names of the institutions they studied and served at. Later, use the internet to check on these institutions and to ensure they’re viable.

There are many reasons a physician might have had legal problems in the past. In the event of having a physician with prior legal problems, be sure to research the reasons why they may have occurred. It’s well worth the effort of investigating a potential physician to ensure that they are trustworthy.

A lot of people base their decision, when selecting a health care provider, by the proximity of the hand doctor to home and the ability to get to and from appointments. If you decide on a hand doctor doesn’t live in close proximity to you, it’s likely you could encounter problems when attempting to make it to appointments in a timely manner. Remember that, while in a rural area, extended time driving to a hand doctor’s office could keep you from completing other important activities.

It is important that their physician not only be skilled, educated and experienced, but pleasant as well. Some patients also consider the age of the physician to be of importance when making a decision. While some consider physicians that are older to be more experienced, and therefore of greater value as a physician, it can be a concern that these practitioners may well not have current knowledge, or be as accepting of new technology that has been unveiled in the medical world. Likewise, younger physicians are more likely to embrace new technologies for medical procedures, diagnosis, or special tests.

Detroit Hour Magazine has named Michigan Hand and Wrist as one of Michigan’s top doctors for the past three years! The highly skilled, board certified orthopedic surgeons at Michigan Hand and Wrist will treat your condition with the utmost care. Contact us today to eliminate your pain!

Is Hand or Wrist Surgery Right For You?

Dealing with hand and wrist pain can be endlessly frustrating in its ability to prevent you from interacting with the world around you.  Every daily activity can become a struggle.  Managing and treating wrist pain should always be a priority, but how do you know if surgery is a viable option?  Here are some of the most common conditions that can be treated with surgery:

Carpal Tunnel Syndrome

Carpal tunnel syndrome is caused by pressure on the median nerve in the hand and results in a pain, tingling, numbness, swelling, and weakness.  Surgery can relieve the pressure on the nerve by creating a small incision on the transverse carpal ligament and relieving the pressure. 

Recovery from this surgery usually takes about four to six weeks and may require hand therapy.

Tennis Elbow (Lateral Epicondylitis)

Tennis elbow, also commonly referred to as golfer’s elbow, is a type of painful tendonitis that results in pain on the outer side of the elbow and forearm.  Symptoms are typically most severe while gripping and lifting with the hand in specific positions.

Chronically irritated tissues can be removed though surgery, with the main goal to relieve pain. Surgery alleviates the symptoms of tennis elbow in around 70-90% of patients.

Ganglion Cyst

Ganglion cysts, which are small fluid-filled lumps, grow out of the tissues surrounding a joint.  While most commonly occurring on the back or underside of the wrist, they can appear on a number of joints on the hand. 

While mostly harmless, a ganglion cyst can put pressure on the nerves that pass through the joint, causing pain, tingling, and muscle weakness. If a ganglion cyst is recurring, or doesn’t respond to nonsurgical treatment, a procedure can be performed that removes the ganglion, as well as the involved joint capsule that’s considered its root.

To learn more about how hand and wrist surgery can help you eliminate your pain, contact the award-winning orthopedic surgeons at Michigan Hand and Wrist, P.C. and discuss with them your individualized treatment plan.

What is Tennis Elbow?

To the average person, tennis elbow sounds like a sports injury that’s usually reserved for people who play tennis. But this isn’t the case. In fact, most people who get tennis elbow aren’t even tennis players. Tennis elbow is the name given to the painful sensation that occurs when the tendons in the elbow are overworked, usually as the result of repetitive wrist and arm motions. These repeated motions put stress on the tissue and can cause a series of tiny tears in the tendons that attach the forearm muscles to the outside of the elbow. High instances of tennis elbow occur in professions such as plumbing, painting, carpentry, and butchery.

The pain from tennis elbow is usually felt in the area where the forearm muscle tendons attach to the bone on the outside of the elbow, although the pain can also spread into the forearm and down into the wrist. People most frequently experience pain from tennis elbow when they try to do things like open a door, hold a cup of coffee, or shake hands. If left untreated, serious tennis elbow can result in chronic pain that is especially noticeable when gripping objects, and using the arm too strenuously before the elbow has healed can exasperate the problem. While over-the-counter pain relievers and rest are the most common treatments for tennis elbow, some people experience such significant pain that conservative methods of treatment simply don’t work. When this is the case, a doctor will sometimes suggest corrective surgery.

If tennis elbow is a persistent problem for you, and conventional methods of treatment have done little to alleviate your pain, then it’s probably time to talk to a doctor about surgery. If you live in Southeast Michigan, contact the friendly experts at Michigan Hand and Wrist today to speak with a skilled professional who can help you take the first steps toward eliminating your pain.

Frequently Asked Questions About Ganglion Cysts

Q: What is a ganglion cyst?

A: A ganglion cyst is a buildup of fluid under the skin, and although they can occur anywhere on the body, they are most commonly found on the wrist, feet, or ankles.

Q: What are the symptoms of a ganglion cyst?

A: The most common symptoms of a ganglion cyst include:

  • A firm, round lump under the skin.
  • Joint pain around the affected area.
  • Swelling, numbness, and muscle weakness surrounding the cyst.

Q: What causes a ganglion cyst?

A: The cause is not known at this time.

Q: How is a ganglion cyst diagnosed?

A: A licensed medical professional will perform a thorough examination may involve any of the following:

  • Moving the joint around the cyst while performing a visual inspection.
  • An ultrasound of the affected area.
  • An MRI of the joint where the cyst is located.

Q: How is a ganglion cyst treated.

A: While, some ganglion cysts pose no threat and will go away on their own, some require one or more of the following treatment methods:

  • Aspiration, or draining, of the cyst to decrease inflammation and reduce pain.
  • A steroid injection directly into the cyst.
  • Surgical removal of the cyst.

Q: What can I do to manage the symptoms?

A: Your medical professional will likely suggest one of the following:

  • Hand therapy designed to help improve movement and reduce pain.
  • A protective splint that will limit movement and shrink the cyst.
  • If surgery is required, proper wound care will prevent tissue damage and reduce pain and swelling.

Q: When should I seek professional care?

A: Seek the assistance of a medical professional if you experience any of the following:

  • You are experience pain, numbness, or limited motion in the affected joint.
  • The limb containing a cyst gets stiff, unstable, numb, or weak.
  • A previously treated cyst returns or grows.
  • Your pain is ongoing after treatment.

If you have any questions, or have any reason to believe you are suffering from a ganglion cyst located in your wrist, contact the medical professionals at Michigan Hand and Wrist today to schedule an appointment.

5 Ways to Ease Carpal Tunnel Pain

Carpal tunnel syndrome, if left untreated, can result in debilitating pain that can make it nearly impossible to carry out even the most basic tasks. Fortunately, there are some things that people can do to remedy the pain. Often, these techniques not only bring immediate relief, but they can also delay the need for surgery.

  1. Do regular carpal tunnel exercises. Doctors have created a series of exercises designed for those experiencing carpal tunnel pain.  Doing these regularly have proven to be very beneficial for some.
  2. Yoga. Some studies have shown that those who practice yoga have seen a reduction in the pain felt in their wrists.  Stretching the muscles in the hands and wrists has been shown to provide relief for many.
  3. Wear a wrist splint. By using a wrist splint, the wrist sits in a neutral position that allows for the wrist to rest.  For some, wearing a wrist splint has provided tremendous relief.
  4. Take medication that targets inflammation. Non-steroid anti-inflammatory drugs (NSAIDs) are designed to reduce inflammation.  A reduction of inflammation can greatly relieve pain felt by those with carpal tunnel.  
  5. Take breaks at work. If you use your hands a great deal at work, it is important to take frequent breaks.  While breaks are beneficial for carpal tunnel, they can result in a decreased production, which can anger employers.  We suggest talking with your boss to see if there is another task that you could do while taking a break from using your hands.  Perhaps you’ll reach a creative decision that results in a win-win.

We suggest using a combination of the above techniques in order to maximize the possibility of decreasing the pain experienced by carpal tunnel syndrome. Remember, however, that while these techniques will help you manage pain, they won’t get rid of the problem entirely. If you’re ready to tackle your carpal tunnel syndrome with surgery, contact the expert team at Michigan Hand and Wrist. With state-of-the-art equipment and advanced physical therapy programs, your hands are in good hands at Michigan Hand and Wrist. Schedule your consultation today!

Common Arthritis of the Hand Symptoms

Arthritis can present itself in various parts of the body and usually results in pain for the affected person.  Arthritis of the hand can incapacitate someone who relies on themselves for their day-to-day activities and for those who use their hands at work.  Whether a job entails typing, manufacturing, delivering, stocking, or writing, the hands perform much of the work for most people on the job.  The experts at Michigan Hand and Wrist offer the following characteristics of arthritis of the hand so that readers can begin to take action to combat the debilitating condition.

In the beginning stages of arthritis in the hand, the hand can feel stiff or even somewhat numb, especially in the morning.  As arthritis progresses, the pain intensifies and can even interfere with sleep.  Additionally, with arthritis in the hands, parts of the hand can swell and can also change shape over time.  The doctors at Michigan Hand and Wrist also warn those suffering from hand discomfort to pay attention to a warming sensation that might present itself.  Another symptom of arthritis in the hand pertains to a loss of fine motor skills.  If your handwriting has deteriorated and you can no longer thread a needle or cut on a line, it is possible that arthritis has invaded your hands.

It seems like some people think that nothing can be done about arthritic conditions, which is simply not true.  The surgeons at Michigan Hand and Wrist are happy to discuss your symptoms, assess the arthritis in your hands, and provide the appropriate treatment.  They accept most major insurance plans, so it is likely that your insurance will cover the cost of your consultation and treatment.  If you want to learn more about the various ways they can reduce, or perhaps eliminate, the pain caused by your arthritic condition in your hands, contact Michigan Hand and Wrist today!