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Cubital Tunnel Syndrome

Cubital tunnel syndrome is brought on by increased pressure on the ulnar nerve at the elbow. The ulnar nerve passes under a bump of bone on the inner portion of the elbow (medial epicondyle or “funny bone”). At this site, the ulnar nerve lies directly next to the bone and is susceptible to pressure. When the pressure on the nerve becomes great enough to affect the way the nerve works, then numbness, tingling, and pain may be felt in the elbow, forearm, hand, and/or fingers.

What Causes Cubital Tunnel Syndrome?

The ulnar nerve is positioned right next to a bone that has very little padding. Pressure on this bone can put pressure on this nerve. Below are a few examples:

If you learn your arm against a table on the inner part of your elbow, your arm may fall asleep and be painful from sustained pressure on the nerve. If this occurs repetitively, the numbness and pain may be more persistent.

Sometimes the ulnar nerve at the elbow clicks back and forth over the bony bump as the elbow is straightened. If this occurs repetitively, the nerve may be significantly irritated.

Pressure on the ulnar nerve can also occur from holding the elbow in a bent position for a long time, stretching the nerve across the medial epicondyle. Sustained bending of the elbow tends to occur during sleep.

Sometimes the connective tissue over the nerve grows thicker, or there may be variations of the muscle structure over the nerve at the elbow that causes pressure on the nerve.

Cubital tunnel syndrome occurs when the pressure on the nerve is significant enough, and sustained enough, to disturb the way the ulnar nerve works.

Symptoms of Cubital Tunnel Syndrome

Symptoms usually include pain, numbness and/or tingling. Numbness or tingling most often occurs in the ring and little fingers.

You’ll usually notice symptoms when there is pressure on the nerve, such as when you are sitting with your elbow on an arm rest or with repetitive elbow bending or straightening. You may also notice symptoms when you’ve held your elbow in a bent position for a period of time, such as when holding the phone or while sleeping.

You may notice weakness while pinching, occasional clumsiness, and/or the tendency to drop things. In severe cases, you may lose sensation and the muscles in the hand may lose bulk and strength.

Diagnosis

Dr. Patel will assess the pattern and distribution of your symptoms and examine for muscle weakness, irritability of the nerve to tapping and/or bending of the elbow, and changes in sensation. He may also need to evaluate other conditions such as thyroid disease or diabetes.

He may perform a test called electromyography (EMG) and/or a nerve conduction study (NCS) to confirm the diagnosis of cubital tunnel syndrome and stage its severity.  This test also checks for other possible nerve problems, such as a pinched nerve in the neck, which may cause similar symptoms.

Cubital Tunnel Treatment

Sometimes symptoms can be relieved without surgery, particularly if the EMG/NCS testing shows that the pressure on the nerve is minimal. Dr. Patel may suggest:

Dr. Patel may also recommend a session with a therapist to learn ways to avoid pressure on the nerve.

If symptoms are severe or do not improve, you may need surgery to relieve the pressure on the nerve. Dr. Patel often recommends shifting the nerve to the front of the elbow, which relieves pressure and tension on the nerve. He may place the nerve under a layer of fat, under the muscle, or within the muscle. He may also recommend trimming the bony bump (medial epicondyle).

Your recovery following surgery depends on the type of procedure performed. Dr. Patel will most likely recommend you avoid lifting and/or certain elbow movements for a period of time. Therapy may also be necessary.

If you’re suffering from cubital tunnel syndrome, call Atlanta Hand Specialist at (770) 333-7888 to make an appointment today. We have offices in Smyrna, Douglasville, and Marietta.

Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome (CTS) is a condition caused by increased in pressure on the median nerve at the wrist. Simply put, it is a pinched nerve at the wrist.

The carpal tunnel is a space in the wrist where the median nerve and nine tendons pass from the forearm to the hand. When pressure builds from the swelling in the tunnel, it puts pressure on the nerve. When the pressure becomes great enough, you may experience one or all of the following symptoms:

What Causes Carpal Tunnel Syndrome?

The cause is often unknown, but pressure on the nerve can occur in several ways:

Signs and Symptoms

Symptoms usually include pain, numbness, tingling or a combination of the three, with tingling and numbness most often in the thumb, index, middle and ring fingers.

You will most likely experience symptoms at night, but some notice them during daily activities. Some patients also notice a weaker grip, occasional clumsiness or a tendency to drop things.

In severe cases, it’s possible to lose sensation permanently while the muscles at the base of the thumb slowly shrink (thenaratrophy).

Carpal Tunnel Diagnosis

In order to diagnose carpal tunnel, one of our doctors will complete a detailed history, which will include any previous medical condition, how you’ve used your hands, and whether there were any prior injuries. He will also take an x-ray to check for other causes of your symptoms such as arthritis or a fracture.

In some cases, a laboratory test may be needed if your doctor suspects a medical condition associated with CTS. Your doctor may also perform a nerve conduction study (NCV) and/or electromyogram (EMG) to confirm your diagnosis, as well as to check for other possible nerve problems.

Carpal Tunnel Treatment

It is often possible to relieve carpal tunnel symptoms without surgery. By identifying and treating the underlying medical condition, changing the patterns of hand use, or keeping the wrist splinted in a straight position, you may be able to reduce pressure on the nerve.

Other Treatment Options Include:

If your symptoms are severe or do not improve, a hand surgeon may recommend surgery to make more room for the nerve. By cutting the ligament that forms the top of the tunnel on the palm side of the hand, it is possible to decrease the pressure on the nerve. The incision allows the doctor to enlarge the tunnel and decrease pressure on the nerve.

If you’re experiencing any carpal tunnel symptoms, don’t hesitate to make an appointment with one of the dedicated hand doctors at Atlanta Hand Specialist. We have multiple locations throughout the metro Atlanta area.

Hand Burns

In addition to many other conditions, Atlanta Hand Specialist treats hand burns.

Degrees of Burn Injuries

Burns are classified by the depth (degree) of injury to help determine the appropriate treatment.

1st Degree: Superficial—redness of skin without blisters
2nd Degree: Partial thickness skin damage –blisters present
3rd Degree: Full thickness skin damage –skin is white and leathery
4th Degree: Similar to 3rd degree, but with damage to deeper structures such as tendons, joints and bone

Burn Treatment

The depth and extent of your burn injury will determine your treatment needs. In most cases, Atlanta Hand Specialist can treat hand burns on an outpatient basis if the pain can be controlled.

Treatment will focus on preventing further problems with stiffness and infection.

1st Degree (Superficial Burns): These burns usually heal within a week and can be treated for pain with local analgesics and pain medications.

2nd Degree (Partial Thickness Burns): We may or may not trim blisters, but the hand and forearm should be splinted in a position of safety to prevent later stiffness. If there are open, raw surfaces, we recommend cleaning with frequent dressing changes and the application of local topical antibiotics until the wounds are healed. Wounds should begin healing within two to three weeks. Some 2nd degree burns may need excision of damaged skin followed by skin grafting.

3rd Degree (Full Thickness Burns): We will remove the dead skin and replace it with skin grafts. The timing of this procedure depends on the size and location of the burns. Dr. Patel usually removes dead skin as soon as it is evident that the burn is at full thickness, and grafts immediately. Your hand will probably be splinted until the grafts are healed, and then mobilization begins (ideally within two to three weeks after the injury).

Small full thickness burns may be treated like the partial thickness but will take longer to heal and will leave scarring. A burn that goes around the full circumference of the limb can sometimes constrict it like a tourniquet. If this is the case, Dr. Patel may release the construction with a procedure known as escharotomy.

Therapy and Rehabilitation

The need for therapy depends on the depth of the burn and any other factors that may lead to stiffness in the hand. Superficial burns generally do not require hand therapy. Deep burns or burns that occur in conjunction with other injuries may require extensive therapy and rehabilitation. Dr. Patel will coordinate therapy with a therapist if he feels you would benefit from rehabilitation.

Additional Surgery

Many patients with burn injuries will require more than one operation. Burned hands may develop contractures months or years after the original injury. Dr. Patel will plan your long-term follow up to evaluate the possibility of further surgery to improve hand function.

If you’ve suffered from a hand burn injury, call Atlanta Hand Specialist at (770) 333-7888 to make an appointment today. We have offices in Smyrna, Douglasville, and Marietta.

Rheumatoid Arthritis in the Hands

Rheumatoid arthritis affects the cells that lubricate and line joints, causing the tissue (synovium) to become inflamed and swollen. The swollen tissue stretches the ligaments and the tendons, causing the joints to deform and become unstable. Joint cartilage and bone also erodes. Your knuckle may feel hot and look red. Rheumatoid arthritis in the hands most often occurs in the wrist and knuckles. The disease is symmetric, meaning what occurs in one hand usually occurs in the other.

Signs and Symptoms of Hand Rheumatoid Arthritis

While common arthritis symptoms such as stiffness, swelling, and pain may occur, the classic features of rheumatoid arthritis include:

You may also experience numbness and tingling in your hands (carpal tunnel syndrome) because the swelling of the tendons causes pressure on the adjacent nerve. They may make a squeaky sound as they move joints (crepitus), and sometimes the joints snap or lock because of the swelling.

How is Hand Rheumatoid Arthritis Diagnosed?

Dr. Patel will perform a clinical examination, x-rays, and lab tests. He will also ask you questions about your symptoms and how the disease has affected your activities. Because Rheumatoid arthritis may have a hereditary component, he may ask if any family members suffer from similar symptoms.

Dr. Patel will also complete a detailed examination of your hands. The appearance of your hands will help him diagnose the specific type of arthritis.

An x-ray may reveal characteristics of Rheumatoid arthritis including:

There are also several blood tests that can confirm the clinical diagnosis.

Hand Rheumatoid Arthritis Treatment

Treatment is designed to decrease inflammation, relieve pain, and maintain function. While there is no cure for rheumatoid arthritis, there are medications that slow the progression of the disease.

Hand therapy may help relieve pain and protect the joints. Exercises, splints, and adaptive devices can also help you cope with activities of daily living.

Rheumatoid arthritis can be a progressive disease. Surgical intervention may be necessary to maximize function and minimize deformity. In certain cases, Dr. Patel may recommend preventative surgery which could include:

Several types of procedures treat joints affected by rheumatoid arthritis including:

The procedure Dr. Patel recommends will depend on many factors including which joint is involved, the degree of damage present, and the condition of surrounding joints.

If you’re suffering from hand rheumatoid arthritis, don’t hesitate to call Atlanta Hand Specialist at (770) 333-7888. We have offices in Smyrna, Douglasville, and Marietta.

Find Expert Finger Surgery & Treatment Options at Atlanta Hand Specialist

Dr. Viralkumar Patel: Your Finger Surgeon in Atlanta

Finger surgeons in Atlanta such as Dr. Viralkumar Patel, the expert surgeon practicing at Atlanta Hand Specialist, are experienced at the skillful diagnosis and treatment of a number of hand and finger conditions. Common conditions that can be treated by finger surgeons in Atlanta include:

Dr. Patel is one of the many finger surgeons in Atlanta who can provide expert treatment for these conditions and more using state-of-the-art equipment and modern, cutting-edge facilities. Like many finger surgeons in Atlanta, he and his expert team can offer the highest quality hand and finger treatment to patients of all ages.

Finger surgeons in Atlanta can provide treatment for disorders that are not easily treated by more conservative means, allowing for a complete recovery and elimination of pain and other symptoms. Dr. Patel is one of the premier finger surgeons in Atlanta with experience treating all types of finger pain. Patients of all ages in the Atlanta area who suffer from finger pain can benefit from scheduling an appointment at Atlanta Hand Specialist.

To find more information about finger surgeons in Atlanta like Dr. Patel at Atlanta Hand Specialist, simply visit the website at http://atlantahandspecialist.com, or call (770) 333-7888 to learn more.

Osteoarthritis of the Hand

Osteoarthritis is a degenerative joint disease that causes the cartilage that covers the bone surfaces at the joints to wear out. It may be caused by simple “wear and tear” on joints, or it may develop after an injury.

In the hand, osteoarthritis most develops in three areas:

It often develops in the wrist as well.

Signs and Symptoms of Hand Osteoarthritis

Common symptoms include:

How is Hand Osteoarthritis Diagnosed?

Your hand doctor will examine you to determine whether you have similar symptoms in other joints and assess the impact of arthritis on your life and activities.

The appearance of your hands and fingers will help your doctor diagnose the type of arthritis. X-rays will also reveal certain characteristics of osteoarthritis such as narrowing of the joint space, the formation of bony outgrowths (osteophytes or “nodes”), and the development of dense, hard areas of bone along the joint margins.

Treatment of Hand Osteoarthritis

Anti-inflammatory or other analgesic medication may help relieve pain. Your doctor may also advise you to wear wrist splints at night and for selected activities. Soft sleeves may be of some benefit when rigid splints are too restrictive, especially when arthritis affects the joint at the base of your thumb. Heat modalities such as warm wax or paraffin baths might help with swelling.

You will need to use your hands as productively as possible to maintain motion in the fingers. Hand therapy may also be helpful.

A cortisone injection can often provide relief of symptoms, but does not cure the arthritis.

Hand Surgery for Osteoarthritis

Your hand surgeon will usually not advise surgery unless more conservative treatments fail. He may recommend surgery when you either have too much pain or too little function. The goal is to restore as much function as possible and to eliminate pain or reduce it to a tolerable level.

Joint fusion is one type of surgery in which the arthritic surface is removed and the bones on each side of the joint are fused together, eliminating motion from the problem joint. It may also be used to relieve pain and correct the deformity that interferes with function.

Joint reconstruction is another approach, in which degenerated joint surface is removed in order to eliminate the rough, irregular bone-to-bone contact that causes pain and restricts motion. The degenerated portion may be replaced with rolled-up soft tissue, such as a tendon, or with a joint replacement implant.

The type of surgery you undergo depends on the particular joint(s) involved, your activities, and your own needs. Your hand surgeon will help you decide which surgery will be most helpful.

If you’re suffering from hand osteoarthritis, call (770) 333-7888 to make an appointment with Atlanta Hand Specialist at any one of our multiple metro Atlanta locations.

Skilled GA Finger Surgeon Treats Conditions of the Fingers, Hands & Wrists

Find Expert Hand Care at Atlanta Hand Specialist

An expert GA finger surgeon such as Dr. Viralkumar Patel at the Atlanta Hand Specialist can treat a wide variety of common conditions affecting the fingers and hands, such as:

Dr. Patel and his talented staff have years of experience diagnosing and treating these conditions of the fingers and hands, and are dedicated to providing the highest quality patient care. With a state of the art facility and advanced technological equipment, the GA finger surgeon and staff at Atlanta Hand Specialist is capable of handling even the most challenging of cases.

A skilled GA finger surgeon will take care to listen to their patients’ concerns and conduct a careful examination before determining an adequate course of treatment. In order to provide the most excellent care, a GA finger surgeon will strive to keep their patients informed and educated about each and every step of their treatment.

To schedule an appointment with the expert GA finger surgeon at Atlanta Hand Specialist, please don’t hesitate to call (770) 333-7888 or visit the website at http://www.atlantahandspecialist.com.

Metacarpophalangeal Joint Arthritis

The metacarpophalangeal (MP or MCP) joints are large joints at the base of each finger. These complex hinge joints are important for both power grip and pinch activities.

Causes of Metacarpophalangeal Joint Arthritis

The MP joints are less often affected by arthritis than the smaller joints in the hand or the joints where the thumb joints the wrist (CMC).

Rheumatoid arthritis is the most common arthritic condition affecting the MP joints. When this condition develops, the joint lining (synovium) produces chemical factors that inflame and destroy the cartilage and soft tissue, such as ligaments and tendons. The joint surfaces are ultimately destroyed and the fingers drift into a characteristic ulnar-deviated position in which they point toward the little finger.

Less commonly, other conditions produce pain, deformity, and loss of motion. Previous injury may result in gradual loss of joint cartilage (post-traumatic arthritis) with progressive pain and stiffness. There are similar findings with osteoarthritis. Post-traumatic and osteoarthritis usually affect the thumb, index, and middle fingers, with the degree for deformity much less severe than in rheumatoid arthritis. Gout, psoriasis, and infection are less common causes of MP joint arthritis.

Diagnosis of Metacarpophalangeal Joint Arthritis

Rheumatoid arthritis causes longstanding pain, swelling, and deformity in multiple joints of both the upper and lower extremities. You may also notice a characteristic ulnar drift of your fingers with loss of motion, particularly extension (straightening) of the fingers.

In cases of osteoarthritis and post-traumatic arthritis, you may experience deep, aching joint pain that is worsened by grip and pinch activities. You may not have an obvious finger deformity, although swelling, especially in the spaces between large knuckles, may be present.

Dr. Patel can confirm the presence of MP arthritis thru x-rays. Special x-rays may also be necessary to look carefully at the metacarpal head may also be helpful, particularly in milder cases.

Treatment Options for MP Arthritis

There are various treatment options available, based on the degree of the joint destruction and the symptoms you are experiencing.

If you are experiencing progressive pain, deformity, and motion loss despite medical management, you may be a candidate for surgical treatment.

MP Joint Fusion or Replacement

Patients with severe joint destruction may benefit from either a joint fusion or joint replacement. Although thumb function improves after an MP joint fusion, the fingers may lose motion. Because of this, a joint replacement is usually preferred.

Salastic hinged implants offer reasonable pain relief and function, and have been particularly successful in older, more sedentary patients with low demand on the use of their hands. More recent types of implants that try to replicate the joint surface may offer benefits to younger individuals and patients with more active, vigorous lifestyles.

If you’re suffering from metacarpophalangeal joint arthritis, make an appointment with Atlanta Hand Specialist. Call (770) 333-7888 today. We have offices in Smyrna, Douglasville, and Marietta.

Atlanta Finger Specialists Treat Finger Disorders, Conditions, & Injuries

Meet Dr. Patel, One of the Expert Atlanta Finger Specialists, Today

The fingers are so important to performing everyday tasks, and so when they are injured or suffer from a painful condition or disorder, it is important to seek treatment from expert Atlanta finger specialists.

Atlanta finger specialists like Dr. Viralkumar Patel, the practicing physician at Atlanta Hand Specialist, can offer skillful treatment for an array of finger conditions and disorders, such as:

Atlanta finger specialists like Dr. Patel are known for their specialized training in the diagnosis and treatment of all conditions affecting the fingers. While a general practitioner may be able to treat some hand disorders, only one of the skilled Atlanta finger specialists has the knowledge necessary to provide an expert treatment plan.

At Atlanta Hand Specialist, patients will receive expert care courtesy of one of the premier Atlanta finger specialists, all in a comfortable yet modern environment. Atlanta residents can schedule their appointments today.

To learn more about the Atlanta finger specialists offering treatment and services aimed at relieving finger pain at Atlanta Hand Specialist, visit the website online at http://atlantahandspecialist.com today or call the offices at (770) 333-7888 to speak with a knowledgeable staff member.

Arthritis at the Base of the Thumb

When a joint is normal, cartilage covers the end of the bones and works as a shock absorber to allow smooth, pain-free movement. In osteoarthritis (OA), the cartilage layer wears out. This lack of cartilage results in direct contact between the bones, causing pain and deformity.

The base of the thumb often develops OA. The basal thumb joint, also called the carpometacarpal (CMC) joint, is a specialized saddle-shaped joint that is formed by a small bone in the wrist (trapezium) and the first bone in the thumb (metacarpal). Thanks to its shape, the joint allows the thumb to have a wider range of motion. OA affects this range of motion and can cause severe pain.

Who Gets Basal Thumb Arthritis?

Basal thumb arthritis is more commonly seen in women over the age of 40. The exact cause remains unknown, but genetics, previous injuries such as fractures or dislocations, and generalized joint laxity may predispose someone to develop of this type of arthritis.

What Are the Signs and Symptoms?

Pain at the base of the thumb is the most common symptom. This pain can be aggravated by activities that require pinching, such as opening jars, turning door knobs or keys, and writing. Severity can also progress to pain at rest and pain at night.

In more severe cases, the joint progressively deteriorates and becomes mal-aligned. This causes a bump to develop as the metacarpal moves out of the saddle joint. This shift can limit motion and cause weakness, making a pinch difficult. The joint above the CMC may compensate by loosening, which causes it to bend further back (hyperextension).

How is the Diagnosis Made?

Your doctor will make a diagnosis through a physical evaluation and a review of your medical history. Pressure and movement such as twisting will cause pain at the joint. You may also experience a grinding sensation. X-rays will be used to confirm the diagnosis, although symptoms and severity often does not correlate with x-ray findings.

What Are the Treatment Options?

Less severe thumb arthritis usually responds to non-surgical care. Arthritis medication, splinting, and limited cortisone injections may help relieve pain. Your hand doctor may also provide a variety of rigid and non-rigid splints which can be worn while sleeping or during activities.

If you are suffering from advanced disease or non-surgical treatment has failed, you may be a candidate for surgical reconstruction. There are a variety of surgical techniques that can successfully reduce or eliminate pain.

Surgical procedures include:

If you’re suffering from thumb joint pain, make an appointment with Atlanta Hand Specialist. Call (770) 333-7888 today. We have offices throughout the entire metro Atlanta area.

Carpal Tunnel Syndrome

Do you have pressure on your wrists? Many people have symptoms of Carpal Tunnel Syndrome without knowing it. Find out how the condition is caused and what treatment you’ll receive from Atlanta Hand Specialists for Carpal Tunnel Syndrome.

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Wrist & Hand Fracture

If you have shooting pain in your hand or wrist, you may have a wrist or hand fracture. Fracturing, or breaking, the bones in the wrist or hand is extremely easy because of their size and structure. Read on to learn how wrist and hand fractures are treated by Dr. Patel and the Atlanta Hand Specialists.

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Trigger Finger

Trigger finger is caused by stressing the tendons and getting your thumb or finger stuck in the bent position. Inflammation and localized pressure are common signs for trigger finger. Seek treatment from the Atlanta Hand Specialists about trigger finger and your treatment options available.

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Ganglion Cyst

Tender lumps found on the hand or wrist can be a cyst. Ganglion Cysts are commonly filled with fluid, and form because of tendon or joint irritation. Find out more about how Ganglion Cysts are treated by the specialists at Atlanta Hand Specialist.

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