Carpal tunnel syndrome

 What is Carpal tunnel syndrome?

Carpal tunnel happens when the carpal tunnel swells and pinches on one of the nerves (median nerve) in the wrist.

It causes tingling, numbness, pain in your wrist and fingers.

What are the symptoms of carpal tunnel syndrome?

Symptoms are ache or pain in the fingers, or arm.

Tingling, pins and needles, numbness in the hand or fingers.

Difficulty grasping objects.

Thumb feels weak.

What are the risk factors?

You are at risk if you are

Overweight

Pregnant

Work or have hobbies where you repeatedly bend your wrist or grip like working with vibrating tools, typing

Illnesses like arthritis, diabetes, Thyroid problems

Family history.

Previous wrist injury 

What should I do if I have carpal tunnel syndrome symptoms?

Consult your healthcare provider.

How can my healthcare provider help me?Your healthcare provider will talk to you about your symptoms, perform a physical exam.

Your healthcare provider might order an x-ray or ultrasound. Sometimes tests are done to assess nerve function.

How is carpal tunnel syndrome treated?

Your healthcare provider may recommend medicines, wrist splint, injections around the nerve, surgery.

Self-help?

Self-help is for mild symptoms only. Consult a healthcare provider if your symptoms do not get better.

Wear a wrist splint.

A wrist splint is something you wear on your hand to keep your wrist straight. It helps to relieve pressure on the nerve.

You wear it at night while you sleep. You'll have to wear a splint for at least 4 weeks before you start to feel better.

You can buy wrist splints online or from pharmacies.

Stop or cut down on activities that may be causing carpal tunnel syndrome.

Stop or cut down on anything that causes you to frequently bend your wrist or grip hard, such as using vibrating tools for work, playing an instrument, typing.

Medicines to relieve pain

Painkillers like Tylenol or Ibuprofen may offer short-term relief from carpal tunnel pain.

But there's little evidence to say they can treat the cause of CTS, so it's important not to rely on them.

Hand exercises

Consult your healthcare provider for exercises. 

 

Joint pain

Please consult your healthcare provider if you have any joint complaints.

Joint pain is a very common complaint, due to various causes. Common reasons for joint pain are osteoarthritis and injury.

In older adults, joint pain, which gets steadily worse maybe due to osteoarthritis.
Joint pain can been a single joint or multiple joints.

The knee joint is probably the most frequently damaged joint and is particularly vulnerable as it takes the full weight of your body.

But knee pain is not always a joint problem. Please consult your healthcare provider for diagnosis and treatment.

Inflammation of the lining of the joints:

After the recent joint injury, if the joint gets painful again, the thin layer of tissue lining the joints and tendons may be inflamed, a condition called traumatic synovitis.

It usually does not cause any redness or heat.

You should be able to manage injury-related swelling at home with NSAID's, such as ibuprofen, an icepack and rest.

Gout or pseudogout:

If the skin over the joint is hot and red, and the pain comes in repeated attacks, the cause is likely to be either gout or pseudogout.

Both of these are types of arthritis.

Gout usually affects the joint of the big toe first before affecting other joints.

It's important to correctly diagnose gout, as treatment will prevent future attacks of joint pain and disability.

Pseudogout is similar to gout, but usually affects the knee joint first.

Consult your healthcare provider if you think you have gout or pseudogout.

Damage to the cartilage behind the knee:

Knee pain that feels worse when you go up or down stairs could be a sign of a damaged kneecap, called chondromalacia patellae. 

This should not cause any redness or heat around the knee.

The cause is not understood, but it can be linked to overuse of the knee.

You can treat this problem yourself with NSAID's, such as ibuprofen, an icepack and rest.

Bleeding into the joint space:

If you have recently had an injury to the knee joint, such as a torn ligament or knee fracture, it may cause bleeding into the joint spaces. This is known as haemarthrosis.

This is more likely to happen if you take blood thinners like warfarin

Signs of Blood in the joint

Swelling of the knee.

Warmth

Stiffness, bruising after injury.

You should get immediate medical attention.

Other less common causes are

Fracture: Usually after trauma, although it can occur easily in patients with osteoporosis or other health conditions.

Reactive arthritis: develops after an infection and commonly affects young adults.

Psoriatic arthritis: joint get affected in patients with psoriasis.

Rheumatoid arthritis: autoimmune condition, which can start in one joint. The pain comes and goes.

Osgood Schlatter's disease: Discomfort and swelling over the bony bump beneath the knee cap.

Infection in the joint: serious condition, get immediate medical attention.

Bleeding disorders: patients can bleed in the joints.

Cancer

Crumbling of the bones.

Dislocation of the joint

Rheumatoid arthritis.

Rheumatoid arthritis is a type of arthritis that causes pain and swelling in the joints, usually the hands, feet and wrists.

The pain may come and go in the early stages, with long periods between attacks.

It can make you feel generally unwell and tired.

Psoriatic arthritis.

Psoriatic arthritis affects up to 1 in 5 people with Psoriasis

This type of arthritis is unpredictable, but flare-ups can usually be controlled with treatment. 

Like other types of arthritis, it means that 1 or more of your joints are inflamed and become swollen, stiff, painful and difficult to move.

Joint pain after infection:

Examples of viral infections that can cause pain in the joints and symptoms of a fever include:

Viral hepatitis.

Rubella

Connective tissue diseases.

Widespread joint pain is sometimes a sign of a disease that affects almost all the organs of the body, such as:

Lupus: Autoimmune disease

Scleroderma

Other less common conditions:

Widespread joint pain can less commonly be caused by:

Rarer type of arthritis – such as Ankylosing spondylitis, juvenile arthritis, reactive arthritis 

Bechets syndrome  – a rare and poorly understood condition that causes inflammation of the blood vessels

Henoch-Schonlein purpura: Condition usually seen in children, that causes blood vessels to become inflamed.

Hypertrophic pulmonary osteoarthropathy: Affects the fingers, seen in patients with lung cancer.

Sarcoidosis: causes small patches of tissue to develop in the audience.

Medications: like steroids, hydralazine, isoniazid

Osteoarthritis of the fingers with nodules on the fingers.

Image result for osteoarthritis fingers

Swelling and redness of the right foot from gout

Image result for gout toes

 Rheumatoid arthritis of the hands with swelling of the knuckles and extensive deformities

Image result for Rheumatoid arthritis hands

 

Knee pain

What causes knee pain?

Knee pain can be caused after injuries from over exercising, repetitive running or jumping, torn ligament, tendon, meniscus, cartilage damage, dislocation, arthritis, inflammation of structures around the knee joint, infection in the knee joint, bleeding, fractures.

What are the symptoms of knee problems?

Pain, Stiffness in the knee on standing up, walking.

Pain between the kneecap and the shin bone

sensation that the knee will give out, popping sound in the knee.

Kneecap changing shape.

Swelling in the knee.

Warmth, Bruising and redness in the knee

What should I do if I have knee problems?

Consult your healthcare provider right away.

How can my healthcare provider help me?

Your healthcare provider will ask you a few questions, and perform a physical exam.

Based on your condition, Bloodwork, imaging will be ordered.

Medicines, Exercises will be prescribed for pain relief.

Self-help?

Self-help is only for mild complaints. Consult your healthcare provider if your symptoms get worse.

Rest: Put as little weight as possible on the knee, avoid standing for a long time.

Ice: Use Ice pack, or a bag of frozen peas on the knee for up to 20 minutes every 2-3 hours. Avoid ice burn of the skin.

Compression: You can use a knee brace to provide support.

Elevation: keep the knee joint elevated with a couple of pillows or recliner.

Medications: use medicines as prescribed by your healthcare provider for pain relief.

Ankle pain

What are the common causes of ankle pain?

Common causes are sprained ankle, tendinitis of the Achilles tendon, inflammation of the bursa, fracture

What are the symptoms?

Pain, swelling, bruising around the ankle

Discomfort in the heel, pain in the calf when standing on tip toes.

Redness and swelling around the ankle

Sudden sharp popping or snapping sound during the injury.

Difficulty walking.

Ankle appears at an odd angle

What should I do if I have Ankle problems?

Consult your healthcare provider right away if you have

Severe pain.

Feels strange dizzy or sick from the pain.

Ankle or foot has changed shape or appears at an odd angle.

Snap, grinding or popping noise at the time of injury.

Unable to walk.

How can my healthcare provider help me?

Your healthcare provider will ask you a few questions, and perform a physical exam.

Based on your condition, Bloodwork, imaging will be ordered.

Medicines, Exercises will be prescribed for pain relief.

Self-help?

Self-help is only for mild complaints. Consult your healthcare provider if your symptoms get worse.

Rest: Put as little weight as possible on the ankle, avoid standing for a long time.

Ice: Use Ice pack, or a bag of frozen peas on the knee for up to 20 minutes every 2-3 hours. Avoid ice burn of the skin.

Compression: You can use a ace bandage to provide support.

Elevation: keep the ankle joint elevated with a couple of pillows or recliner.

Medications: use medicines as prescribed by your healthcare provider for pain relief.

Use wide comfortable shoes with low heel and soft sole. Use soft insoles or heel pads in your shoes.

Talk to your healthcare provider about gentle stretching exercises.

 

Exercise (5-18 years of age)

How much physical activity should children and young people aged 5 to 18 do to stay healthy?

Children and young people need to do 2 types of physical activity each week:

Aerobic exercises.

Exercises to strengthen muscles and bones

Children and young people aged 5 to 18 should:

Perform average of 60 minutes of moderate intensity exercise a day, across the week.

Take part in variety of physical activity to develop movement skills, muscles and bones.

Reduce the time spent sitting or lying around, stay active.

What counts as moderate exercise?

Moderate intensity activities will raise your heart rate, and make you breathe faster and feel warmer.

One way to tell if you're working at a moderate intensity level is if you can still talk, but not sing.

Examples of moderate intensity activities are:

Walking to school.

Playground activities.

Riding a scooter.

Skateboarding

Rollerblading

Walking the dog.

Cycling on level ground

What activities will help strengthen muscles and bones?

Examples of exercise which strengthen muscles and bones are:

Walking

Running

Games like tug-of-war

Jump rope

Swinging on Monkey bars

Gymnastics

climbing

Sit ups, push-ups

Basketball, football, tennis, hockey

Dancing

Martial arts

Rockclimbing

Please contact your healthcare provider before starting exercise routine. Children should be monitored by adults while performing exercises/physical activity.

Information

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In the event of an error in your insurance, please let our front office staff know.

We are in network with most insurances. However individual plans may vary and not known till a claim is adjudicated.

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We need every patient to finish all the forms online and check in online if possible. 

Most visits start on time, so please plan to be at the office, fifteen minutes before your appointment.

Habitual no show patients are terminated from the patient panel.

We charge a no show fee.

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