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Find Relief & Reduce The Pain

Neuropathy is the term used to describe a problem with the nerves, usually the “peripheral nerves” as opposed to the central nervous system (e.g., the brain and spinal cord). Peripheral neuropathy is a common disease caused by nerve deterioration.

Neuropathy is seen with a number of different underlying medical conditions, including diabetes.



Reduce your risk.

Neuropathy is preventable only to the extent that the underlying condition or cause is preventable.
For those with diabetes, long-term control of blood glucose levels is critically important in preventing the development of neuropathy and other complications of diabetes. Further, take care of your feet and check daily for blisters, cuts or calluses. Neuropathy that arises due to poor nutrition or alcohol abuse may be preventable if these causes can be eliminated. Of course, genetic or inherited causes of neuropathy are not preventable.



Pinpoint your pain.

Impacting the body’s ability to send messages, neuropathy causes patients to suffer from a range of neurological symptoms. These may include burning, tingling, itching, clumsiness, and severe pain. Since the term neuropathy covers a wide area and many nerves, the symptoms it causes depends on the type of nerves that are affected:● Sensory nerves, or the nerves that control sensation, can cause tingling, pain, numbness, or weakness in the feet and hands when injured.● Motor nerves, which are the nerves that allow power and movement, can cause weakness in the feet and hands.● Autonomic nerves—those that control the systems of the body— can cause changes in heart rate and blood pressure, or body temperature regulation.



Get the answers you need.

To identify the severity of the condition, our experts examine a patient’s symptoms, general health, family medical history, and any other relevant factors. Then, they provide a thorough physical exam—looking at the skin thoroughly, checking the pulses, testing sensation, examining tendon reflexes, and so on. Then, your physician decides that you need a nerve conduction study or electromyography.



Life’s too short to put up with pain.

We may use MLS Laser Therapy, a painless, non-invasive application of light energy, which is proven to deliver results for neuropathy and similar nerve conditions. As our MLS Laser Therapy system penetrates the skin, it promotes cellular regeneration, decreased inflammation, and a reduction in neuropathy symptoms. Depending upon the severity of their condition, patients report pain relief, improved nerve function, and a “quieter” nervous system. Diabetic foot checks are recommended to be done every six months by a podiatrist or foot/ankle physician in order to ensure that the foot is well taken care of and problems or infections are not developing in the foot due to neuropathy.


Carpal Tunnel Syndrome

Our Carpal Tunnel Specialists in Bergen County Can Restore Feeling, Eliminate Pain

The “carpal tunnel” is a narrow passageway that runs from the base of the hand through the wrist. The median nerve, which controls our sense of touch in the palm, and touch and fine movement in the thumb and three larger fingers, passes through the carpal tunnel along with several tendons. If any of those tendons become irritated, or any other swelling encroaches on the space within the tunnel, the median nerve can become compressed. Compression of the median nerve may cause symptoms that range from tingling in the fingers to pain radiating up the arm.

  • Causes

    Carpal tunnel syndrome is caused by a combination of factors that increase pressure on the median nerve. People who genetically have smaller carpal tunnels are more vulnerable to the condition. Three out of every four people who develop carpal tunnel syndrome are women, most likely due to the anatomy of having smaller carpal tunnels than men. The stature of the smaller carpal tunnel leaves very little room for irritated tendons to swell without putting stress on the medial nerve, making the medial nerves in smaller tunnels more susceptible to experiencing pressure frequently and swiftly. Although carpal tunnel syndrome is more commonly considered a workplace injury, it can also happen to athletes. Kayal Orthopaedic Center’s experts in sports medicine will properly diagnose and treat carpal tunnel syndrome.

    Other contributing factors include:
    ● Trauma or injury to the wrist, such as a sprain or fracture● Overactive pituitary gland● Hypothyroidism● Rheumatoid arthritis● Mechanical problems in the wrist joint● Repetitive work-related wrist activity● Repeated use of vibrating hand tools● Fluid retention during pregnancy or menopause● Development of a cyst or tumor in the canal

  • Symptoms

    Carpal tunnel syndrome symptoms often begin gradually and typically stem from the thumb side of the hand. Initially, symptoms may be intermittent, but without intervention, they may become chronic. The two most common forms of arthritis—rheumatoid and osteoarthritis—raise your risk for carpal tunnel syndrome.

    Common symptoms include:
    ● Numbness, tingling and pain in the hand, especially at night● An electric shock-like feeling mostly in the thumb, index and long fingers● Strange sensations and pain traveling up the arm toward the shoulder● Delicate motions, such as buttoning a shirt, become increasingly difficult

  • Diagnosis

    In order to diagnose you properly, your doctor will consider your symptoms, examine your hand and wrist, and ask you to perform specific movements that reproduce the symptoms of carpal tunnel syndrome. Your doctor may also require you to have X-rays, an MRI or a nerve conduction test to look closely at the nerve function in your hand.

  • Treatment

    Without some form of treatment, carpal tunnel syndrome will progressively worsen. However, if diagnosed and treated early by our specialists, relief can be attained through the following non-surgical treatments. In cases where non-surgical treatments fail to resolve carpal tunnel syndrome, our physicians, who specialize in hand and wrist surgery, will use their knowledge and expertise to perform either open or endoscopic surgery. Open surgery is designed to increase the size of the carpal tunnel and decrease pressure on the nerve, while endoscopic surgery is performed through a small incision and aims to cut ligaments in order to alleviate the pressure that’s being put on the median nerve. The end result of these surgical options is parallel, but each condition has specific determinants that make it better suited for certain situations. Our physicians will thoroughly evaluate each carpal tunnel syndrome situation to decide which surgery option is best for each patient’s individualized condition.

Ganglion Cysts

Discover, Remove & Restore Functionality

Ganglion cysts are harmless tumors, masses, or lumps that occur adjacent to joints or tendons, and are most commonly found on the hands and wrists. Depending on the extent of the concurring wrist activity, these lumps are susceptible to frequently appearing, disappearing, or changing in size.
Ganglion cysts grow from the tissues that surround the joints, including ligaments, sheaths, and joint linings, and are filled with fluid. This fluid is similar to the fluid that lubricates the body’s joints. A majority of ganglion cysts occur in people between 20 to 40 years of age, with women being three times more likely to develop cysts than men.

  • Prevention

    Ganglion cysts are extremely difficult to prevent but may reduce in size or pain through early detection, proper evaluation, and reduced usage of the associated joint.

  • Symptoms

    Ganglion cysts usually appear in the form of a visible, immovable, yet soft bump on the surface of the skin. However, occult ganglion cysts may remain hidden, never fully breaching the skin’s surface. Other than appearance, ganglion cysts typically do not display noticeable symptoms. Depending on its location, though, there’s a possibility that the cyst will connect with a tendon, causing symptoms of pain and muscle weakness in an accompanying finger. Pain and a tingling sensation are clear indications that the condition may be chronic and will potentially worsen through continuous joint movement.

  • Diagnosis

    A physical exam is typically all that is needed to diagnose a ganglion cyst, but physicians may get further condition confirmation through testing a small portion of the cyst’s liquid or performing an ultrasound, X-ray or MRI.

  • Treatment

    Ganglion cysts typically do not require treatment, since they are not necessarily harmful to an individual’s health. If the ganglion cyst is painful, interferes with wrist functioning, grows into an unacceptable appearance, or severely limits an individual’s ability to perform everyday activities, our physicians can perform minor surgical procedures to reduce symptoms or completely eliminate ganglion cysts. In ganglion cyst removal, a doctor will remove the cyst capsule or stalk in order to completely remove the cyst and prevent ganglion cysts from recurring. Even though our surgical procedure is extremely effective for the removal of the ganglion cyst’s root and hindering its ability to grow back, there is always a small chance that the cyst may eventually return.


Alleviating Pressure and Preventing Pain

Several sensitive nerves in the body branch away from the spinal column through canals before they travel to peripheral areas. These nerves transmit sensory information back and forth from the central nervous system. However, sometimes your nerves stop working properly because they are compressed and damaged as they leave the spine. The resulting pain is referred to as radiculopathy.

  • Causes

    Radiculopathy is often caused when there is a change in the tissue that surrounds the root of one of your nerves. Tissues such as spinal vertebrae, tendons, and intervertebral discs can change in size, causing the space to narrow where your nerve roots travel in the spine. This narrowing (stenosis) leads to a degeneration of the spine.
    Herniated discs or discs that move out of place and place pressure on nerves are a form of stenosis and will usually occur in your lower back or neck. Bone spurs are another cause of radiculopathy, as they form in the spine. Other, less common causes are cancerous or noncancerous growths in the spine that place pressure against nerve roots.

  • Symptoms

    When you suffer from radiculopathy, your symptoms may vary depending on the location of the compressed nerve root. When a nerve root is squeezed, it becomes inflamed, resulting in symptoms such as sharp pain that increases with certain activities. This can typically occur in the back, arms, legs or shoulders. You may experience a loss in arm and leg reflexes, tingling or “pins and needles” sensations.

    You also might experience only intermittent pain—or no symptoms at all. The elite team of experts at Kayal Pain & Spine Center has the skills and expertise to assess, diagnose and treat your condition.

  • Diagnosis

    The experts at Kayal Pain & Spine Center will often take several measures to diagnose radiculopathy, such as a physical exam to check muscle strength and reflexes. If you experience pain with particular movements, your doctor will be able to identify the nerve root that is affected. Imaging tests such as X-rays or MRI scans are often helpful to evaluate structures in the affected area. Nerve conduction studies, in conjunction with electromyography, also can help your doctor determine if the radiculopathy is neurological or muscular.

  • Treatment

    The recommended treatment for radiculopathy will depend on the location and cause. At Kayal Pain & Spine Center, your doctor will explore nonsurgical treatments when possible. They may include anti-inflammatory pain medication to manage the discomfort, physical therapy to strengthen the muscles and prevent future damage or steroid injections to help reduce pain.

    If your condition does not improve after several weeks following these treatments, your doctor may recommend surgical treatment, exploring less invasive procedures when feasible. No matter which choice you and your medical team make, the aim of surgery is to minimize and alleviate pressure on your nerve root by removing part of a disc or vertebrae. Our goal is to relieve your pain and restore your mobility.

Tarsal Tunnel Syndrome

Get Healthy Feet for An Active Life

Tarsal tunnel syndrome (TTS) is the compression or squeezing of the tibial nerve, which runs through the tarsal tunnel on the inside of the ankle and leads into the foot, producing pain or a tingling sensation anywhere along the nerve’s pathway.
The tarsal tunnel is a narrow space that lies on the inside of the ankle, next to the anklebones, and protects the posterior tibial nerve, arteries, veins, and tendons that run through it. As aggravation is inflicted upon these structures, swelling occurs, causing them to expand in the tunnel and putting stress and compression on the tibial nerve. This leads to tingling, burning, numbness, or pain in areas of the lower leg.

  • Prevention

    Prevention of tarsal tunnel syndrome is largely based on avoiding stress or injury to the tibial nerve and reducing the possibility of aggravating the blood vessels and tendons that accompany the nerve in the tarsal tunnel. Prevention suggestions include:● Rest your foot in between long bouts of walking by sitting down occasionally, as well as changing your standing position frequently after long standing durations.● Properly warm your muscles up before partaking in any strenuous workout to reduce the chance of injury.● Wear properly fitted shoes and tie them correctly.● Use a wrap or brace when participating in athletic activities, especially if uneven surfaces or sudden direction changes are involved.● Engage in a good strength program to keep the supporting muscles of the lower leg strong.● Stretch frequently to maintain muscle flexibility, which keeps the foot in proper alignment and reduces any pull on the tendons.

  • Symptoms

    Symptoms of tarsal tunnel syndrome may develop suddenly or progress gradually. Individuals may experience a range of symptoms:● Sharp, shooting pain along their tibial nerve● Radiating pain that can’t be localized to one spot● Presence of numbness, burning, or a tingling sensation commonly described as ‘pins and needles’ in a specific areaSymptoms are often worsened by prolonged standing or walking, and after an active day. Though rest often alleviates symptoms, individuals with more severe cases of tarsal tunnel syndrome have reported that their pain is persistent even after rest, and is still present at night while he or she attempts to sleep.

  • Diagnosis

    Tarsal tunnel syndrome diagnosis requires a physical examination, where a physician will evaluate an individual’s symptoms, review the patient’s medical history, and perform a thorough clinical evaluation and a variety of specialized tests, such as an MRI or nerve conduction study. A simple, yet efficient test that a physician will perform is the Tinel’s sign test, where a doctor will tap or apply pressure to the tibial nerve. If this contact stimulates a tingling or ‘pins and needles’ sensation in the foot or toes, the patient is deemed to have tarsal tunnel syndrome.

  • Treatment

    A variety of non-surgical treatment options are often used to reduce or eliminate symptoms, including:● Rest up. Staying off your foot and ankle alleviates pressure from standing and walking, and is an efficient way to promote healing.● Consistently apply ice. Applying ice to the affected area reduces swelling and temporarily alleviates pain.● Take oral medications. Over-the-counter and prescription anti-inflammatory drugs help to reduce pain and inflammation in the ankle area, which lessens the pressure on the tibial nerve.● Use orthotic devices to limit mobility. Braces and wraps help to restrict movement of the ankle and foot, while reducing the pressure severity and promoting the healing of the tibial nerve.● Home exercises and physical therapy. Physical therapy exercises and at-home practices will increase the strength and flexibility of the ankle and foot, which will help to decrease pressure and reduce other associated symptoms.● Doctor-administered therapy. Corticosteroid injections will reduce inflammation in the tarsal tunnel, while anesthetic injections may alleviate pain symptoms.● Wearing proper shoes with custom inserts. Supportive shoes, along with custom shoe inserts, help to maintain the arch in the foot and limit excessive motion. Sometimes simply changing to looser or larger footwear may lead to reduced pressure on the foot and relieve pain.
    When non-surgical treatments fail to alleviate or cure tarsal tunnel syndrome, our physicians will determine if surgery is necessary, and then select the appropriate procedure based on each individual’s condition.

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