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

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.

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 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.

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.

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.

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.

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.

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.

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.

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.

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.