January 2023

HAND Cover

Dr. Nelson’s Research Published in December Issue of HAND

HAND CoverAlong with Dr. Richard Singer and a team of researchers including Samuel Gay, Scott Diamond MD, and and Mitchell Gauger MD, Dr. Nelson recently published their findings from a retrospective study investigating the relationship between common hand conditions, such as carpal tunnel syndrome and trigger finger, and undiagnosed or “pre” diabetes.

Their study, titled “Warning Signs: Occult Diabetes and Dysglycemia in the Hand Surgery Patient Population,” was originally delivered as a podium presentation by Dr. Nelson at the 2020 Annual Meeting for the American Society for Surgery of the Hand. It suggests a strong link between carpal tunnel syndrome on both sides and early, undiagnosed, or impending diabetes or pre-diabetes. Male patients with elevated BMI and bilateral carpal tunnel syndrome were most at risk of having diabetes or pre-diabetes and not even knowing it!

It is well known that patients who have a diagnosis with diabetes are more likely to suffer from carpal tunnel syndrome and trigger finger, more likely to need surgery, and more likely to have continued nerve problems even if successful surgery is performed. What is NOT known, however, is how often patients have diabetes or pre-diabetes and don’t even know it, and the first “warning sign” is carpal tunnel symptoms.

“Hand surgeons encounter a patient population with high rates of undiagnosed prediabetes and diabetes, with some presentations as much as 6 times higher than the general population. Certain patient presentations should prompt appropriate diagnostic testing and referral, especially those presenting with bilateral compression neuropathy and elevated body mass index.” (Excerpt from Manuscript)

If you would like to read the manuscript, contact us here to request a free copy. Congratulations to Drs. Nelson, Singer, Gay, Diamond, and Gauger, and thank you for your contributions to our understanding of musculoskeletal conditions.

Dr. Nelson’s Research Published in December Issue of HAND Read More »

0127b 1

Can I Have My Carpal Tunnel Released on Both Sides at the Same Time?

0127b 1What do I do if I have carpal tunnel on both sides?

Unfortunately, carpal tunnel syndrome is very common.  1 out of every 20 adult Americans has this condition, which can interfere with sleep, the quality of life, the use of the hands both at home and at work. Symptoms include numbness and tingling, especially in your thumb, pointer, and middle finger, waking up at night to shake your hands out, pain and numbness/tingling with activities that require gripping and repetitive wrist motions (holding a steering wheel, using tools, knitting, etc.).

Worse still, many have severe problems in both hands, and that may be YOU.

Sometimes simple treatments for carpal tunnel can help to quiet down your symptoms, especially if your symptoms came on recently.  These include oral anti-inflammatories such as steroids or NSAIDs, wearing a wrist splint at night, avoiding activities that make your symptoms worse, and even injections performed by a hand surgeon such as Dr. Nelson.

But what happens when you have carpal tunnel on both sides that does not respond to these measures?

Carpal tunnel release is a great treatment for carpal tunnel syndrome.  No matter how it is performed, it reliably relieves your numbness, tingling, and especially night pain and gripping pain due to carpal tunnel syndrome.

However, you may be worried about having surgery on both hands at the same time, also called “bilateral” carpal tunnel release.  Maybe you have concerns that you will not be able to take care of yourself or others (children, elderly parents), dress yourself, use the bathroom, prepare food, and participate in other activities of daily life. Or perhaps you are concerned that you will have to take too much time off of work, and that is something you can’t afford. Simply put, you may feel the need to have one “good hand” to help out while the operated hand heals.

But with new technologies and techniques, this is no longer the case.

In years past, carpal tunnel release was always done through an open incision in the palm.  While this can reliably treat and cure the symptoms of carpal tunnel syndrome, the incision in the palm can be painful especially in the early days and weeks after surgery.  This can require prolonged periods of healing where heavier activities or even simple activities around the house can be difficult for you or need to be avoided altogether.

However, Dr. Johnny T. Nelson uses a new technology to treat your carpal tunnel syndrome under ultrasound guidance.  Due to the extremely smallsonexhealed incision (about the size of a pea!) further back on the wrist, and no incision on the palm, the same release and relief of your symptoms can be performed while minimizing the period of healing pain after the surgery.

With ultrasound guided carpal tunnel release, almost all patients with carpal tunnel on both sides have it treated on the same day.  With ultrasound-guided carpal tunnel release, you may return to all activities immediately, including cooking, hygiene, dressing, and even work, including manual labor. There is no splinting or casting required, there is no heavy anesthesia on the day of surgery. Some patients who do very heavy work with their hands (for example, mechanics, plumbers, and other heavy laborers) may need to allow for 5-7 days for the area to heal.

In Dr. Nelson’s experience, he has yet to encounter a patient who has had ultrasound-guided carpal tunnel release done on both sides who wishes that they had it done only on one side.  However, many patients who had it done on one side only for fear of the healing process wish they had it performed on both sides.

So to answer your question: YES!  If you have carpal tunnel on both sides, and your symptoms are bad enough to need surgery, ultrasound-guided carpal tunnel release on the same day for both hands is often the best option for you. Click here for a complimentary printable handout about what to expect from ultrasound-guided carpal tunnel release.

Remember, every patient is different, your treatment depends on a one-on-one consultation with Dr. Johnny T. Nelson which includes a physical exam and discussion of your symptoms.  If you are a candidate for ultrasound-guided carpal tunnel release, even if on both sides at the same time, he will let you know.  Call 919-872-5296 for an appointment, or visit www.drnelsonctr.com to learn more.

Can I Have My Carpal Tunnel Released on Both Sides at the Same Time? Read More »

Book An Appointment

* All indicated fields must be completed.
Please include non-medical questions and correspondence only.

Location Map: 3801 Wake Forest Road Raleigh, NC 27609
rue logo wt

OFFICE HOURS

Monday - Friday: 8:30 am - 4:30 pm

CONTACT US

Accessibility Toolbar

Scroll to Top