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When Can I Return to Work After Carpal Tunnel Release?

hand holding wrench vectorWhen can I return to work after carpal tunnel release?

This is the most common question patients ask while discussing carpal tunnel release surgery with their doctor.  It is a very important question.  Our ability to work is one reason to consider carpal tunnel release, since carpal tunnel syndrome can severely affect your ability to use your hands and work well.  Our ability to work is how we pay rent, feet our families, and one way to find fulfillment in life.

But many patients avoid having carpal tunnel release!

This is understandable and not very surprising. After talking to friends, family, and co-workers who have had older forms of carpal tunnel release, many are afraid of how much time they will need to take off of work. They also worry about the pain of the healing process and the physical therapy that will be needed. But this fear is often caused by a misunderstanding of how quick, comfortable, and targeted modern carpal tunnel release techniques are!

Raleigh North Carolina Carpal Tunnel Specialist Dr. Johnny T. Nelson offers carpal tunnel release under ultrasound guidance. 

This requires only a small pea-sized “poke” over the wrist (not the palm), no IV or anesthesia is required, no painful tourniquet is required. Also, both sides often are performed on the same day if you have carpal tunnel syndrome in both hands.  See here for a video where Dr. Nelson explains the healing after this procedure. Unlike other traditional methods of releasing the carpal tunnel, this technique does not require a long open incision in the palm or across the wrist.  The “old” technique does work to relieve carpal tunnel symptoms, but there are “innocent bystanders” caught in the action. Skin and tissue is unnecessarily cut through and makes performing release on both sides too painful. With the ”old” technique patients often need therapy or weeks or months off of work.

Okay, that sounds good, but with the new technique, how much time off do I need?

First of all, the amount of time you need off of work really depends on what you do for work.  Dr. Johnny T. Nelson does not usually restrict your activities after carpal tunnel release.  This is because most activities, even heavier activities will not “ruin” the work that was done.  It is however good to wait 3-5 days before doing very heavy gripping such as yard work, heavy tools, and lifting weights. This allows the hands to “cool down,” after the procedure.

It is also important to understand that every patient is a little bit different and heals differently.  There is no “one size fitsHow to Stop Hand and Wrist Pain When Typing all” healing after carpal tunnel release.  Some patients are comfortable enough to perform heavy gripping, pushing, and pulling 3 days after carpal tunnel release, while some patients those activities may take several weeks to return. Many plumbers, electricians, and mechanics have their carpal tunnel release on a Thursday, and are back to work the following Monday! In a few patients, return to full grip and pinch strength may take 1-2 months.

If you work at a desk during the day, and perform other light activities such as answering phones and handling papers and light paperwork, you can return to work immediately, even the day after the procedure.

If you perform repetitive activities, such as assembly line, cutting fabric, factory work, or hairdressing, you may need to take more time off of work, such as 2 to 4 weeks.  Again, this is not because your job will interfere with your healing or ruin the surgery, but because you may be uncomfortable performing repetitive activities all day long.  Most patients with these types of jobs are able to return with restrictions right away, or “play things by ear” and returned to work when they feel good enough.

There are special jobs where patients need more time due to the nature of their work.  For example, police officers do and perform certain activities that need to be 100% expertly performed before they can return to work.  The same applies to lifeguards.

Do you have carpal tunnel syndrome?  Are you worried about how long you will need to stay out of work?  Call 919-872-5296 today to schedule a visit with Raleigh North Carolina Carpal Tunnel Specialist Dr. Johnny T. Nelson, MD.  He will discuss your condition and situation in detail and together you will form a plan on how to treat your carpal tunnel symptoms with minimal interruption to your life and work.

When Can I Return to Work After Carpal Tunnel Release? Read More »

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Do I Need Nerve Studies If I Have Carpal Tunnel Syndrome?

Do I Need Nerve Studies If I Have Carpal Tunnel Syndrome? The short answer is: NO!

 

What is a nerve study?

If you have carpal tunnel syndrome, many doctors order a test called a “nerve study.”  These are also called “EMGs” or “electrodiagnostic studies.”  Do not worry about the name, just know that it is a test performed by a doctor or other trained medical provider. It looks closely at the different nerves in your arm to see if there are any problems with the “signals” being sent along the nerve.  These include the signals being sent from your brain to your hand, and also the signals going in

EMG pic

the other direction, from your hand to your brain. Think of the nerve like an electrical cord sending signals back and forth.

Nerve studies usually take about 30 minutes to perform, and sadly can be very uncomfortable. It requires multiple needles
inserted through your skin and deep into your muscles with many electrical shocks along the length of your arm.

 

If they are painful, why do doctors still order nerve studies?

There are still some hand doctors and hand surgeons that require nerve studies to prove that you have carpal tunnel syndrome. Because of this, many doctors still order these studies.  In some situations, nerve studies can be very helpful. For example, sometimes it is hard even for an experienced doctor to tell exactly what your problem is. In the past, nerve studies were the only way to test for carpal tunnel syndrome.

However, most recent evidence shows that for carpal tunnel syndrome, nerve studies are not important or necessary to get.

For example, Raleigh North Carolina Carpal Tunnel Specialist Johnny T. Nelson uses a special scoring system called the CTS-6, which is equal to or better than nerve studies at detecting carpal tunnel syndrome.  The CTS-6 includes a few simple questions about your symptoms and a few physical exam findings. If you have carpal tunnel, the CTS-6 is part of your visit with Dr. Nelson, and takes only 1-2 minutes to complete.

 

Dr. Nelson also performs in-office ultrasound. 

There is new evidence that simply measuring the swelling of the carpal tunnel nerve at the wrist is EVEN BETTER than nerve studies at showing carpal tunnel syndrome.  In office ultrasound

  • Only takes Dr. Nelson about 30 seconds to perform
  • Is COMPLETELY painless
  • Is a FRACTION of the cost of nerve studies!

You have carpal tunnel syndrome?  Do you wake up at night and shake your hands out?  Do you drop things during the day because you cannot feel your fingers well?  If so, you probably do not need expensive and painful nerve studies.  You DO need a visit with Dr. Johnny T. Nelson, MD, Raleigh North Carolina Carpal Tunnel Expert!  Call 919-872-5296 to make your visit today!

Do I Need Nerve Studies If I Have Carpal Tunnel Syndrome? Read More »

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Free Scanning Open House at Bone & Joint Surgery Clinic – September 13th

Free Scanning Open House at Bone & Joint Surgery Clinic – September 13th

Do you wake up every night, shaking your hands out to make them stop hurting? Are you dropping things? Does pain or shooting electricity interruptsonex cropsome of your favorite activities?

More importantly: are you ignoring or suffering through these symptoms because you are worried about what the doctor will say you need to make it better?

Dr. Johnny Nelson is hosting a free educational open house and scanning event at The Bone & Joint Surgery Clinic on Tuesday, September 13th at 6PM. Dr. Nelson will briefly help to explain carpal tunnel syndrome in simple, easy-to-understand terms and will explain a new ultrasound-guided technique for treating carpal tunnel symptoms with the UltraGuideCTR device. Dr. Nelson will then be available for informal consultation and a free ultrasound exam of your wrist to measure your carpal tunnel nerve and confirm your diagnosis.

Dr. Nelson is the first and remains the only orthopaedic surgeon in the Raleigh-Durham area to offer ultrasound-guided micro-invasive carpal tunnel release.

Are you interested in attending? Does someone you know or love have carpal tunnel syndrome and are avoiding treatment? Call 919-872-5296 to RSVP or visit www.DrNelsonCTR.com for more information.

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Call 919-872-5296 to RSVP or visit www.DrNelsonCTR.com for more information.

Free Scanning Open House at Bone & Joint Surgery Clinic – September 13th Read More »

traditional vs micro invasive ctr

What are the Different Types of Carpal Tunnel Release?

What are the Different Types of Carpal Tunnel Release?

Do you have carpal tunnel syndrome?

While it is important to be properly evaluated and diagnosed by a fellowship trained upper extremity specialist such as Dr. Nelson, symptoms of carpal tunnel syndrome include numbness and tingling in the thumb, index, and middle finger, “shaking out” of the hands either at night or during the day, pain, cramping or weakness of the hands, dropping objects, and frequently being awoken by the symptoms.

If you do have carpal tunnel syndrome, chances are if your symptoms are bad enough, you will benefit immensely from carpal tunnel release. When treated with carpal tunnel release in a timely manner, your sensation will improve, your strength will likely improve, your sleep will improve, and your overall quality of life will improve.

But there are different ways of performing carpal tunnel release.

Traditional Open Carpal Tunnel Release Incision

Traditionally, carpal tunnel release was performed in an open fashion. This means that an incision is made over the base of your palm that is 1 to 2 inches in length, and through this incision, your surgeon will release the tight tissues that are pressing on the nerve in your wrist. While this is a time tested approach, this method is more painful and requires increased healing time after surgery. The incision usually requires sutures, there will be redness and bruising, and more soreness around the area of the surgery. If you do heavier things either at home or at work with your hands, it may take more time, even up to 6 weeks, to get back to work and activities that require gripping and lifting.

From the standpoint of early healing, endoscopic carpal tunnel release has fixed some of

endoscopic carpal tunnel surgery pt1b
Endoscopic Carpal Tunnel Release Incision

these early healing problems. Endoscopic carpal tunnel release is performed through a very small incision at the end of your wrist, not on the palm, and does not require an incision over the palm skin. While final outcome and patient satisfaction is the same compared to open release after 3 months, endoscopic release helps patients to get back to full activities, gripping, lifting and working much sooner with less pain, stiffness, scarring, and soreness after the surgery.

But wait, it gets better!

Recently, new techniques have become available to perform carpal tunnel release without anesthesia, under ultrasound guidance through a very tiny “poke” incision in the wrist. This procedure has been termed “micro-invasive CTR,” and soon will be offered by Dr. Nelson.

Micro-Invasive CTR Incisions

A large percentage of the American population has carpal tunnel syndrome, and many of those patients have moderate to severe carpal tunnel syndrome. Unfortunately, many patients avoid carpal tunnel release because they feel they do not have the time to heal after surgery or they are afraid of the soreness and pain that is part of the healing process.

Micro-invasive CTR under ultrasound guidance is a new answer for these patients. This procedure does not require anesthesia, it does not require a tourniquet, and eventually it will be offered in the office setting, even on the same day that you see Dr. Nelson to talk about your symptoms and confirm your diagnosis.

Do you or someone you know or love suffer from carpal tunnel symptoms? Make a visit to see Dr. Johnny Nelson today to discuss your diagnosis and her treatment options. Microinvasive CTR may be the right treatment for you!

What are the Different Types of Carpal Tunnel Release? Read More »

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