Carpal tunnel syndrome is one of the most common conditions in my practice today. Early symptoms include off and on numbness and tingling in the fingertips.  In severe cases burning pain and weakness may develop in the hand. These symptoms are from compression of the median nerve at the wrist. Frequently, patients complain of numbness that wakes them up at night.  For relief, patients frequently have to shake their hands or hang their hand off the bed to get rid of the numbness.  Numbness and burning pain can also be experienced when driving, writing, using a computer, power tools or lawnmower.  

As the problem progresses, patients may experience constant numbness weakness and atrophy of the muscles of the hand. Treatment is most successful prior to this progression. Treatment may initially consist of night time splinting. Injections may help with diagnosis and provide temporary relief from burning pain. 

Ultimately, surgery may be necessary to relieve the pressure off of the nerve. Whether the procedure is done open, mini open or endoscopically the ultimate goal is to release the roof of the tunnel, called the transverse carpal ligament. Recovery gently consists of wearing a dressing for 3 to 5 days followed by switch removal at two weeks and a gradual return to full activity. 

Trigger fingers can affect any finger including the thumb.  Initially patients may experience pain, but as the trigger finger progresses they may experience clicking followed by locking and ultimately the digit may lock down.  The underlying problem is that one of the tendons of the finger has difficulty passing through the A1 pulley.  

Treatment initially starts with anti-inflammatories and nighttime splinting. If this fails further treatment may consist of injections which have the potential to cure the problem. Ultimately, if the problem is not cured after one or two injections, a trigger finger release maybe offered.  

Multiple trigger fingers may exist at the same time and people may develop other trigger fingers after successful treatment of one trigger finger. 

Thumb arthritis is a very common condition and frequently interferes with daily activities such as; gripping objects, opening jars, pinching and heavy grasp.  Patients experience pain at the base of the thumb and can have a characteristic shoulder sign in which the thumb metacarpal base has a dorsal prominence. Initial symptomatic treatment options for thumb arthritis include anti-inflammatories, splints and injections. 

Ultimately, if non-operative treatment fails, thumb CMC arthroplasty may be beneficial to improve function and decrease pain.