Specialized Care for Hands and Wrists from an Expert

Whether you need relief from carpal syndrome or an arthritic thumb, you’ll receive advanced care from Dr. Joshua Thomas. He’s a fellowship-trained shoulder surgeon who also treats hand and wrist conditions at Glacial Ridge Center for Surgical Care.

Specialized care is essential because the hand and wrists are complicated parts of the human anatomy. They consist of 27 bones and joints and over 100 ligaments.

Healing Without Surgery

Before considering surgery for a patient, Dr. Thomas exhausts non-surgical options, like pain medication, occupational therapy, splints, braces, and icing.

Hand and Wrist Surgical Services

Dr. Thomas provides relief to his patients through 9 different procedures:

• Carpal Tunnel Release
• Basal Joint Arthroplasty, LRTI for Thumb Arthritis
• Dorsal Compartment Release
• Cubital Tunnel
• Tendon Repair
• FCR Tendonitis
• Trigger Finger Release
• Ganglion Cyst Excision
• Fractures

Carpal Tunnel Release

Carpal Tunnel Syndrome is the most common hand condition that affects 1 to 5% of the population. It’s three times more prevalent in women than men. It affects your thumb and first three fingers with numbness, tingling, burning, and pain. It often interferes with daily activities, like typing at a computer keyboard, gardening, or grasping a tennis racket.

When It’s Time for Surgery

The carpal tunnel diagnosis and its severity are confirmed by a test that measures the response of your muscles to a mild electric stimulation called an EMG. The test takes about 40 to 60 minutes.

In mild cases, or if caught early enough, you can wear a wrist brace, ice the affected area, elevate the wrist with a pad while using a computer, or receive steroid injections. “If it’s not better in a year, you need to see me,” says Dr. Joshua Thomas.

Tip: Wearing a wrist brace for carpal tunnel syndrome while sleeping can help alleviate symptoms at night.

Inside the Carpal Tunnel

The carpal tunnel in your wrist is formed by three bones on the bottom and sides of the wrist and a tendon that stretches over the back of the hand. The median nerve passes through this tunnel. When the tunnel becomes inflamed, it presses on the nerve, creating the numbness, tingling, and weakness you experience.

The surgical solution is to relieve the pressure on the nerve by making a small incision in the palm of the hand near the wrist and dividing the transverse carpal ligament.

The procedure is usually conducted under local anesthesia and mild sedation and takes about 15 to 60 minutes. The recovery period is typically two weeks, depending on the severity of your case.

Basal Joint Arthroplasty (Thumb Arthritis)

Basal joint arthritis can take your thumb out of action. It happens when the cartilage at the end of the two bones at the base of your thumb wears out. They rub together, causing friction, a deep, aching pain, and a loss of gripping strength. You’ll notice it when you grasp or pinch objects, like opening a jar, playing a musical instrument, or emptying the dishwasher. It’s a very common type of arthritis, and many patients recover with only steroid injections and physical therapy.

More severe cases require a surgical procedure to repair the joint. It’s called LRTI (ligament reconstruction and tendon interposition). Tissue is taken from inside the hand and inserted between the joints to act as a cushion.

During recovery, you’ll wear a splint for two weeks and a cast for three to four weeks, and undergo hand therapy to regain motion and function in your thumb. The entire healing process can take two to three months.

First Dorsal Compartment Release­­ – Tendonitis

If moving your thumb or grasping objects is painful, you may have de Quervains tendonitis. Symptoms include numbness, weakness, or pins and needles caused by the inflammation of the wrist tendons at the base of the thumb. Dr. Thomas estimates that 60 to 70% of these patients can recover with a steroid shot and physical therapy.

In de Quervains tenosynovitis (tendonitis), the tendon rubs against the tissue surrounding it, which is called the sheath. The surgical procedure creates more room for the swollen tendons by making an incision in the sheath to release the pressure. The surgery is usually done under local anesthesia to numb your hand and prevent pain.

During recovery, you’ll wear a brace for 1 to 2 weeks, and it will take 6 to 12 weeks for your hand to heal completely.

Why You Should See a Surgeon Now

In most hand and wrist conditions, non-surgical options are available to patients with mild to moderate cases. If you’re experiencing tingling, numbness, or pain in your hands or wrist, please make an appointment today.