By: Dr. John Fatti, SOS Hand & Wrist Doctor
Being a practicing Hand Surgeon for 29 years, I have seen many, many different conditions affecting the hand. Today, I'll talk about the most common one and one that is really rare. The most common one is carpal tunnel syndrome (CTS)- everyone knows something about that! But, did you know that it happens much more commonly in women? Did you know that the symptoms mostly begin - at night? Waking up from sleep having to shake the numbness out of your hand to return to sleep is THE MOST COMMON PRESENTING SYMPTOM of CTS.
It can be caused by repetitive work conditions (especially keyboarding). But did you know that , by far, the majority of CTS patients do not work? Carpal tunnel syndrome eventually causes increasing numbness in your thumb, index, and middle fingers. Then the numbness becomes constant. Then you start to have your hand feel weak. You drop things inexplicably.
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CTS is diagnosed through a physical exam and a Nerve Conduction Study(NCS). Did you know that the NCS doesn't hurt? If the test says it's severe - then you need surgery. If the test says it's mild or moderate, did you know that we TREAT YOU WITHOUT SURGERY? Did you know that 85% of the CTS patients I see in the office are made better WITHOUT SURGERY?
The surgery these days is fairly noninvasive - one way to do it is through an endoscope that is placed through a 1 centimeter cut in the wrist, and the carpal ligament is released from the inside! No need to cut through the skin, and the muscle, to get to the ligament to cut it. Depending upon your job, you can be back at work rather quickly!! However, before you are doing push-ups, or water skiing - it's about 6 weeks.
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The rarely seen thing that I want to talk about is something I have NEVER SEEN! That is - problems with cracking your knuckles! "Doc, am I doing something harmful if I crack my knuckles a lot?" I get asked that question frequently because of my job - usually at parties, at the grocery store, etc. What actually is that snapping sound when one cracks their knuckles? I did some research into this. When someone hyperflexes or hyperextends their knuckles, they create negative pressure within their joint spaces. That causes the nitrogen molecules in the liquid form inside the joint to actually become gaseous - and those gas bubbles actually POP - thus causing the noise that you hear. There are no scientific studies that have ever been published linking popping nitrogen bubbles in your finger joints with deleterious effects (arthritis) on those joints.
In closing: be careful and take care of your hands! Keep them where they belong and where they are SAFE! It has been written that 25% of all Emergency Room visits are some form of hand trauma !!