We often take our hands and arms for granted. Few parts of the body get more voluntary use, and we simply expect these tools will do the job.
But when their function is impeded by pain, stiffness, numbness or injury, we are quickly reminded how important they are in our daily lives.
Many afflictions of the hand are temporary and heal on their own. It’s time to see a orthopedic hand specialist when the pain and symptoms are significant enough to impair your ability to perform normal activities, says local surgeon Dr. Steven Alter.
Patients experiencing these issues have access to three talented hand specialists in Dr. Alter, Dr. Kevin Tomany and Dr. Elizabeth Gennis, all affiliated with Circle Health and based in the Chelmsford area. Each physician is an upper-extremity specialist, which means they are experts in treating conditions from the shoulder down.
Some of the most common conditions these specialists see are arthritis, carpal tunnel syndrome, trigger fingers, tendinitis, fractures and strains.
Most of these conditions can be treated with medication, injections, physical therapy and/or bracing, Dr. Alter says. For those that require surgery, the procedures are largely done with minimally invasive techniques that require only local anesthesia, sending patients home that same day.
“A lot of people think (hand surgery) is more painful than it is,” Dr. Alter says. “We do a lot of surgery that doesn’t require a lot of pain medication. Patients are often moving right away, without immobilization or casting. We get them back to their activities as soon as possible.”
While some surgeries still require anesthesia, Alter now uses an injection of epinephrine that eliminates blood loss, allowing him to perform the procedure while a patient is awake and alert.
“During many surgeries I do, patients are talking and moving their fingers,” Dr. Alter says. “It has changed the way we operate in many cases, and has made the process much easier for patients.”
A common misconception of hand surgeons is that they just focus on the hands. While hands comprise the majority of the cases these orthopedic surgeons see, they also see patients dealing with elbow and shoulder pain and mobility issues.
One of the newest advances for these specialists is a new type of shoulder replacement surgery, Dr. Alter says. Though not common, some individuals will suffer from a rotator cuff tear that is accompanied by an arthritic joint, severely compromising the joint’s function. Previously, there was no good treatment for these patients.
Dr. Alter performs what is known as a reverse shoulder replacement that changes the biomechanics of the shoulder, resulting in decreasing pain and increased range of motion a week after surgery.
For a condition called basal joint arthritis, which causes pain at the base of the thumb, Dr. Tomany is a recognized expert in an advanced technique called wrist arthroscopy. Using a telescope rather than large incision, he is able to shave away bone to get the joint moving, with about half the recovery time. Dr. Tomany is now teaching the technique to fellowship students at Yale University.
“People today can’t afford downtime,” Dr. Tomany says. “The care we provide is something patients can have confidence in, and for follow-ups you can stay close to home.”