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Expert hand, wrist, & elbow care at your fingertips

You’re tired of living with chronic hand, wrist, & elbow pain, but you want to avoid any unnecessary procedures. With access to the country’s best hand, wrist, & elbow experts, you can be on your way back to doing the activities you love.

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Feel completely confident in your journey toward hand, wrist & elbow health

Whether you need a second opinion or you’re just starting out, it’s time to work with a hand, wrist, & elbow specialist at Best In Class MD. Find your condition or recommended treatment below and see how we can help.

What is carpal tunnel syndrome?

The carpal tunnel is a narrow passageway on the palm-side of the hand that is surrounded by ligaments and bones. The median nerve, one of the major nerves within the hand, travels through the carpal tunnel. Carpal tunnel syndrome is marked by pain, numbness and tingling in the hand and arm, and is caused when the median nerve is compressed or pinched in the wrist. The orthopedic experts at BICMD can diagnose carpal tunnel syndrome and can offer expert advice and a second opinion about the treatment options available for your individual hand and wrist condition.

What causes carpal tunnel syndrome?

Carpal tunnel syndrome is when the tunnel that the median nerves travels through becomes narrowed and causes compression on the nerve. This can occur when the tissues, called synovium, surrounding the flexor tendons in the wrist, swell and narrow the space. In a healthy wrist, the synovium lubricates the tendons, making it easier to move the fingers. However, when the synovium swells, it crowds the nerve and places abnormal pressure on the median nerve. This creates numbness, tingling and weakness in the hand. Some of the most frequent health conditions that can cause the synovium to swell are:

  • Diabetes
  • Thyroid dysfunction
  • Trauma to the wrist or wrist fractures
  • Rheumatoid arthritis or other auto-immune diseases
  • Fluid retention

Carpal tunnel syndrome can also be caused by:

  • Repetitive hand motions which aggravate the tendons in the wrist
  • Hand positions that are extreme – over extension or flexion for long periods of time can increase pressure on the median nerve.
  • Heredity – It the carpal tunnel is more narrow than normal

What are the symptoms of carpal tunnel syndrome?

Individuals who have carpal tunnel syndrome report one or more of the following symptoms:

  • Numbness, tingling, burning or pain – often in the thumb, and fingers
  • Pain in the wrist, especially the palm-side
  • Pain that may travel up the wrist to the shoulder
  • Weakness when gripping objects
  • Stinging sensation, or feeling “pins and needles” in the fingers
  • Pain at night that interrupts sleep
  • Deep throbbing or ache in the wrist

How is carpal tunnel syndrome diagnosed?

The experts at BICMD will obtain a detailed medical history that includes the onset of symptoms and the severity of pain or numbness. An x-ray may be used to rule out bone abnormalities but are not used to diagnose carpal tunnel syndrome. Instead, our specialists may request an EMG (Electromyogram) that measures the amount of electrical activity in the muscle. An EMG will check for nerve and/or muscle damage. An ultrasound may be used to check the median nerve for signs of compression. Our doctors can offer a second opinion and can give expert advise for the type of treatment you should seek for the best possible outcome.

What is the treatment for carpal tunnel syndrome?

Non-surgical treatment:

  • Anti-inflammatory medication such as NSAIDs or ibuprofen to manage pain
  • Splinting – keeps the wrist from moving and eases the compression of the nerve
  • Work changes – discontinuing the same motions that cause pain, numbness or tingling
  • Strengthening exercises – should be supervised by one of our expert physical therapists
  • Corticosteroid injections

Surgical treatment:

We highly recommend a second opinion of your carpal tunnel syndrome before undergoing a surgical procedure. Our expertly trained physicians can explain the risk and benefits for the following possible surgical procedures:

  • Endoscopic Carpal Tunnel Release
  • Open Carpal Tunnel Release

 

For more information about carpal tunnel syndrome and the treatments available, or if you would like to receive an expert consultation about your hand and wrist pain, please contact our specialists, by clicking on “Get Started.” You will be connected to one of our orthopedic telemedicine experts through our state-of-the-art telemedicine platform.

Cubital Tunnel Syndrome is a condition that involves pressure or stretching of the ulnar nerve (also known as the “funny bone” nerve), which can cause numbness or tingling in the ring and small fingers, pain in the forearm, and/or weakness in the hand.

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What is Tennis Elbow (Lateral Epicondylitis)?

Lateral Epicondylitis is also called tennis elbow and is a painful condition caused by overuse. The repetitive motion of the forearm muscles and tendons can cause small tears in the tendons which surround the elbow area. These “micro-tears” cause inflammation and can lead to tenderness and pain felt on the outer side of the elbow. Tennis players are not the only individuals who can suffer from lateral epicondylitis. Plumbers, painters, butchers, and gardeners who all have the same repetitive arm motions can also have tennis elbow. An accident can also cause a tendon injury that does not heal and can make an individual more likely to develop lateral epicondylitis. Through our state-of-the-art telemedicine platform, the experts at BICMD can diagnose and offer the best treatment options for your lateral epicondylitis.

What are the symptoms of tennis elbow?

The symptoms of lateral epicondylitis include pain and tenderness on the outside of the elbow. Symptoms associated with tennis elbow are:

  • Tenderness and pain on the outside of the elbow
  • Pain when gripping an object
  • Pain when making a fist
  • Persistent ache, centered on the outside of the elbow joint
  • In some cases, pain that disrupts sleep

How is lateral epicondylitis diagnosed?

Through our telemedicine platform, our experts can diagnose lateral epicondylitis and can offer the best options for treatment. During a telehealth visit, the doctor will go over your medical history which will include the types of activities that caused your elbow pain. You will be asked to move your arm and elbow in different directions and to apply pressure to the arm and elbow. A few simple tests by our experts can help determine the severity of your tennis elbow.

When should I seek a second opinion for my tennis elbow?

Patients should seek a second opinion or consultation with one of our telemedicine experts at BICMD if they are experiencing the following with their lateral epicondylitis:

  • Pain or weakness when grasping items such as a pen or tennis racket
  • Difficulty carrying a purse or briefcase
  • Inability to shake hands without pain
  • Pain when turning a knob
  • Difficulty holding a coffee cup
  • Inability to pick something up with the palm facing downward

What is the treatment for tennis elbow?

Non-Surgical Treatment:

Most patients who are diagnosed with lateral epicondylitis or tennis elbow can be treated non-surgically with conservative methods. Depending on the severity, we may recommend one or more of the following:

  • RICE – Rest, Ice, Compression and Elevation to help relieve the symptoms of tennis elbow
  • NSAIDs – Non-steroidal anti-inflammatory drugs
  • Arm Brace – A specialized brace that protects the tendons and muscles
  • Physical therapy – Specific and specialized exercises can help alleviate symptoms
  • Corticosteroid injections
  • PRP – Platelet Rich Plasma

Surgical Treatment:

Lateral epicondylitis that is left untreated can cause long-term affects and may require surgery. A torn tendon in the arm can be repaired through arthroscopic surgery which is a minimally invasive technique.

Arthroscopic repair involves small incisions with small, specialized instruments and a camera called an arthroscope. This specialized repair offers less chance of infection, shorter recovery times and smaller incisions.

 

For more information lateral epicondylitis or tennis elbow, or if you would like to receive an expert consultation about your hand and wrist pain, please contact our specialists, by clicking on “Get Started.” You will be connected to one of our orthopedic telemedicine experts through our state-of-the-art telemedicine platform.

What is Golfer’s Elbow (Medial Epicondylitis)?

Medial Epicondylitis is the medical term for “golfer’s elbow”; it has also been called baseball elbow, forehand tennis elbow or suitcase elbow. Each name refers to a type of tendinitis that affects the inside of the elbow. Medial epicondylitis develops in the forearm muscles where the tendons connect muscle to the bony part on the inside of the elbow called the medial epicondyle. The tendons become damaged through repetitive micro-trauma, due to over-use. The irritated tendons then cause inflammation and pain. Repetitive motions which use the forearm muscles can cause medial epicondylitis. The experts at BICMD have extensive experience with diagnosing and treating medial epicondylitis and can offer the best treatment options through our state-of-the-art telemedicine platform.

How are medial epicondylitis and lateral epicondylitis different?

Both types of epicondylitis involve the elbow and pain that radiates into the forearm from overuse. The difference is which side of the arm the symptoms are occurring. In medial epicondylitis, or golfer’s elbow, pain is felt on the inside or medial side of the arm (toward the body). In lateral epicondylitis, pain is felt on the outside of the elbow and arm, on the lateral side. The causes of golfer’s elbow or tennis elbow are the same; microtrauma to the tendons. The difference is where the microtrauma is occurring and where on the arm and elbow the symptoms are experienced from the irritated tendon.

What are the symptoms of golfer’s elbow or medial epicondylitis?

Individuals who experience medial epicondylitis often report the following symptoms:

  • Pain along the palm-side of the forearm
  • Pain when squeezing a rubber ball
  • Stiffness in the elbow
  • Pain and tenderness on the inside of the elbow
  • Weakness in the wrist or hand
  • Numbness or tingling in the fingers, especially the ring finger and little finger

How is medial epicondylitis diagnosed?

The orthopedic specialists at BCMD will conduct a thorough review of the patient’s medical history and symptoms through their state-of-the-art telemedicine platform. They will ask about daily activities, the onset of symptoms and recent injuries. The doctor may ask the patient to apply pressure to the affected areas and to move the fingers, wrist and arm in different directions. If further injury is suspected, they may order an MRI or x-ray to fully assess the elbow, arm, ligaments and tendons.

How is golfer’s elbow or medial epicondylitis treated?

Medial epicondylitis is usually treated conservatively without surgical intervention. The experts at BICMD may prescribe the following:

  • RICE – Rest, Ice, Compression, Elevation
  • NSAIDs – Non-steroidal anti-inflammatory Drugs
  • Physical Therapy
  • Brace – Such as a counterforce brace for the forearm
  • Corticosteroid injections

Will I need surgery for medial epicondylitis or golfer’s elbow?

Surgery for medial epicondylitis is rare and is only recommended if the tendon has torn from the bone. The surgical procedure to reattach the tendon can be done arthroscopically; a minimally invasive surgery that involves a small camera and small, specialized instruments that complete the repair within the elbow.

 

For more information medial epicondylitis or golfer’s elbow, or if you would like to receive an expert consultation about your hand, wrist or elbow, please contact our specialists, by clicking on “Get Started.” You will be connected to one of our orthopedic telemedicine experts through our state-of-the-art telemedicine platform.

A broken, or fractured, finger occurs when one or more of these bones breaks. A break is usually the result of an injury to the hand. A fracture can occur in any of the phalanges. Fractures can also occur in your knuckles, which are the joints where your finger bones meet.

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Can arthritis occur in the hand and wrist?

The term “arthritis” means inflamed joint. Arthritis can occur in any joint in the body and can occur in the hand and wrist. The wrist and the hand have the highest concentration of joints in one area in the body. When healthy, the bones are protected by a smooth cartilage that allows them to glide easily over each other during movement. If the protective cartilage is damaged, a bone-on-bone event can occur, causing inflammation and eventually, arthritis. Stiffness and pain are common symptoms of arthritis as well as swelling in the joints. The orthopedic experts at BICMD can diagnose hand and wrist arthritis through a state-of-the-art telemedicine platform. They can offer the best treatment options for your form of arthritis.

What are the types of hand and wrist arthritis?

There are many types of arthritis, any of which can affect the wrist and hand. The severity of symptoms can vary, even from one hand or wrist to the other. The most common types of arthritis that can affect the hand and wrist are:

  • Osteoarthritis – Often referred to as “Wear-and-tear” arthritis. Over time the cartilage breaks down due to use or age and the protective space decreases between the bones.
    • Kienböck’s disease – A specific kind of wrist osteoarthritis caused by a disruption of the blood supply to one of the carpal bones. Overtime the bone can die and collapse, causing arthritis in the joints around the carpal bone.
  • Rheumatoid Arthritis – An autoimmune disease that affects multiple joints throughout the body. Rheumatoid arthritis often starts in smaller joints like the hand and wrist.
  • Posttraumatic Arthritis – This type of arthritis can develop over years after an injury. The trauma to the wrist or hand can cause damage to the cartilage and can change the way the bones move against each other. Injured joints are more likely to become arthritic over time.

What are the symptoms of arthritis in the hand and wrist?

  • Pain in the hand and/or wrist that can be a dull ache or severe
  • Stiffness
  • Weakness in the joint
  • Swelling
  • Limited range of motion
  • Crepitus – or a cracking, grinding sound upon movement

How is arthritis of the hand and wrist diagnosed?

Through our telemedicine platform, our experts can diagnose your hand and wrist arthritis and can offer a comprehensive treatment plan based on your individual condition. Our “best in class” orthopedic specialists will begin with a thorough health history and ask you to describe your symptoms. X-rays are often part of the diagnosis process and will show the doctor the exact location and severity of the arthritis. If Rheumatoid arthritis is suspected, a blood test will be requested. Other diagnostic testing may be ordered, depending on your specific symptoms.

What is the treatment for hand and wrist arthritis?

Arthritis in the hands and wrist is often chronic and does not get better over time. There are treatment options available however, that help many people manage the progression on arthritis. Options for treating arthritis in the hands and wrist may include:

Non-surgical treatment:

  • Activity modification – Discontinue repetitive motions which may contribute to painful symptoms
  • Splint or brace – Temporary restriction of movement can help decrease inflammation
  • Medications – NSAIDs or other medication can be used for pain and to decrease swelling.
  • Hand or wrist injections – Have been shown to help with inflammation and pain
  • Occupational therapy – Specific exercises to help your type of arthritis
  • Hot and cold therapy

Surgical treatment:

If non-surgical methods have failed to alleviate pain and hand or wrist arthritis is affecting your quality of life, there are surgical treatments available. The goal of surgery for hand and wrist arthritis is to alleviate pain and improve hand function. Our experts can explain the surgical procedures and how they may help your individual condition. Some surgical treatments may include:

  • Fusion – fuses the bones together and prevents painful rubbing of bone-on-bone
  • Proximal row carpectomy – Three small bones are removed near the wrist, which reduces pain and maintains wrist motion.
  • Wrist Arthroplasty or total wrist replacement – replaces the arthritic joint with a new, synthetic joint

 

For more information about arthritis of the hand and wrist, or if you would like to receive an expert consultation about your hand, wrist or elbow along with the best treatment options designed for you, please contact our specialists, by clicking on “Get Started.” You will be connected to one of our orthopedic telemedicine experts through our state-of-the-art telemedicine platform.

The 27 tiny bones in the hand undergo a lot of stress and strain in our daily lives, which makes them prone to fractures. The small bones of the fingers, called phalanges, and the long bones that run across the palm, called metacarpals, are often broken by falls, accidents, and athletic activities. Most hand fractures do not require surgery, though on occasion, surgery will be necessary if the break is complex. Usually, treatment for a broken hand includes wearing a cast or splint.

For more information about hand and upper extremity fractures, or if you would like to receive an expert consultation about your hand, wrist or elbow along with the best treatment options designed for you, please contact our specialists, by clicking on “Get Started.” You will be connected to one of our orthopedic telemedicine experts through our state-of-the-art telemedicine platform.

Dupuytren’s contracture is a slow-developing hand deformity characterized by the permanently bent position of the fourth and fifth fingers. Dupuytren’s contracture is caused when knots form in the tissue under the skin of the palm, which eventually pulls the fingers out of position.

For more information about Dupuytren's disease, or if you would like to receive an expert consultation about your hand, wrist or elbow along with the best treatment options designed for you, please contact our specialists, by clicking on “Get Started.” You will be connected to one of our orthopedic telemedicine experts through our state-of-the-art telemedicine platform.

De Quervain’s Tenosynovitis is a condition that’s also referred to as “mother’s thumb” or “gamer’s thumb.” This condition causes extreme pain in the vicinity of the wrist and thumb. De Quervain’s Tenosynovitis is caused by the repetitive use of the hands and wrist.

For more information about De Quervain's disease, or if you would like to receive an expert consultation about your hand, wrist or elbow along with the best treatment options designed for you, please contact our specialists, by clicking on “Get Started.” You will be connected to one of our orthopedic telemedicine experts through our state-of-the-art telemedicine platform.

Trigger finger is a condition in which a finger is stuck in a bent position. Trigger finger is also known as stenosing tenosynovitis, and it is caused by a narrowing of the sheath that covers the tendon in the affected finger. People with diabetes or those who do repetitive gripping motions are more likely to develop trigger finger.

Total elbow replacement is a joint replacement procedure that helps people regain the range of movement after elbow osteoarthritis or injury severely damages their elbow joint. Three bones make up the elbow joint, the ulna, humerus, and radius. In total elbow replacement, the damaged parts of the ulna and humerus are removed and replaced with a metal and plastic hinge.

This list contains some of our most commonly seen conditions, but it is by no means exhaustive. Our hand, wrist, and elbow doctors handle the same wide variety of conditions that an in-person physician would.

No one should have to live with hand, wrist, or elbow pain. Today’s advancements in orthopedic care have made it possible for many to live a pain-free life while maintaining full function.  A consultation with one of our experts is the first step on your path to recovery. Let us discuss the options that will work for you and your specific issue.  Our physicians are committed to helping you feel better.

Click on “Get Started” to reach one of our orthopedic telemedicine experts.

Best in Class Hip Specialist

  • Charles Goldfarb, MD
    • Chief of Pediatric and Adolescent Orthopedic Surgery
    • Executive Vice Chair, Department of Orthopaedic Surgery
  • David Altchek, MD
    • Chief Emeritus of the HSS Sports Medicine Institute
    • Medical Director for the New York Mets (MLB)

Before my BICMD consultation, I didn’t fully understand my treatment options. During my virtual visit, I was offered multiple treatment options with advantages and disadvantages for each. I am confident that I chose the right treatment option for me.

-Katie Hogan

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