Cases of Carpal Tunnel Syndrome are on the rise thanks in part, to our excessive use of technology – particularly smartphones, tablets, and computers – often on a daily basis. Carpal Tunnel Syndrome is a common condition that causes pain, numbness, and tingling in the hand and wrist when the median nerve (one of the main nerves to your hand) becomes compressed as it travels through the wrist and palm. Fortunately, there are treatments that can alleviate the condition.
Dr. David Holt is a Board-Certified Orthopedic Surgeon who practices at the Salt Lake Orthopedic Clinic, located at MountainStar Healthcare’s St. Mark’s Hospital. Dr. Holt joined FOX13’s The PLACE on Tuesday to discuss treatments for Carpal Tunnel Syndrome – surgery and non-surgery – offered at the Millcreek facility. Dr. Holt says surgery is not the only answer.
“The decision between surgery and non-surgery sometimes can be a very easy decision, depending on your specific injury, complaints, symptoms and diagnosis. But oftentimes, it really involves understanding your goals and expectations. What are the risks and benefits of a surgery versus a non-surgical treatment? Developing a treatment plan that really makes sense for an individual patient is the best way to move forward,” Dr. Holt explained.
Dr. Holt specializes in the treatment of hand and upper extremity pathology including pediatrics, adolescents, and adults of all ages. Treating a wide range of upper extremity conditions such as sports injuries, acute trauma, arthritis, and nerve compression, Dr. Holt aims to provide the most up to date, evidence-based treatment for each individual patient.
Dr. Holt completed a subspecialty fellowship in hand and upper extremity at University of Florida in Gainesville. He earned his medical degree at University of Tennessee Health Science Center and completed an orthopedic surgery residency at University of Utah.
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According to the American Academy of Orthopaedic Surgeons, most cases of Carpal Tunnel Syndrome are caused by a combination of factors. Studies show that women and older people are more likely to develop the condition. Other risk factors include:
· Heredity. This is likely an important factor. The carpal tunnel may be naturally smaller in some people, or there may be anatomic differences that change the amount of space for the nerve — and these traits can run in families.
· Repetitive Hand Use. Repeating the same hand and wrist motions or activities over a prolonged period of time may aggravate the tendons in the wrist, causing swelling that puts pressure on the nerve.
· Hand and Wrist Position. Participating in activities that involve extreme flexion or extension of the hand and wrist for a prolonged period of time can increase pressure on the nerve.
· Pregnancy. Hormonal changes during pregnancy can cause swelling that results in pressure on the nerve.
· Health Conditions. Diabetes, rheumatoid arthritis, and thyroid gland imbalance are all conditions that are associated with Carpal Tunnel Syndrome.
Treatment Options for Carpal Tunnel Syndrome
There are several options available that can be used to treat Carpal Tunnel Syndrome.
“I do a lot of procedures in office, which is cheaper and easier for patients,” Dr. Holt said. “Everything from activity modification and therapy to bracing or splinting may be offered. Steroid injections – corticosteroid, or cortisone – are powerful tools made up of anti-inflammatory agents that can be injected into the carpal tunnel to relieve painful symptoms or help to calm a flare-up.”
Carpal Tunnel Release surgery is usually the last treatment after attempting non-surgical treatment.
“It’s a great surgery for most people with great outcomes,” Dr. Holt added.
Endoscopic Carpal Tunnel Release (ECTR) is a minimally invasive surgical procedure that treats Carpal Tunnel Syndrome by relieving pressure on the median nerve in the wrist. During ECTR, the transverse carpal ligament is cut. This releases pressure on the median nerve and relieves Carpal Tunnel Syndrome symptoms.
Dr. Holt performs both ECTR and Open Carpal Tunnel Release Surgery, depending on patient preference. Open surgery is a procedure where the surgeon makes a 2-inch incision in the palm of the hand, cuts the transverse carpal ligament, then closes the skin with stitches.
“After surgery, you should expect some pain, swelling, and stiffness. Most patients can return to light work (computer/desk work) within a few days, but it will often take 6-8 weeks to return to more demanding work (labor, construction, etc.),” Dr. Holt said. “Grip and hand strength usually come back within 2-3 months after surgery, but it can take 12-18 months to fully recover and obtain maximum improvement.”
Many patients obtain quick and complete relief of the symptoms.
Additional Conditions Treated
Dr. David Holt performs most hand and upper extremity surgery, also including trigger finger release, hand/thumb and wrist arthritis surgery, fracture care/surgery, distal biceps repair and many others. He is available to see new patients – oftentimes with same day or next day appointments.
Common Hand/Upper Extremity Conditions Treated by Dr. Holt include:
· Cubital Tunnel Syndrome
· Trigger Finger
· Dupuytren’s Contracture
· DeQuervain’s Tendonitis
· Thumb Arthritis
· Hand Arthritis
· Wrist Arthritis
· Elbow Arthritis
· Ganglion Cysts
· Digital Mucous Cysts
· Skier’s Thumb/UCL Injury
· Finger/Hand Fractures
· Distal Radius Fractures
· Scaphoid Fractures
· Forearm/Elbow Fractures
· Humerus Fractures
· Clavicle Fractures
· Elbow Instability/Dislocation
· Flexor Tendon Lacerations
· Extensor Tendon Lacerations
· Distal Biceps Tear
When you have a hand and/or upper extremity condition, such as wrist pain or a worn shoulder joint, the orthopedic specialists at MountainStar Healthcare hospitals are here for patients. Dr. Holt and other orthopedic specialists can help.
Salt Lake Orthopedic Clinic at St. Mark’s Hospital
1160 East 3900 South Suite 5000
Salt Lake City, UT 84124
Phone: (801) 261-7479
MountainStar Healthcare understands how chronic pain in the hand or any part of the arm can negatively affect quality of life. That is why the health system provides comprehensive hand and upper extremity care, ensuring patients receive the right treatment.
If you want to learn more about hand and upper extremity care at St. Mark’s Hospital or MountainStar Healthcare, click here or call (855) 796-0593.
For more information about the clinic, visit SaltLakeOrthopedics.com.
St. Mark’s Hospital is one of eight MountainStar Healthcare hospitals in Utah.
