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Inflammation of tendons in the 1st dorsal compartment of wrist. Usually occurs in people with repeated thumb movements. Treatment for early symptoms, include Rest/ Local cold pack application/ Anti-Inflammatory medications. Although, Intralesional steroid injections have been advocated as an option, if the first line treatment fails.
Resistant cases may require a surgical release. This procedure is usually done under local anesthesia. However, If the patient is apprehensive, sedation or short GA may be preferred.
A gelatinous fluid filed, cystic swelling, usually on the dorsum or volar aspect of wrist (sometimes elsewhere). The swelling tends to enlarge in size after repeated movements at the wrist or hand. May become painful sometimes due to pressure on adjacent structures.
The Ganglion cysts in large majority of patients, doesn't pose a significant health risk. However, any swelling which is persistently enlarging in size, or becomes painful should be excised, and tissue sent for histo-pathology evaluation. It is important to excise the swelling right to the tail connecting it to the joint, otherwise case of recurrence have been reported.
Aspiration of ganglion cysts is commonly performed, however there is high chance of recurrence.
RESISTANT TENNIS ELBOW THERAPY
Tennis Elbow can be a menacing problem for patients involved in outdoor and sports activity. A lot of treatment options are available with variable results.
Tennis elbow splint/ Local Ultrasonic therapy/ Intra-lesional steroids/ Surgery- All of them have some advantages and dis-advantages. A new treatment modality of Platelet rich plasma has also been advocated.
Before offering a particular treatment to the patient, careful analysis of the underlying factors is required. An informed decision making is mandatory.
CARPAL TUNNEL DECOMPRESSION SURGERY
Carpal Tunnel syndrome develops as a result of the compression of Median Nerve under the transverse carpal ligament at wrist. Common symptoms include, numbness, and paresthesia in the radial digits.
Diagnosis can be easily made by Nerve conduction studies.
Early cases may respond to steroid injections, however success results may vary. In long-standing cases, or those with evidence of neurologic deficit, Surgery is the treatment of choice.
Carpal tunnel decompression can be performed under local anesthesia, under day care settings. Patients can perform most of their activities on the same day, and can resume light office work by next day.
FROZEN SHOULDER TREATMENT
Adhesive Capsulitis of Shoulder causes global restriction of movements, and can be very painful. It causes severe limitation of activity for the patient. Although, most cases of Frozen Shoulder resolve by themselves, the prolonged illness duration causes significant morbidity in an active individual.
At this clinic, we believe in treating such patients aggressively, to regain productive life earlier.
The standard protocol consists of a team approach involving the Orthopedic and a physiotherapist. The patients remain under direct supervision of the treating doctor, to improve compliance and ensure better results.
PLANTAR FASCITIS TREATMENT
A variety of factors can precipitate a recurrent pain in the heel region.
Footwear modification/ Insoles/ Ultrasonic therapy/ Stretches/ Contrast bath - All have limited role. They offer relief to 60- 70 percent of patients.
Resistant cases require Intra-lesional injections. Platelet rich plasma (PRP) has also been used with good success in some research series. Cost- benefit analysis MUST be done, before undertaking such treatment.