Carpal Tunnel Syndrome

by Dr. Glenn Johnson - Posted on Apr 24, 2019

What is Carpal Tunnel Syndrome?

Picture this – you wake up in the middle of the night to a painful numbness or tingling in your hand. At first you think your hand is just asleep but this sensation doesn’t go away. If this is something you have experienced, you might be dealing with Carpal Tunnel Syndrome.

Carpal Tunnel Syndrome is a condition that affects the nerve of your wrist. This can cause pain, numbness, and tingling in your hand. This condition affects the thumb, pointer, middle, and part of the ring finger.


The cause of Carpal Tunnel Syndrome is inflammation of the nerve at the wrist. The inflammation causes swelling of the nerve in a confined space which results in increased pressure on the nerve. This pressure causes the nerve dysfunction. Nerve dysfunction leads to the numbness and tingling sensation that people experience. There is no single cause that leads to Carpal Tunnel. However, one of the most common causes is repetitive movement.


  • Pain, numbness, tingling in the hand
  • Pain waking you up at night
  • Hand feels “dead”
  • Shaking hand to “wake it up”

Carpal Tunnel symptoms usually start gradually and are most commonly aggravated by repetitive movement. Stages vary from mild to moderate to severe Carpal Tunnel, all of which will result in different treatment options.

Carpal Tunnel Examination

This process usually begins with an evaluation of the hands to determine where the numbness is. Next, the arm would be examined to ensure there are no associated conditions (pinched nerve at elbow and wrist is common). After examining the hand and arm, an evaluation of the nerves in the neck are done to rule out any other potential problems.

The next step of the Examination includes Diagnostic Testing. This can be done one of two ways, Nerve Conduction Study or Ultrasound exam. Nerve Conduction Study tells how well the nerves are functioning in the wrist/arm and also can tell the severity of Carpal Tunnel Syndrome.


The ultimate goal is to avoid surgery if possible. Depending on the severity of the Carpal Tunnel, there are some Non-Operative Treatment options available. Some of these treatment options for mild to moderate Carpal Tunnel include:

  • Bracing
  • Therapy
  • Medicine
  • Steroid Injections

Although Steroid Injections are a possible treatment, studies show that nearly 90% of patients will have their symptoms return after a years’ time. For severe Carpal Tunnel, these non-operative treatments will simply not work. Surgery is the best option for those with severe Carpal Tunnel.

If you believe you are suffering from Carpal Tunnel Syndrome, schedule an appointment with one of our Hand, Wrist, Elbow specialist.

Treating orthopedic conditions, including sports injuries and arthritis, with regenerative therapies such as Stem Cell Therapy and Platelet Rich Plasma (PRP) is becoming more mainstream.

Peyton Manning reportedly traveled to Europe in 2011 for stem-cell therapy to treat a neck injury while playing for the Colts (Manning has not publicly acknowledged this).  Andrew Luck also reportedly received PRP and stem cell therapy in 2015 to treat a shoulder injury.  The truth is, that stem cell therapy has been widely used by elite athletes for quite some time.  Hundreds of NFL players have been treated with stem cell therapy as reported in Sports Illustrated.  The magazine noted on how running back Chris Johnson was treated with stem cells from his bone marrow to rebuild his cartilage after a knee injury.

“Stem Cell Therapy and PRP—-not just for professional athletes”


Tri-State Orthopaedics recently celebrated the career of Dr. James M. Heinrich and the many years of devotion to his patients. Dr. Heinrich has been with Tri-State since January 1978 specializing in joint replacement, arthroscopy of the knee and shoulder, and ACL reconstruction. The relationship side to medicine is what gave Dr. Heinrich a profound sense of satisfaction. He always approached the field of medicine with a patient-centered mindset. In his words, “My promise to my patients is to treat them as I would want to be treated or as I would treat a member of my family.” The patients and staff cannot thank Dr. Heinrich enough for his 40 plus years dedicated to TSOS.


On behalf of the Tri-State family, we wish Dr. Heinrich a very happy retirement. We will miss you dearly!

Plantar Fasciitis

by Dr. Paul Daines - Posted on Dec 5, 2018

Plantar fasciitis is characterized by inflammation and/or thickening of the band of tissue (plantar fascia) that extends from the heel to the toes. Oftentimes, patients have many questions regarding this common cause of heel pain. What leads to plantar fasciitis? Are there prevention techniques? If pain is already present, what treatment options exist? With so much information at our fingertips, it can be difficult to differentiate between tried and true methods and common misconceptions. Continue reading to learn more from one of our board certified podiatrists, Dr. Paul Daines.

“Plantar Fasciitis”