3 Signs You May Have Carpal Tunnel Syndrome

by TOI Admin February 10, 2017

By Rodger Powell, M.D.

Carpal Tunnel is the most common nerve compression in the upper extremity and one of the most common problems seen today by hand surgeons. Compression neuropathy as its name implies is a pressure applied to a nerve from any of a variety of reasons.

The signs of carpal tunnel can be varied, but the most common and classic findings are:

  • Numbness and tingling at night that often awaken you from sleep.  Patients also describe getting up and shaking their hands or "shaking them down by the bedside to restore circulation".
  • Numbness while driving, doing your hair, applying makeup, reading, writing, typing or any other repetitive motion.  Many times vibratory instruments such as chainsaws, weed eaters or motorcycle riding make it worse.
  • Pain radiating into the forearm and occasionally all the way to the shoulder, mimicking shoulder problems.

Diagnosis can be made by physical examination and/or neurological studies such as nerve conduction studies. Underlying diseases such as diabetes and thyroid problems need to be excluded as well. Non-surgical treatments include splints, nonsteriodal anti-inflammatory medications such as Advil and carpal tunnel exercises.

When choosing a hand surgeon the patient should consider the surgeon's qualifications including training, experience and board certification, as well as a certificate of added qualification in hand surgery.

Effects of Smartphones on our Fingers, Hands & Elbows

by TOI Admin December 6, 2016

By Rodger Powell, M.D.

Smartphones have become a lifestyle must have for most of us, from senior citizens to young children. These devices help us with learning, playing games, sharing stuff we like, liking stuff other people share, sending emails, watching videos and staying in touch with loved ones through video calls, voice calls and of course text. According to a recent study by Flurry, a digital analytics firm, the average person spends an about 2 hours and 57 minutes on their smartphone each day.

Although smartphones have made our lives easier, an increasing number of people have complained of finger, hand and elbow pain as a result of using their device. In non-medical terms, these conditions have been referred to as “text claw” and “cell phone elbow”.

So are smartphones really having a negative impact on the health of our upper extremities?

To find out, we asked Dr. Roger Powell, a board certified orthopedic surgeon, specializing in hand and elbow surgery.

In the last 10 years, have you seen a rise in your patients complaining of pain or injuries from using their smartphones?

Yes I have, an increasing number of patients complain of pain or come in with injuries as a result of using their Smartphone

What are the common complaints?

The most common complaint is pain or numbness in the hand—especially in the ring and pinky fingers.

Can you provide a percent estimate of the increase in patients with these conditions?

According to a survey by 02 (a mobile provider), in the last 5 years, forty three percent of smartphone users have experienced thumb pain and from my own experience I have noticed that its occurrence corresponds with the rise in the use of computer workstations and cell phones.

Have you heard of text clawor &cell phone elbow?

Yes I have, they are the popular names for cubital tunnel syndrome and carpal tunnel syndrome.

What are these and what are the actual medical terms for these conditions?

"Text Claw" is a non-medical term that describes all of the finger cramping and aching muscles that come from constant gaming, scrolling and texting on smartphones, the medical term for it is cubital tunnel syndrome. It can also be called "Cell Phone Elbow", described numbness or tingling in the ring and pinky fingers that occurs after when the elbow is bent for long periods of time.

Have you coined any non-medical terms for these complaints?

"Text Claw" and "Cell Phone Elbow" are actually non-medical terms

As recognized conditions, what are some of the symptoms of cubital tunnel syndrome?

The symptoms are numbness or pain or tingling in the little finger and on half of the pinky facing side of the ring finger. Those are fingers that their sensation is supplied by the ulnar nerve. The median nerve supplies the other fingers.

What are some of the symptoms of carpal tunnel syndrome?

The symptoms are tingling and numbness in the index, thumb and middle finger

How is cubital tunnel syndrome different from carpal tunnel syndrome?

The cubital tunnel; the nerve gets pinched back behind the elbow and gives you numbness in the small and ring finger, whereas Carpal tunnel gives you tingling and numbness in the thumb, middle and index finger. They are similar because it is pressure on the nerve, but there is a little difference in the anatomy. The pain and tingling are the nerve telling you that it is uncomfortable.

Do you think cell phone usage is to blame for cubital tunnel syndrome, carpal tunnel syndrome or any other medical condition of the fingers, hand, or elbow?

It's not actually caused by anything. There are hundreds of millions of people who use smartphones who are never symptomatic. Some people are born with a narrower cubital tunnel or a little extra muscle that not everyone has. A person with a predisposition to this problem may become symptomatic when the elbow is flexed beyond 90 degrees. That can happen at night when we sleep or when performing a task like talking on the cell phone. Cubital tunnel syndrome may be on the rise due to heavy cell phone use.

Do people have a predisposition to these conditions?

Yes they do, someone who gets this often has a predisposition to have the problem

What are some other conditions smartphone usage can cause?

Different types of Repetitive Strain Injury

Repetitive Strain Injury?

Repetitive strain injury is a term used to refer to discrete conditions that are associated with repetitive tasks, and sustained awkward positions. Its cause is related to the overuse of muscles and tendons in the upper body

When should someone see a doctor if they think they are experiencing any of these conditions?

I advise you do some hand and wrist stretches at the initial occurrence of pain or discomfort, if the pain persists for longer than a week then it may be time to see a doctor.

How is it diagnosed? Answer for cubital tunnel syndrome and carpal tunnel syndrome

Cubital tunnel: by observing and inspecting the forearm and the elbow, checking the strength of some specific muscles and by checking their griping and pinching through an elbow flexion test.

Carpal tunnel: by examining the neck region, checking wrist and hand range of motion and performing a wrist flexion test and some sensory tests.

How is it treated? Answer for cubital tunnel syndrome and carpal tunnel syndrome

Mild cases of cubital tunnel syndrome can be treated by keeping pressure away from the elbow, protecting the funny bone by wearing an elbow pad or wearing a splint to sleep to avoid over-bending the elbow. Surgery is performed where the nerve compression is so severe as to release the pressure on the ulnar nerve.

For carpal tunnel, wrist splinting, non-steroid anti-inflammatory drugs or corticosteroids may be used to relieve the pain, endoscopic or open surgery might be the way to go if severe.

How is it prevented? Answer for cubital tunnel syndrome and carpal tunnel syndrome

  • You could use a hands-free device or an earphone.
  • Reduce usage time
  • Constant positional changes
  • Use headsets when speaking on a smartphone
  • Heat/cold packs
  • Stretches 


Happy National Occupational Therapy Month!

by TOI Admin April 14, 2016

The month of April is designated as Occupational Therapy Month by the American Occupational Therapy Association to call attention to the important role occupational therapists play in patient care. Occupational therapists are part of an important profession to help patients participate in certain tasks they want and need to accomplish through the therapeutic use of daily activities. Occupational therapists focus on treatment to help develop, recover and maintain the daily skills of patients with specialized services and support. TOI would like to give a special thank you to its hand therapy staff at all of its locations! 


Hand | hand therapy

9 Facts About Bones

by TOI Admin March 1, 2016

Infographic courtesy of DailyRandomFacts.com


bones | Foot & Ankle | Hand

World Arthritis Day! #WADHigh5

by TOI Admin October 12, 2015

World Arthritis Day (WAD) is...

A global initiative bringing people together to raise awareness of issues affecting people with rheumatic and musculoskeletal diseases (RMDs). WAD is recognized every year on October 12!  

Did you know?

RMDs can affect people of all ages including children and babies and if not treated appropriately, daily activities such as walking, climbing stairs, cooking and personal hygiene and working are affected – reducing quality of life and impacting on physicalabilities[1],[2]

The prevalence of clinical anxiety and depression in those with RMDs is about twice that seen in the general population

Here's what YOU can do...

High 5 for World Arthritis Day’ forms part of the wider two-year World Arthritis Day campaign: 'It's in your hands, take action'. Our aim is to encourage people with rheumatic and musculoskeletal diseases (RMDs) along with their families and friends, carers, healthcare professionals, policy-makers, researchers and the general public to seize every opportunity to make a difference to the quality of life of people with RMDs. 

Take action by sharing virtual High 5s on social media until end of October. uSE #WADHigh5

[1]. 10 things you should know about rheumatic diseases fact sheet. EULAR. Available at: http://www.eular.org/myUploadData/files/10%20things%20on%20RD.pdf

[2]. Physical activities and exercises for people with RMDs fact sheet. World Arthritis Day. Available at: http://www.worldarthritisday.org/resources/documents/get-expert-advice-on-physical.pdf

Welcome to TOI's Blog!

TOI's Blog is dedicated to patient education with topics addressing current issues in health and medicine. We will also blog about some of our other favorite things, like community events, our wonderful employees, helping the environment and whatever else comes to our minds! We hope the information contained in our blog is fun to read, assists you in making educated decisions regarding your health, and supports your decision to select TOI when you are in need of quality musculoskeletal care.


«  May 2018  »

View posts in large calendar