Hand surgery in Portland, OR
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What Causes Carpal Tunnel Syndrome?
Studies show that women and older people are more likely to develop the condition. This condition is also common in patients who type or use computers repeatedly, since these motions can put constant pressure on the important nerve that runs from the hand and through the wrist. This condition can arise from swelling in the area due to repeated movements.
Other risk factors for carpal tunnel syndrome include:
- The carpal tunnel may be 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. Doing activities that involve extreme flexion or extension of the hand and wrist for a prolonged period of time can increase pressure on the nerve.
- Hormonal changes during pregnancy can cause swelling.
- Health conditions. Diabetes, rheumatoid arthritis, and thyroid gland imbalance are conditions that are associated with carpal tunnel syndrome.
Why Choose Dr. Hetal Fichadia?
Choosing the right surgeon is just as important as choosing the right procedure. Dr. Hetal Fichadia is a double board-certified plastic surgeon with over a decade in private practice. Her philosophy is rooted in respect, patient education, and individualized care. With Dr. Fichadia, you’ll feel seen, heard, and safe—every step of the way.
Here’s what sets her apart:
- A surgeon who listens: Dr. Fichadia takes time to understand your story, your body, and your goals. She is your guide—not just your surgeon—through every step of the process. Her commitment to honest guidance, patient education, and comfort has led her peers to name her a Portland Monthly Top Doctor every year since 2018.
- Woman-to-woman care: As one of the few female plastic surgeons in Portland, Dr. Fichadia offers a rare level of empathy and understanding, particularly for women navigating changes from pregnancy, aging, or weight fluctuations.
- Holistic support: Surgical care doesn’t end when the sutures are placed. Dr. Fichadia and her team offer extensive pre-op education, nutritional guidance, and long-term follow-up care.
What Happens During The Carpal Tunnel Procedure?
Carpal tunnel can sometimes be managed with lifestyle changes and the use of anti-inflammatories or a brace. However, if these steps haven’t been working for you, a surgical technique can be used to release the transverse carpal ligament, which can eliminate the pressure on the nerve. After you have had your initial consultation with Dr. Fichadia, she will then decide if you are in need of carpal tunnel release surgery and which type she will decide to use. There are two ways of doing carpal tunnel release – open technique and endoscopic (minimally invasive) technique. Both techniques have similar outcomes at one year. The benefit of using an endoscopic technique is that it is less invasive with a faster recovery period. During this endoscopic surgery, Dr. Fichadia will cut or “release” the transverse carpal ligament. This eliminates the pressure on the median nerve and therefore relieves the painful symptoms of carpal tunnel syndrome.
Carpal Tunnel Surgery Results and Recovery
When using an endoscopic technique, patients are typically able to return to desk jobs in about 1-2 weeks. Full strength and heavy gripping may take longer, about 4-6 weeks to return.
If you are having difficulty with the symptoms of carpal tunnel syndrome, call Dr. Fichadia’s office today to schedule a consultation. We would be happy to answer any questions that you may have!
Hetal Fichadia MD, FACS
Double Board-Certified Plastic Surgeon in Portland, OR
What is Arthritis?
Arthritis is a degenerative disease of the joints that can affect joints all over the body and can be particularly debilitating in the hands. Arthritis can cause a great deal of pain in the hands and, over time, can cause deformity and disability. Dr. Fichadia has helped many patients regain their independence by restoring function and comfort.
Who is a Candidate for Arthritis Hand Surgery?
Patients experiencing arthritic pain and loss of function may benefit greatly from available surgical options for hand procedures. Patients who may be considered for arthritis hand surgery may have the following symptoms:
- Range of motion changes – patients with moderate to severe arthritis may experience range of motion changes such as a rough, grinding motion or even a looseness to the joint that inhibits control and function.
- Swelling – As the joints begin to accumulate stress they will swell, preventing further movement.
- Warm to the touch – Much of the time, an arthritic joint will feel warm to the touch as the body’s response to inflammation.
What Happens During Arthritis Surgery?
Arthritis does not have to result in a painful or sedentary life. It is important to seek help early so that treatment can begin, and you can return to doing what matters most to you.
What Are Arthritis Treatment Options?
Fortunately, there are non-surgical options such as medications, injections, and supporting the joint with a splint. If these are not effective, you’ll have a few surgical options. The first is using a fusion of the bones of the knuckle joints to create a stronger joint, but this can lead to decreased range of motion. Another option is a complete replacement of the joint using an artificial substitute. You’ll discuss these options at length with Dr. Fichadia, but here are some basics to know before your consultation.
Nonsurgical Treatment
Treatment options for arthritis of the hand and wrist include medication, splinting, injections, and surgery, and are determined based on:
- How far the arthritis has progressed
- How many joints are involved
- Your age, activity level and other medical conditions
- If the dominant or non-dominant hand is affected
- Your personal goals, home support structure, and ability to understand the treatment and comply with a therapy program
Medications
Medications treat symptoms but cannot restore joint cartilage or reverse joint damage. The most common medications for arthritis are anti-inflammatories, which stop the body from producing chemicals that cause joint swelling and pain. Examples of anti-inflammatory drugs include acetaminophen and ibuprofen.
Glucosamine and chondroitin are widely advertised dietary supplements, or “nutraceuticals.” Nutraceuticals are not drugs. Rather, they are compounds that are the “building blocks” of cartilage. They were originally used by veterinarians to treat arthritic hips in dogs. However, nutraceuticals have not yet been studied as a treatment for hand and wrist arthritis. (Note: The U.S. Food and Drug Administration does not test dietary supplements. These compounds may cause negative interactions with other medications. Always consult your doctor before taking dietary supplements.)
Injections
When first-line treatment with anti-inflammatory medication is not appropriate, injections may be used. These typically contain a long-lasting anesthetic and a steroid that can provide pain relief for weeks to months. The injections can be repeated, but only a limited number of times, due to possible side effects, such as lightening of the skin, weakening of the tendons and ligaments and infection.
Splinting
Injections are usually combined with splinting of the affected joint. The splint helps support the affected joint to ease the stress placed on it from frequent use and activities. Splints are typically worn during periods when the joints hurt. They should be small enough to allow functional use of the hand when they are worn. Wearing the splint for too long can lead to muscle deterioration (atrophy). Muscles can assist in stabilizing injured joints, so atrophy should be prevented.
What Are Arthritis Surgical Treatment Options?
If nonsurgical treatment fails to give relief, surgery is usually discussed. There are many surgical options. The chosen course of surgical treatment should be one that has a reasonable chance of providing long-term pain relief and return to function. It should be tailored to your individual needs.
If there is any way the joint can be preserved or reconstructed, this option is usually chosen.
When the damage has progressed to a point that the surfaces will no longer work, a joint replacement or a fusion (arthrodesis) is performed.
Fusion
During fusion, also known as arthrodesis, the bones of the knuckle joints are fused to create a stronger and more stable knuckle. While this method can eliminate pain, it will also result in less flexibility and range of motion.
Joint Replacement
Joint replacement, or arthroplasty, includes removing the worn-down joint and replacing it with an artificial replacement. This type of arthritis hand surgery also relieves pain but since the joint is being replaced, some function is possible.
Arthritis Surgery Results and Recovery
After your procedure, it will be very important that you follow Dr. Fichadia’s aftercare and recovery instructions. During this recovery period, you may need to modify your everyday activities in order to put less stress on your hand while it heals. Dr. Fichadia may also recommend that you see a physical therapist or an occupational therapist to help you return to your normal everyday activities.
If you are experiencing arthritic pain in your hands and you feel that you may need a more intensive solution, contact Dr. Fichadia’s office today to schedule a consultation.
What are Nerve and Tendon Injuries?
The nerves and tendons in our hands are hugely responsible for the function and movement of our hands and other appendages. When these nerves and tendons are damaged, our daily activities are significantly reduced. Dr. Fichadia is experienced in hand surgeries that than can help patients regain normal function and feeling.
Who is a Candidate for Nerve or Tendon Repair?
Once it has been established that there is severe damage to either a nerve or tendon in the hand or wrist, Dr. Fichadia will then examine the site of the injury to determine the best plan for treatment. Candidates for hand, nerve, or tendon surgery will probably have injuries that resulted in the tearing or splitting of a tendon or nerve.
What Are Nerve Tendon Treatment Options?
Unfortunately, if you suffer from a severe nerve or tendon injury in your hand, surgery maybe your best option. Because nerves and tendons repair themselves very slowly, you should seek out a hand reconstruction surgeon to surgically facilitate the healing or repair it using nerve allograft. This means there’s no donor site needed from your body and the nerve can be repaired using donor tissue.
A cut tendon or nerve will not be able to heal without surgery. In the case of nerve repair, nerve fibers grow slowly and may grow about one inch every month after a nerve is surgically repaired. Dr Fichadia has special interest in peripheral nerve surgery and is experienced with using the latest technology. It can also take a long time for tendons to work well again. Once the nerves are reconnected, there may be numbness, discomfort, or a “pins and needles” feeling during recovery.
It can also take a long time for tendons to work well again. You will be referred to an experienced hand therapist after tendon repair to ensure optimal function of the repaired tendon.
Nerve Tendon Surgery Results and Recovery
After surgery, it will be imperative to follow the specific instructions provided to you by Dr. Fichadia. The area that was operated on will need to be protected but also exercised to limit stiffness and speed up recovery. Oftentimes, Dr. Fichadia will recommend physical therapy to aid in recovery and return to normal function.
If you have had nerve or tendon injuries of the hand, contact Dr. Fichadia’s Portland office today to schedule a consultation.
Take the First Step Toward Feeling Like Yourself Again
Dr. Hetal Fichadia is honored to be a part of healing your hands. Serving patients from Portland, Lake Oswego, Tigard, Beaverton, Hillsboro and beyond, she offers compassionate care and surgical excellence. Call (503) 488-2344 or contact us through our online form to schedule your consultation today.