Orthopaedics

Carpal tunnel syndrome symptoms usually start gradually and include:

• Tingling or numbness. You may notice tingling and numbness in the fingers or hand. Usually the thumb and index, middle or ring fingers are affected, but not the little finger. You might feel a sensation like an electric shock in these fingers.
  
  The sensation may travel from the wrist up the arm. These symptoms often occur while holding a steering wheel, phone or newspaper, or may wake you from sleep.
  
  Many people "shake out" their hands to try to relieve their symptoms. The numb feeling may become constant over time.
  
  
• Weakness. You may experience weakness in the hand and drop objects. This may be due to the numbness in the hand or weakness of the thumb's pinching muscles, which are also controlled by the median nerve.

Nonsurgical therapy

If the condition is diagnosed early, nonsurgical methods may help improve carpal tunnel syndrome, including:

• Wrist splinting. A splint that holds the wrist still while you sleep can help relieve nighttime symptoms of tingling and numbness. 
• Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as ibuprofen
• Corticosteroids. Your doctor may inject the carpal tunnel with a corticosteroid such as cortisone to relieve pain.

Surgery:

Open surgery. Your surgeon makes an incision in the palm of the hand over the carpal tunnel and cuts through the ligament to free the nerve.

• Osteoarthritis. Commonly known as wear-and-tear arthritis, osteoarthritis damages the slick cartilage that covers the ends of bones and helps joints move smoothly.
• Rheumatoid arthritis. Caused by an overactive immune system, rheumatoid arthritis produces a type of inflammation that can erode cartilage and occasionally underlying bone, resulting in damaged and deformed joints.
• Osteonecrosis. If there isn't enough blood supplied to the ball portion of the hip joint, such as might result from a dislocation or fracture, the bone might collapse and deform.

Hip replacement may be an option if hip pain:

• Persists, despite pain medication
• Worsens with walking, even with a cane or walker
• Interferes with sleep
• Affects the ability to walk up or down stairs
• Makes it difficult to rise from a seated position

• Knee
• Shoulder
• Elbow
• Ankle
• Hip
• Wrist

Diagnostic procedures

Doctors often turn to arthroscopy if X-rays and other imaging studies have left some diagnostic questions unanswered.

Surgical procedures

Conditions treated with arthroscopy include:

• Loose bone fragments
• Damaged or torn cartilage
• Inflamed joint linings
• Torn ligaments
• Scarring within joints

• Resting the tendon by using crutches
• Applying ice to the area
• Taking over-the-counter pain relievers
• Keeping the ankle from moving for the first few weeks, usually with a walking boot with heel wedges or a cast, with the foot flexed down

Surgery

The procedure generally involves making an incision in the back of your lower leg and stitching the torn tendon together. Depending on the condition of the torn tissue, the repair might be reinforced with other tendons.

• Conservative treatment, such as medication or physical therapy, fails to improve symptoms
• Muscle weakness or numbness makes standing or walking difficult
• Symptoms include loss of bowel or bladder control

In some situations, laminectomy may be necessary as part of surgery to treat a herniated spinal disk. A surgeon may need to remove part of the lamina to get to the damaged disk.