Spine and Wrist Disorders
and Pain Management
Index
Overview
Carpal Tunnel Syndrome
Disc Disease
Industrial Accidents / Industrial Rehabilitation Program
Pain Management
Spinal Disorders
Spinal Stenosis
Overview
The physicians of New England Neurological are experts in both conservative and surgical management of ruptured discs in the cervical and lumbar spine. This program is aimed at individuals with abnormalities of the spinal column, intervertebral discs, nerve roots, spinal cord, and surrounding structures. Lumbar and cervical degenerative disc disease, as well as less common vascular, neoplastic and congenital anomalies are evaluated and treated by a surgical team. Outcomes in the treatment of spinal disorder have been improved through progress in diagnostic techniques such as CT and MRI, as well as developments in microsurgery and minimally invasive techniques.
Where appropriate, non-operative approaches to spinal disorders are employed, offering medical therapy and rehabilitation programs.
Carpal Tunnel Syndrome
Carpal tunnel syndrome involves compression of the median nerve at the wrist. The median nerve is one of the three major nerves serving the hand, providing both sensation and movement. When it is compressed, numbness, weakness, and/or pain may occur. The diagnosis is made by clinical exam combined with a test of the electrical function of the nerve, called an electromyelogram or EMG.
Treatment of carpal tunnel syndrome may involve wrist braces, injection, occupational therapy, or surgery. The surgical treatment of carpal tunnel involves releasing the thickened fibrous band compressing the nerve. This operation can be done in an outpatient setting with local anesthesia. Occupational therapy can help to speed recovery.
Disc Disease
Problems with spinal discs occur most commonly in the neck and lower back. Injured discs may put pressure on nerves as they exit the spine, causing pain along the limb where the nerve travels. Muscle weakness and numbness may also occur from this nerve compression. The diagnosis and treatment of disc disorders is carried out by many of the specialists at New England Neurological Associates. The initial diagnosis is often made by the neurologists or neurosurgeons. Imaging tests, such as CAT scan or MRI, may be ordered to confirm their clinical impression. Electrodiagnostic tests such as an electromyelogram (EMG) may be employed. Once a certain diagnosis is established, treatment can begin.
For most people, the initial treatment of disc disease involves rest, medication, and physical therapy in some combination. The physical medicine and rehabilitation specialist, or physiatrist, is frequently consulted to assure that the maximal benefit is achieved in this phase. For a majority of patients, improvement occurs and no further treatment is needed. If the symptoms persist despite aggressive non-surgical care, a referral to the surgeon may be indicated.
Surgery for disc problems has evolved over many years to a point where it often can be done on an outpatient basis. The ability to do this is based o the use of sophisticated pain management, combined with minimally invasive microscopic surgical techniques.
The pain management specialists and surgeons at New England Neurological Associates have developed methods to prevent most post-operative pain and minimize the need for narcotic medications. Most patients are comfortable with pills alone, even in the time immediately following the surgery. IN addition, the use of the operating microscope allows use of smaller incisions and decreased manipulation of the body tissues, thereby speeding recovery.
After discharge from the hospital, physical therapy is started to smooth the patient�s return to normal activities. Once again, the physical medicine and rehabilitation specialists are frequently involved in this recovery phase and in helping speed the return to work and recreation. By combining the expertise of a number of related specialties, the doctor at New England Neurological Associates provide a uniquely thorough set of treatment options to the patient with disc disease.
Industrial Accidents / Industrial Rehabilitation Program
The doctors of New England Neurological Associates, working with the staff of Northeast Rehabilitation Hospital, have developed a service that is geared to the needs of the injured worker. The doctors and staff design treatment plans for the acutely injured worker, injury prevention programs, and a work hardening program.
Pain Management
Treatment of severe pain of both benign and malignant origin is provided by board certified pain specialists. When medical, physiatric and other non-operative modalities do not provide adequate relief, sophisticated devices such as spinal cord stimulators and implanted spinal drug delivery pumps are available. (Links to Physicians in pain program and Northeast Rehab pain program).
Spinal Disorders
The spine can be afflicted with a number of diseases and problems other than disc disease. These problems often benefit from the combined resources of a team approach. New England Neurological Associates is staffed by a wide range of specialists with expertise regarding the spine. Whether the problem requires rehabilitation, pain management, or a surgical approach, the diagnostic and therapeutic abilities of the group can be brought to bear in providing optimal care.
Disorders that affect the spine include those as widely varied as trauma and chronic degeneration, tumors, and inborn or congenital abnormalities. These may involve the bones and other supporting structures of the spine or may have a direct effect on the spinal cord and nerves. Diagnosis is aided by state of the art imaging, including CT scanning and MRI. Treatment includes a full range of medical and surgical options, supported by comprehensive rehabilitation personnel and facilities.
Spinal Stenosis
Spinal stenosis is an acquired narrowing of the spinal canal. Thickened bone or soft tissues can compress the nerves or spinal cord, causing pain, weakness, numbness, or unsteadiness. Treatments vary, but may include physical therapy, injections, medications, or surgery. New England Neurological Associates physicians from a number of disciplines work together to determine the best treatment plan for each patient.
Surgery for spinal stenosis involves opening the spinal canal to relieve the pressure on neural elements. Use of sophisticated surgical instruments and the operating microscope add to the safety and effectiveness of operations for spinal stenosis. Modern approaches to pain management allow most patients to get out of bed and walk on the day of surgery, and go home in a day or two. Physical therapy speeds the return to normal function.
Non-surgical treatment may include physical therapy or medication. Some patients may benefit from injections supervised by our pain control specialists.
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Disclaimer: The information and references contained
herein are intended solely for the information.
It should not be used for treatment purposes, but rather for
discussion with the patient's own physician.
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220 Sutton Street, North Andover, MA 01845
Phone (978) 687-2321 Fax (978) 685-7265