Fracture Prevention: 6 Tips to Fight Fractures, Falls, and Slips

If you have osteoporosis, treating the condition directly with medicines or calcium supplements is important. But it’s also crucial to do everything you can to avoid the most serious risk of osteoporosis: broken bones. Practicing fracture prevention is a vital part of your osteoporosis treatment.

According to the National Institutes of Health, osteoporosis causes 1.5 million bone fractures every year. And these broken bones can be a lot more than painful and inconvenient. Fractures can have a devastating and sometimes permanent impact on your health.

So what can you do to avoid broken bones and painful rehab? Here’s a list of six tips for fracture prevention that every person with osteoporosis should know. By asking your orthopedic physician the right questions — and making a few changes to your habits — you can greatly reduce your risks.

The Importance of Fracture Prevention

In people with osteoporosis, fractures can happen anywhere, but wrist fractures, hip fractures, and spinal fractures are the most common. The effects can be serious. 700,000 people with osteoporosis fracture their vertebrae every year, and many are left with chronic pain. Of the 300,000 people with osteoporosis who have a hip fracture this year, half will never be able to walk again without assistance. And a staggering 20% of people over age 50 who break a hip will die within a year from complications.

If you’re older and have osteoporosis, not only are falls much more dangerous, but they’re more likely too. As you age, your body’s muscle tone decreases. Your vision worsens. You’re more likely to need medications, which can affect your balance. Even seemingly trivial things, like needing to go to the bathroom more in the night, can up your odds of falling. Essentially, a number of minor risks associated with aging coalesce at the same time, greatly increasing the possibility of a fall and fractured bone.

The good news is that with some simple changes to your lifestyle, you can seriously lower these risks. Here’s a rundown of what you can do.

  1. Exercise to Improve Balance and Strength

Many people with osteoporosis worry about the risks of exercise. The fact is that exercising reduces your risk of falls. Keeping physically active helps your reflexes stay sharp and your muscles stay strong. That can help with coordination and lower your risk of falling. Aside from improving your balance and strength, exercise also has a direct impact on the strength of your bones. Bone is a living tissue. Like muscle, it weakens if you don’t exercise it. By staying fit, you can make your bones stronger and less likely to break during a fall. Experts generally recommend a combination of weight-bearing exercise (like walking), resistance exercise (like lifting weights), and flexibility and balance exercises (like yoga or tai chi).

  1. Tread Carefully

If you have osteoporosis, you need to consider more than fashion when choosing your shoes. Wearing the wrong sort of footwear can really increase your risk of a fall.

But happily, you don’t have to be stuck with “sensible shoes” either. Just look for low-heeled shoes that offer good support and have rubber soles rather than leather ones. While sneakers are fine, avoid ones with deep treads that can trip you up.

Start wearing shoes inside the house too: walking around in socks and slippers can increase your risk of slipping.

When you’re walking outside, play it safe. Walk on the grass when it’s been raining or snowing, since you’re more likely to slip on concrete. Always put down salt or kitty litter on icy patches around your home.

If you have difficulty walking due to a medical condition such as arthritis or another problem, make sure to use the assistive device recommended by your orthopedic physician, such as a cane or walker.

  1. Know How Medicines Might Affect You

Unfortunately, as you get older, you’re more likely to need daily medications. Some medications have side effects which can increase your risk of having a fall. Medications that can cause dizziness or lack of coordination are:

  • Sedatives or sleeping pills
  • Drugs that lower high blood pressure, which can sometimes cause hypotension, or blood pressure that is too low
  • Antidepressants
  • Anticonvulsants, which are used to treat epilepsy and some psychological conditions
  • Muscle relaxants
  • Some medicines for heart conditions

Other drugs, like some corticosteroids, are also associated with a higher risk of osteoporosis and fractures. Just the number of medicines you take can increase the danger. Studies have linked taking four or more prescription medicines with a higher rate of falls, regardless of what the drugs are.

But given that you need these medicines for other health reasons and can’t just stop taking them, what should you do? Go over all the drugs you take with your doctor. Bring in a list or the bottles themselves. Keep in mind that one doctor — like your primary care provider — might not know what other doctors — like your cardiologist, or rheumatologist — have prescribed.

If any of the medicines you take are increasing your risk of falls, ask your doctor for advice. It’s possible that your doctor can change your dosage or change medicines altogether so that you’re less likely to fall.

  1. Lighten Up

As you age, you may notice that your vision isn’t quite as sharp as it once was. Sometimes this is due to a treatable health condition, like cataracts. But it’s also natural to lose some of the contrast sensitivity in our vision as we age, making it harder to discern objects, especially in low light. So you need to brighten up your home. Here are some tips:

  • Install overhead lights in all rooms, so you don’t have to stumble around in the dark to find the lamp.
  • Use nightlights in your bedroom, bathroom, and any hallways that connect them.
  • Make sure all stairways, both inside and outside, are well lit.
  • Keep a flashlight by your bed.
  1. “Fall-Proof” Your Home

A key part of fracture prevention is to make your home safer. Here are some tips:

  • Keep rooms free of clutter — get rid of those piles of clothes and boxes of papers.
  • Put down carpet or plastic runners on polished — and potentially slippery — floors.
  • Get throw rugs, electric cords, and phone lines off the floor.
  • Make sure to have handrails on all stairs.
  • Install railings in the bathroom around the toilet and the shower.
  • Put a rubber mat on the floor of your bath or shower.
  1. Treat Health Conditions

Many chronic diseases and health conditions become more common as you get older. Some can affect your strength or physical functioning and increase the risk of a fall. Arthritis can make it hard to move around. Vision problems directly increase your risk of tripping.

If you have any other health conditions, ask your doctor if they might increase your risk of a fall. If they do, seek out treatments that might help. One difficulty is that some of these problems may come on so gradually that you might not even notice. For instance, you might not realize that your vision is slowly getting worse, or if your gait has become a little less steady. That’s why it’s important to get regular check-ups: not only with your primary physician, but your eye doctor and any other specialists you need.

Bone Fractures Aren’t Inevitable

Even with precautions, some types of bone fractures are tough to avoid. Just a mild bump can be enough to break a bone in people with severe osteoporosis. Only 10-15 percent of vertebral fractures are caused by falls. Many fractures in people with severe osteoporosis are caused by physical stress, even by something as simple as bending over or even coughing.

While some fractures can’t be prevented, you can work on the fracture risks you can control. While bone fractures may be more likely as you get older, they aren’t inevitable.

Get a Grip on Winter’s Falls and Trips

No matter how often snow and ice is salted and removed from walking surfaces, you will probably encounter some slippery surfaces this winter. Walking to and from parking lots, on sidewalks, and between buildings during the winter months requires special attention to avoid slipping and falling. We often forget how dangerous slipping and falling can be.

According to the National Safety Council, falls are one of the leading causes of unintentional injuries in the United States, accounting for approximately 8.9 million visits to the emergency department annually. Many winter trips and falls result in fractures, spine injuries, and broken joints requiring care by an orthopedic physician.

Hazards to watch for in winter include snow-covered ice, black ice, uneven surfaces, and unsalted sidewalks and parking lots.

Report unsafe areas and unsalted parking lots and sidewalks to the appropriate personnel immediately. There are steps you can take to avoid injury. Wear shoes or boots that provide traction on snow and ice. Avoid boots or shoes with smooth soles and heels. Walk in designated walkways as much as possible. Taking shortcuts over snow piles and other frozen areas is dangerous. Look ahead when you walk; a snow- or ice-covered sidewalk may require travel along its grassy edge for traction. Focus completely on getting from point A to point B. Use extreme caution when clearing snow and ice.

How to keep from slipping on ice?

Here are some tips to help keep you safe – and upright – this wHowinter:

Walk Like a Penguin
Do the penguin shuffle!

Walking like a penguin can reduce your chances of slipping and falling. Focus on your footing – keep your head up, slowly take short steps or shuffle, extend your arms out to your sides for balance, and walk flatfooted. If you fall, try to avoid landing on your knees, wrists, or spine; relax your muscles and fall on your side.

Step Down – Not Out – of Cars
Swing both legs out. Place both feet, flatfooted, on the ground. Grab onto your car’s door frame or steering wheel to help support yourself to a standing position. Use at least three points of contact for support – two feet and one hand – when getting in and out of vehicles.

Step Down, Not Out…on the Curb
Be careful of transitions like curb to sidewalk.

Shorten your steps. Do not step too far out. Step flatfooted off the curb. This minimizes your forward momentum. Don’t allow your leading foot to land heel-first. If you do, you will slip.

Winter Sports Injury Prevention

Outdoor activities can be an excellent way to get some fresh air and exercise during the long, chilly winter months, but the cold temperatures and icy surfaces can also lead to more injuries.

Common winter sports injuries include sprains, strains, dislocations, and fractures. Orthopedic surgeons advise that a majority of these injuries can easily be prevented if participants prepare for their winter sport by keeping in good physical condition, staying alert, and stopping when they are tired or in pain.

Many of these sports injuries happen at the end of the day, when people overexert themselves to finish that one last run before the day’s end.

There are many things you can do to help prevent injury during favorite winter activities. Following is a list of tips to help you have fun while minimizing your risk of injury while enjoying winter sports such as skiing, skating, hockey, snowboarding, and sledding.

Never participate alone in a winter sport.

Keep in shape and condition muscles before participating in winter activities.

Warm up thoroughly before playing or participating. Cold muscles, tendons, and ligaments are vulnerable to injury. Start with some light exercises, followed by gentle stretching. Make sure to hold each stretch for at least 30 seconds. If skiing, take at least one warm up run before heading to more difficult slopes.

Wear appropriate winter sports protective gear, including goggles, helmets, gloves and padding.

Check that equipment is working properly prior to use.

Wear several layers of light, loose and water- and wind-resistant clothing for warmth and protection. Layering allows you to accommodate your body’s constantly changing temperature. Wear proper footwear that provides warmth and dryness, as well as ample ankle support.

Know and abide by all rules of the sport in which you are participating.

Take a lesson (or several) from a qualified instructor, especially in winter sports like skiing and snowboarding. Learning how to fall correctly and safely can reduce the risk of injury.

Pay attention to warnings about upcoming winter storms and severe drops in temperature to ensure safety.

Seek shelter and medical attention immediately if you, or anyone with you, is experiencing hypothermia or frostbite. Make sure everyone is aware of proper procedures for getting help, if injuries occur.

Drink plenty of water before, during, and after activities.

Avoid participating in sports when you are in pain or exhausted.

Become familiar with your surroundings. Know the whereabouts of fences, trees, rocks, open water, and ice patches so they can be avoided. Stay on marked trails and avoid any potentially dangerous areas such as steep hills. Slippery surfaces are particularly troublesome, as they can cause sudden jarring movements, e.g., unnatural fall avoidance.

Avoiding Leaf Raking Injuries

It is that time of year again. The kids enjoy jumping in the leaf piles but you are faced with the daunting task of raking all of those leaves.

Because raking requires different body positions and utilizes several muscle groups, the potential for injury is high. Orthopedic surgeons estimate that over 76,000 people seek care for injuries related to non-powered garden tools (including rakes) every year.

By following a few simple recommendations, hopefully you will avoid becoming a statistic.

  • Warm-up and stretch for a few minutes before beginning to rake. Example stretches include:
    • Trunk rotation stretch
    • Shoulder stretches
    • Wrist stretches
  • Make sure the yard is clear of debris to avoid trip hazards
  • Use a rake that is sized appropriately to your height and strength.
  • Avoid blisters by wearing gloves.
  • Wear skid-resistant shoes to minimize risks for slipping or falling. • Avoid twisting your body. Move your legs to shift your weight. Do not throw leaves over your shoulder or to the side; rake the leaves towards you. This will help to avoid excessive strain on your back muscles.
  • Do not bend over to pick up leaves or bags. Keep your back straight and bend at the knees to pick things up. Make sure the leaf bag is not too heavy to be able to pick up comfortably.
  • Raking is considered an aerobic activity. Pace yourself, take frequent breaks, and stay hydrated. If you experience chest pain or shortness of breath, call 911.
  • Cool down and stretch afterwards to relieve tension.

By following these simple recommendations, your raking experience can be a pain free, if not enjoyable one.

What our patients have to say

This is our place to reflect and share. Since gratitude is a positive emotion correlated with healing, we have invited you to experience our patients feedback and responses to our procedures. We thank you for all your kind words and are so happy to be of help you in your healing process. We are adding to our testimonial section, video reviews. Please watch as Lawrence Gonnello shares his story with us

 

 

Orthopedic surgeries
by Lawrence Gonnello, October 2014
Lawrence Gonnello has had 15 orthopedic surgeries in his lifetime — and he wouldn’t trust anyone other than Dr. Marshall P. Allegra to treat him. He has now known Dr. Allegra for at least 20 years, and continues to appreciate his personal, attentive care and the fact that Dr. Allegra helps patients get the treatment they need right away so they don’t have to be in pain a moment longer than necessary.

 


Ac Joint reconstructive ligament surgery
by Abe R on Aug 30th, 2013
Dr Allegra is outstanding in his ability perform great results from my surgery. I was extremely pleased with the outcome., patient care, his follow up and the staff.

Satisfied Patient
Jun 8th, 2013
Doctor Allegra is knowledgeable and competent. I had a successful knee replacement (after a manipulation 5 weeks post op). His office staff is responsive to calls and concerns. Wait time for your appointment is minimal – respects patient’s time, not just doctor’s time. I would recommend (and have!) to anyone who is looking for a good outcome to an orthopedic problem.

My Rotator cuff and Dr. Allegra
by Nora Tupino on Feb 21st, 2013
In August I fell while training for a marathon. By September I could not raise my right arm. I went to Dr. Allegra (he had done my knee several years ago) After an MRI he diagnosed a torn rotator cuff. After giving me a great deal of information as to the surgery I would need, what my post-op recovery would be, I had surgery in October at Shrewsbury Surgical Center. Even though the recovery for me was tough, I felt Dr. Allegra was sensitive to my need for pain control. My follow up visits were informative. He was persistent in my having a minimum of 3 months of physical therapy. Now 4 months after surgery, I have almost 100% range of motion in my right arm and I am training for my 2nd half Iron Man Triathlon in June.

Excellent Surgeon
by Sharon Rothenberg on Feb 8th, 2013
On 1/28/2013, I had a total hip replacement. Dr. Allegra used the transverse method, a procdure that he invented. This procedure is much better than the standard posterior hip replacement, in that it offers a quicker healing time, and results in less pain. No heavy pain medications are needed, after the first night. In fact, as of 2/1, I was only using tylenol for pain. This doctor is terrific. I would not use any other orthopedic surgeon.

Great doctor
Dec 3rd, 2012
When you have a big problem , your Dr. Has to be good. Well Dr. Allegra is the best orthopedic Dr. On earth. Just can’t say enough about him. Kind , gentile and so very smart. A Dr.’s doctor. Whatever the wait in the office it is well worth it. Be patient , he is worth the wait , the best in his field. None better period.

Wouldn’t choose any other doctor
Mar 5th, 2012
I’m a 51 year old guy who unfortunately has not had very much luck with my joints. I’ve had ACL Surgery, two Rotator Cuff surgeries and a Meniscus procedure done. I tore my ACL and made an appointment with Doctor Marshall Allegra . After meeting with Doctor Allegra I decided to go through with the surgery. Today my knee is stronger then ever. When I tore my Meniscus and then both Rotator Cuffs I decided to go back to the doctor who I put on a pedestal ! Doctor Allegra has fixed me up each and every time . My Physical Therapist is always amazed with my recovery and I always tell him the same thing, ‘ I have Doctor Allegra to thank for my recovery !”..I would rate Doctor Allegra as THE Top orthopedic doctor in New Jersey ! ! ! Thank You Doctor Allegra !

Very Happy
Apr 20th, 2011
I was first impressed with Dr Allegra when he treated my husband for a serious leg injury. He was honest and explained every dtail of his coindition and how to treat it and care for my husband once he was home. When my knee became an issue he did all he could to treat it without surgery and once it was obvious that surgery was necessary he took Wonderful care of me. He is very blunt and to the point but on one visit I was very emotional and he sat with me and reassured me that I was recovering well and I would have days when I did not feel that I was making progress. His compassion made me feel so much better

Sport Safety for Young Athletes

For young athletes, sports activities are more than just play.

Participation can improve physical fitness, coordination, and self-discipline, and help children learn teamwork.

However, children’s bones, muscles, tendons, and ligaments are still growing, making them more susceptible to injury. Growth plates are the areas of developing cartilage at the ends of long bones where bone growth occurs in children. The growth plates are weaker than the nearby ligaments and tendons. A twisted ankle that might result in a sprain in an adult, could result in a more serious growth plate fracture in a young athlete.

There are also significant differences in coordination, strength, and stamina from child to child and between children and adults. Young athletes of the same age can differ greatly in size and physical maturity. Grade school students are less likely to experience severe injuries during athletic activities because they are smaller and slower than older athletes. High school athletes, however, are bigger, faster, stronger, and capable of delivering tremendous forces in contact sports.

Acute sports injuries are caused by a sudden trauma, such as a twist, fall, or collision. Common acute injuries include broken bones, sprains (ligament injuries), strains (muscle and tendon injuries), and cuts or bruises.

Most acute injuries should be evaluated by an orthopedic physician. Prompt first aid treatment should be provided by coaches and parents when the injury occurs. This usually consists of the RICE method: rest, applying ice, wrapping with elastic bandages (compression), and elevating the injured arm, hand, leg, or foot. This usually limits discomfort and reduces healing time. Proper first aid will minimize swelling and help the doctor establish an accurate diagnosis.

Follow these tips to play it safe:
• Always be in proper physical condition to play a sport
• Know and abide by the rules of a sport
• Wear appropriate protective gear
• Know how to correctly use athletic equipment
• Always warm up before playing
• Stay hydrated
• Avoid playing when very tired or in pain

Following a regular conditioning program with exercises designed specifically for their chosen sport can help young athletes avoid injuries.

Coaches and parents are responsible for creating an atmosphere that promotes teamwork and sportsmanship. A young athlete striving to meet the unrealistic expectations of others may ignore warning signs of injury and continue to play with pain. The “win at all costs” attitude of many parents, coaches, professional athletes and peers can lead to injuries. Above all else, youth sports should always be fun.

Avoiding Overuse Injuries

Understanding how to pace yourself while getting fit is key to staying healthy and enjoying physical activity throughout your life.

Overuse injuries can be any type of muscle or joint injury like rotator cuff injury, bursitis, tendonitis, or stress fractures that are caused by repetitive trauma. Overuse injuries are usually caused by biting off more than you can chew, or using bad form when you exercise.

When you take on too much physical activity too quickly, you can hurt yourself. Pushing too hard too soon or simply doing too much of one type of physical activity can strain your body and lead to an overuse injury.

The fear of overuse injuries should not prevent you from exercising. Here are some common sense ways you can avoid overuse injuries:

  • Get a physical before you start exercising. You may have muscular imbalances or medical conditions that can make you predisposed to developing an overuse injury.
  • Consider using a personal trainer. Using the correct technique is crucial to preventing overuse injuries. A good, certified personal trainer can help you begin a new, safe exercise regimen.
  • Use new/well-maintained shoes. When your shoes wear down, you don’t get the proper support, and this can contribute to overuse injuries.
  • Consider the tortoise and the hare. Easing into your new fitness routine/training will help you continue to stay active for years to come. Don’t try to do too much too soon.
  • Warm up, cool down, and stretch. A dynamic stretching warm-up of 5 to 10 minutes and a static stretching routine for 5 to 10 minutes at the end of the hour will do wonders for avoiding injuries. Consider ways to modify activities to fit your present fitness level.
  • Gradually increase your activity level. When changing your activity level or the amount of weight you’re using while strength training, keep it gradual — such as increases of no more than 10 percent each week until you reach your new goal.
  • Try a tri. Done correctly, triathlon training is a perfect balance of running, swimming, cycling, and core strength – a perfect balance to make you really fit and avoid overuse injuries. Even just following a triathlon training program will give you a nice balance of different forms of cardio, strength, and flexibility.

It’s great to set new fitness goals; don’t let overuse injuries sideline you. By working with your orthopedic physician and a personal trainer or physical therapist, easing into activities, and cross training, you can prevent overuse injuries.

What Is Minimally Invasive Surgery?

In 1988, Dr. J. Barry McKernan, after making only a 10mm incision – (equivalent to 0.39 inches, less than half an inch) – inserted a miniature camera into a patient’s abdomen and removed a gall bladder. The patient recovered in days, rather than weeks or months. This was the first laparoscopic cholecystectomy performed in the U.S. and the beginning of the minimally invasive movement in surgery.

Twenty-six years later, minimally invasive procedures have changed the way people think about surgery. Patients who choose innovative minimally invasive procedures over conventional surgery usually have shorter hospital stays and quicker recovery. This means getting back sooner to the things that are important in life.

An orthopedic doctor may recommend minimally invasive surgery for many conditions, including orthopedic injuries and disorders.

More than 20 million Americans have had minimally invasive surgery, and time has proven it to be as effective as conventional surgery. When you have minimally invasive surgery, you’re likely to lose less blood and have less postoperative pain, fewer and smaller scars, and a reduced risk of infection than you would following conventional, or “open” surgery.

Minimally invasive laparoscopic surgery uses state-of-the-art technology to reduce damage to human tissue when performing surgery. For example, in most procedures, a surgeon makes several small incisions and inserts thin tubes called trocars. Carbon dioxide gas may be used to inflate the area, creating a space between the internal organs and the skin. Then the miniature camera (usually a laparoscope or endoscope) is placed through one of the trocars so the surgical team can view the procedure as a magnified image on video monitors in the operating room. Specialized instruments are placed through the other trocars to perform the procedures.

There are some advanced minimally invasive surgical procedures that can be performed almost exclusively through a single point of entry – meaning only one small incision. This is called single site laparoscopy, and is another approach to performing traditional laparoscopic surgery using the same tools. Orthopedic surgeons often perform single site laparoscopy to repair conditions of the hip and knee. These kinds of procedures are not for everyone, and only your doctor can determine if a minimally invasive surgery is right for you.

Understanding Minimally Invasive Knee Surgery

Arthroscopy is a common surgical procedure in which a joint (arthro-) is viewed (-scopy) using a small camera. Arthroscopy gives doctors a clear view of the inside of the knee. This helps them diagnose and treat knee problems.

Technical advances have led to high-definition monitors and high-resolution cameras. These and other improvements have made arthroscopy a very effective tool for treating knee problems. According to the American Orthopaedic Society for Sports Medicine, more than 4 million knee arthroscopies are performed worldwide each year.

Arthroscopy is done through small incisions. During the procedure, an orthopedic surgeon inserts the arthroscope (a small camera instrument about the size of a pencil) into your knee joint. The arthroscope sends the image to a television monitor. On the monitor, your surgeon can see the structures of the knee in great detail. Your surgeon can use arthroscopy to feel, repair or remove damaged tissue.

Almost all arthroscopic knee surgery is done on an outpatient basis. Arthroscopy can be performed under local (numbs just your knee), regional (numbs below the waist), or general anesthesia (puts you to sleep). The anesthesiologist will help you decide which method would be best for you. If you have local or regional anesthesia, you may be able to watch the procedure on a television monitor.

The orthopedic surgeon will make a few small incisions in your knee. A sterile solution will be used to fill the knee joint and rinse away any cloudy fluid. This helps your orthopedic surgeon see your knee clearly and in great detail.

Your surgeon’s first task is to properly diagnose your problem. Your surgeon will insert the arthroscope and use the image projected on the screen to guide it. If surgical treatment is needed, your surgeon will insert tiny instruments through another small incision.

Arthroscopy for the knee is most commonly used for:

  • Removal or repair of torn meniscal cartilage
  • Reconstruction of a torn anterior cruciate ligament
  • Trimming of torn pieces of articular cartilage
  • Removal of loose fragments of bone or cartilage
  • Removal of inflamed synovial tissue

Recovery from knee arthroscopy is much faster than recovery from traditional open knee surgery. Keep your leg elevated as much as possible for the first few days after surgery. Apply ice to relieve swelling and pain. Your surgeon will see you in a few days to check your progress, review the surgical findings, and begin your postoperative treatment program.

Your doctor will prescribe pain medication to help relieve discomfort and may also recommend medication such as aspirin to lessen the risk of blood clots.

You should exercise your knee regularly for several weeks after surgery. This will restore motion and strengthen the muscles of your leg and knee. A formal physical therapy program may improve your final outcome.

Unless you have had a ligament reconstruction, you should be able to return to most physical activities after 6 to 8 weeks, or sometimes sooner. Higher impact activities may need to be avoided for a longer time. If your job involves heavy work, it may be longer before you can return to your job. Discuss when you can safely return to work with your doctor.

You will need to talk with your doctor before returning to intense physical activities. The final outcome of your surgery will likely be determined by the degree of damage to your knee.

Carpal Tunnel Syndrome

You’re working at your desk, trying to ignore the tingling or numbness you’ve had for months in your hand and wrist. Suddenly, a sharp, piercing pain shoots through the wrist and up your arm. Just a passing cramp? More likely you have carpal tunnel syndrome, a painful progressive condition caused by compression of a key nerve in the wrist.

Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers as well as impulses to some small muscles in the hand that allow the fingers and thumb to move. The carpal tunnel – a narrow, rigid passageway of ligament and bones at the base of the hand – houses the median nerve and tendons.

Women are three times more likely than men to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself may be smaller in women than in men. The dominant hand is usually affected first and produces the most severe pain. Persons with diabetes or other metabolic disorders that affect the body’s nerves and make them more susceptible to compression are also at high risk.

Early diagnosis and treatment by an orthopedic doctor are important to avoid permanent damage to the median nerve. Treatments for carpal tunnel syndrome should begin as early as possible, under a doctor’s direction. Underlying causes such as diabetes or arthritis should be treated first. Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending. If there is inflammation, applying cool packs can help reduce swelling.

Nonsteroidal anti-inflammatory drugs may ease symptoms. Other medications can be injected directly into the wrist or taken orally to relieve pressure on the median nerve, providing immediate, temporary relief.

Stretching and strengthening exercises supervised by a physical therapist, who is trained to use exercises to treat physical impairments, or an occupational therapist, who is trained in evaluating people with physical impairments and helping them build skills to improve their health and well-being, may be ordered by your orthopedic physician.

Alternative therapies such as acupuncture and yoga have been shown to reduce pain and improve grip strength among patients with carpal tunnel syndrome.

Carpal tunnel release is one of the most common surgical procedures in the U.S. Generally recommended if symptoms last for 6 months, surgery involves releasing the ligament around a portion of the wrist that compresses the median nerve. Surgery is done under local anesthesia and does not require an overnight hospital stay.

Although symptoms may be relieved immediately after surgery, full recovery from carpal tunnel surgery can take several months. Patients should undergo physical therapy after surgery to restore wrist strength.

Recurrence of carpal tunnel syndrome following treatment is rare. The majority of patients recover completely.

You can help to prevent this disabling occupational illness by performing stretching exercises, taking frequent rest breaks, wearing splints to keep wrists straight, and by being mindful to maintain correct posture and wrist position.