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Showing posts with label physicians. Show all posts
Showing posts with label physicians. Show all posts

Friday, September 15, 2017

What Causes Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome (CTS) is the compression – and sometimes squashing – of the median nerve that passes through the wrist. Its symptoms can include numbness, tingling and pain in the thumbs, fingers and wrists, which can travel as far as to the arms and even to the shoulder. Modern medicine has a firm grip on what CTS is; what causes it is quite a different story.
Carpal Tunnel Syndrome Mount Sinai Department of Rehabilitation
Diagnosing CTS can be done through a relatively simple physical examination. One test is called the ‘flick signal’, for which the patient is asked, ‘what do you do when your symptoms are worse?’ If the patient responds with a hand movement that resembles the shaking of a thermometer, there is good reason to suspect CTS. There are plenty of other tests such as Phalen’s Test and Tinel’s Sign – yet, despite the relative wealth of ways to diagnose CTS, there actually isn’t any kind of test to identify the precise cause CTS, and – except for patients suffering from underlying diseases – the biological mechanisms that create this inflammatory disorder remain unknown. 

It is a common story that CTS is caused through repetitive and often high-stress tasks that involve the wrists and hands – typing, using a computer mouse, manual labour to even playing the piano. While the correlation between CTS and tasks of this nature is undoubted, there is minimal evidence to suggest any clear causality.
Carpal Tunnel Syndrome Mount Sinai Department of Rehabilitation
In fact, most studies today indicate that CTS’ causes go above and beyond mere so-called ‘workplace factors’ and that they are rather linked to ailments that cause swelling in the wrist (osteoarthritis and rheumatoid arthritis) and others that obstruct blood flow (hypothyroidism and diabetes). We also see CTS pop up in clusters within a family, which suggests that something genetic is at play. Lifestyle also appears to play a significant factor, as those who smoke, drink alcohol excessively, consume excessive salt and who are obese all show increased risk of developing CTS. Women are also three times more likely to develop CTS than men, particularly after childbirth and during menopause.

Despite the range of medical, physical, genetic and life-style related items that are linked to an increased risk in developing CTS, their relationship is that of a correlation and not one of cause and effect. A modicum of clarity might be achieved, however, by overlapping both ends of the spectrum – the ‘workplace effect’ with medical/genetic/lifestyle factors. When somebody is susceptible to CTS – whether it be through genetics, a medical condition or an unhealthy or stressful lifestyle – and they also subject their hands and wrist to frequent, repetitive task, the likelihood of suffering from CTS will be at its greatest.
Carpal Tunnel Syndrome Mount Sinai Department of Rehabilitation
If you believe you are at risk of developing CTS, we would like to encourage you to seek medical advice on how to prevent it; if you believe you might already be suffering from it, we suggest you speak to one of our specialists for a suitable treatment. The earlier CTS is treated, the more likely – and easier – a full recovery will become.



Friday, May 12, 2017

Olympic-Level Care With Dr. Gerardo E. Miranda-Comas

This week Mount Sinai is proud to introduce you to Assistant Professor of Rehabilitation Medicine, Dr. Gerardo E. Miranda-Comas. Trained in Physical Medicine and Rehabilitation, Dr. Miranda-Comas has sub-specialized in Sports Medicine, with a clinical focus on a vast range of sports-related injuries. His medical interests include the diagnosis and non-surgical management of musculoskeletal injuries, sport-related injuries, exercise prescription, electrodiagnosis, regenerative medicine, and diagnostic-therapeutic musculoskeletal sonography. With every injury case, Dr. Miranda-Comas believes that the best intervention lies in increasing patient awareness and education, and he aims to aid early return to function, and improvement in the patient's quality of life.


Dr. Miranda-Comas' interest in sports medicine began while completing a fellowship in the field at the University of Puerto Rico School of Medicine. Since then he has been involved in sports medicine at every level, being invited to lecture at scientific meetings at both national and international levels, as well as having published many articles on the subject. His interest in sports stretches beyond his professional life, to his involvement in covering sporting events from high school-level, right through college sports and up to elite-level events.

A true testament to his expertise within the field, Dr. Miranda-Comas was selected to be a member of the medical team at the 2016 Olympic and Paralympic Games in Rio. Only the best physicians are selected to become a member of the Olympic medical team, following a long application process, and are required to have an intimate and expansive knowledge of athletic injuries. However, this is not the only mass participation event that Dr. Miranda-Comas has contributed his medical knowledge to, being present in a professional capacity at both the New York City Marathon and the Pan American Games.


On top of his real-world experience with sports injuries, Dr. Miranda-Comas has earned four board certifications in Physical Medicine and Rehabilitation, Sports Medicine, Electrodiagnostic Medicine, and Musculoskeletal Ultrasound. Holding roles as the Associate Program Director of the Mount Sinai Sports Medicine Fellowship, and as a core member of the of the Physical Medicine and Rehabilitation Program faculty, Dr. Miranda-Comas is extremely qualified to treat a range of sports-related complications. But don't take our word for it – take a look at his customer experience rating of 4.8 out of 5 stars on our website as a true testament to his knowledge and skill in the field!

To book a consultation with Dr. Gerardo E. Miranda-Comas, request an appointment here


Wednesday, February 15, 2017

Introducing Dr. Herrera

Here at Mount Sinai we understand that, as a patient, it is of paramount importance that you feel you know, and can trust, your physician. With this in mind, every month we will be introducing you to one of our doctors in more depth, so that you can get to know them a bit better, and we are beginning with our System Chair and Director of Sports Medicine, Dr. Joseph Herrera.



Dr Herrera began his training at the DO, University of Medicine and Dentistry in New Jersey, before undergoing his residency training in Physical Medicine and Rehabilitation through a combined program organised by Columbia Presbyterian Medical Center and Weill Cornell Medical Center. Following this, he then did a further fellowship in Interventional Spine and Sports Medicine at Beth Israel Medical Center in New York.

Following his training he was appointed to the New York State Athletic Commission and served as the Chief Team Physician for USA Boxing Metro. His work treating and evaluating both amateur and professional athletes led to him being awarded the Rocky Marciano Physician of the Year Award, for excellence in the field of Sports Medicine. This is just one of the many awards Dr. Herrera has won during his time, including being named one of the Best Doctors in America, one of New York’s Super Doctors, a Castle Connolly Top Doctor, and an American Pain Scholar by the American Pain Society.

  
Dr. Herrera has authored and edited a number of prominent medical works, including the “Manual to Musculoskeletal Medicine” and “Essential Sports Medicine”, served as Chief Editor of Medical journal “Current Reviews in Musculoskeletal Medicine” and has been interviewed on TV and radio, and in a number of popular publications, for his expertise.

Having been fellowship trained in Interventional procedures for spinal and joint conditions, he now heads up our own Interventional Spine and Sports Medicine Program as Fellowship Director. He is also the Residency Program Director for the Physical Medicine and Rehabilitation Program. His research and clinical interest focuses on sports-related injuries, knee, back, and shoulder pain, electrodiagnostic studies, and fluoroscopic guided spine and joint intervention. His interventional procedures include – but are not limited to – discography, radiofrequency neurotomy, and interlaminar and trasforaminal epidural injections.


Most importantly, his average patient experience rating is 4.8 out of 5!


If you think Dr. Herrera could help with your condition, you can book a consultation here