- ArthritisIntroduction Rheumatoid arthritis commonly affects the hand. Rheumatoid arthritis is a long-term chronic inflammatory disease. It causes the joints in the hand to become painful, swollen, and stiff. Rheumatoid arthritis can lead to hand deformity and loss of function. Symptoms are treated with medications, hand therapy, splinting, and surgery.
- Primary CareBe sure to bring any diagnostic films or other test results that may have been ordered or performed by another physician. If your insurance requires a referral from your Primary Care Physician (PCP) to see a specialist, you will be required to request that referral prior to your visit at NEHA. We are happy to assist you in navigating that process.
- Emergency CareWhen you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
- ElectrocardiogramDepending on the type of surgery you are having, you may go home the same day or be admitted. If you have a history of medical issues – even if you are scheduled to go home the day of surgery, your surgeon may request pre-operative testing, such as an EKG, chest X-ray, or cardiac stress test.
- ImmunizationsIf an animal bites you or your child, you should try to keep the animal in view and contact your local animal control experts to capture it. They may quarantine the animal and check it for rabies. They can also verify the rabies vaccination status of stray pets.
- Carpal Tunnel SyndromeProblems in the muscles and joints in your wrist, such as arthritis and carpal tunnel syndrome, can cause chronic pain, loss of motion, swelling, and inflammation. At New England Hand Associates, our board-certified and fellowship trained orthopedic surgeons commonly see and treat conditions involving the bones, ligaments, tendons, and nerves of the wrist.
- Multiple SclerosisCauses Loss of function in the hand can occur because of several problems which affect the muscles and tendons directly or indirectly. These include paralysis, nerve injuries, tendon loss, and muscle loss. The nerves that control the muscles in the hand can cause paralysis as a result of direct trauma to the nerves, spinal cord injuries, traumatic brain injuries, or neurological conditions, such as stroke, cerebral palsy, and multiple sclerosis. Rheumatoid arthritis can cause tendons to rupture. Muscles and tendons can be severed by traumatic injuries or affected by scar tissue from burns.
- EpilepsySmoking and drinking alcohol increase the risk of Dupuytren’s disease. Certain medical conditions are associated with an increased risk of Dupuytren’s disease. Such conditions include diabetes, thyroid problems, epilepsy, pulmonary tuberculosis, and liver disease.
- Mental HealthThis Notice of Privacy Practices describes how we may use and disclose your Protected Health Information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. "Protected health information" is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
- UltrasoundWhen appropriate, our surgeons will refer you to hand therapy for custom fabrication of an orthosis or splint on the same day as your office visit – particularly if protection is needed for an acute injury or fracture. Other times, your appointment will be scheduled to coincide with your surgery. Depending on your needs, you may receive a full evaluation, in which your therapist will carefully examine all issues you are having with your hand, wrist, elbow, or shoulder. Our therapists use several different modalities, including heat, ultrasound, or electrical stimulation to help increase motion or to decrease pain. Depending on your needs, home exercises are often given to aid in the healing process.
- MRIX-rays are used to see the condition of your bones and joints, and to identify areas of arthritis or bone spurs. The tissues that surround the joint do not show up on an X-ray. In this case, a Magnetic Resonance Imaging (MRI) scan may be requested to get a better view of the soft tissue structures, such as ligaments, tendons, and cartilage.
- RadiologyWhen you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.
- X-Rays
- Computed TomographyYour doctor can diagnose a Bennett’s fracture by examining your hand and taking X-rays. In some cases, a computed tomography (CT) scan may be used to provide a more detailed image.
- ChemotherapyAn injury, illness, chemotherapy, bed rest, inactivity, or disease may change the amount of control that you have over moving your body. Alterations in your health status may result in poor endurance, decreased muscle movement, paralysis, and loss of balance,... Read More
- Orthopedics
- SciaticaFacet pain and inflammation can be caused by spinal stenosis, spondylolysis, sciatica, arthritis and herniated disc. You may be a candidate for facet injections if you have spine-related pain that is not relieved by conservative treatments. Facet injection treatments involve injecting the facet joint capsule or surrounding tissue with corticosteroid and anesthetic medication. Facet injections can also be used for diagnostic purposes to determine if the cause of your pain is actually coming from your facet joint.
- WhiplashWhiplash occurs when the head moves suddenly from severe impact, such as during a car crash. Whiplash can cause neck pain, upper back pain, shoulder pain, tight muscles, and burning or tingling sensations in your neck or upper back. Most... Read More
- ArthroscopyArthroscopic Surgery is a procedure that allows surgeons to see, diagnose, and treat problems inside a joint. The procedure, also called an Arthroscopy, requires only small incisions and is guided by a miniature viewing instrument or scope. Before arthroscopy existed,... Read More
- Wound CareMelissa Warren is a graduate of the Tufts University School of Occupational Therapy, and she became a Certified Hand Therapist in 2004. She joined New England Hand Associates in 2009 and has 20 + years of experience in the treatment of upper extremity rehabilitation, including advanced dynamic & static splinting, wound care, manual therapy, therapeutic exercise, and patient education. Melissa is a current member of the National Board Certification of Occupational Therapists (NBCOT) as well as the Hand Therapy Certification Commission (HTCC).
- Minimally Invasive SurgeryGenerally, traditional open joint surgeries take several months to heal, depending on the joint. Minimally invasive surgery and arthroscopic surgery use smaller incisions and typically heal in a shorter amount of time, from several weeks to a few months. Your doctor may restrict your activity for a short time following your surgery. In most cases, rehabilitation is recommended to mobilize and strengthen the joint.
- Joint ReplacementIn advanced arthritis, the damaged joint can be replaced with an artificial one. Artificial joints are made of metal, plastic, ceramics, or a combination of the materials. The material selected depends on the reason for the surgery, as well as which joint is being replaced. Joint replacement can provide significant pain relief and improved mobility.
- Arthritis SurgeryRecovery from arthritis surgery is very individualized. Your recovery time will depend on the extent of your condition, the joint that was involved, and the type of surgery that you had. Your doctor will let you know what you may expect.
- Hand SurgeryAll our physicians are fellowship trained in hand surgery in addition to being board-certified orthopedic surgeons. Therefore, our doctors are prepared to diagnose conditions of the hand, and will provide expert advice for treatment and care. Surgery may or may not be required, depending on the nature of your injury or condition. Should surgery become necessary, our physicians are able to provide the full range of surgical care needed for your hand or upper extremity condition.
- Orthopedic SurgeryDr. Brunelli performed his orthopedic surgery residency at New York's Mount Sinai School of Medicine. He returned to Boston to complete a fellowship in hand and upper extremity surgery at Massachusetts General Hospital in 2001.
- NeurosurgeryTreatment Nerve injuries classified as first to third degrees may heal on their own. Fourth and fifth degree injuries require surgery. Nerves cut or severed by a sharp object can be operated on immediately. Nerve injuries from other causes, such as crush injuries, may have a short waiting period before surgery to allow the nerves and tissues to start the healing process. Generally, better results follow early nerve repair. However, nerve surgery criteria are strict, and in cases of catastrophic injury, a person needs to be medically stable before surgery can take place.
- Arthroscopy
- Reconstructive SurgeryDr. Brunelli and Dr. Dietz treat upper extremity injuries and conditions, including the shoulder. Both doctors also specialize in shoulder repair and reconstructive surgery, including total shoulder replacement.
- Cyst
- Burns
- Sports MedicineThe elbow is called a hinged joint, because it moves like a hinge. The elbow is made up of three bones, the humerus, ulna, and radius. The ligaments of the elbow inside and out, called the medial collateral ligament, and the lateral collateral ligament, provide stability and mobility. Trauma, sports injuries, repetitive stress, conditions such as arthritis, and work-related injuries are all common causes of elbow pain.
- Physical TherapyYour surgeon will numb the area before removing the cyst. Following the surgery, you will wear a splint on your wrist for a few days. Your doctor may recommend occupational or physical therapy to mobilize and strengthen the joints.
- Occupational TherapyTreatment There are several different treatment options available to reduce pain and inflammation associated with tendonitis. A splint, cast, or brace may be necessary to allow your tendons to rest and heal. Your doctor may recommend using an ice pack, anti-inflammatory medications, or cortisone injections. Physical or occupational therapy can help to restore function and prevent future injury.
- Tennis ElbowTennis Elbow is a condition that results in deterioration of the tendon fibers that attach to the bone at the outside of the elbow. Tendons are strong fibers that attach muscles to bone. They are tissues that do not stretch... Read More
- Shoulder Pain
- Neck Pain
- Back Pain
- Aquatic TherapyOccupational or physical therapists can help you strengthen the muscles surrounding your joint. The resulting added joint stability can help relieve pain. Aquatic therapy in a heated pool can be especially soothing. In addition, the buoyancy of the water takes stress off the joints while exercising, and the resistance of the water can help strengthening efforts. Your therapists may also apply heat to treat stiffness, and ice to decrease pain. They may recommend splints, walkers, or canes to help relieve stress on your joints. The therapists will instruct you on how to do your daily activities, such as housework and meal preparation, in a manner that puts less stress on your joints.
- Manual TherapyKara LeSiege received her Master of Science degree at Boston University and became a licensed and registered Occupational Therapist in 1997. She has 20 years of experience and became a Certified Hand Therapist (CHT) in 2011. In addition to treating the hand and elbow, Kara specializes in the treatment of upper extremity, including advanced dynamic and static splinting, wound care, manual therapy, therapeutic exercise, and patient education. Kara also received a Master’s of Violin Performance at New England Conservatory in 1994. She performed research and wrote publications on Medical Problems of Performing Artists and has a special interest in working with musicians. Kara is a member of the Hand Therapy Certification Commission (HTCC), National Board Certification of Occupational Therapists (NBCOT) and American Society of Hand Therapy (ASHT).