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I have spent the past 25 years helping patients by surgery and our
therapy program to heal from carpal tunnel, repetitive strain injury
as well as from pain from nerve injuries. I have reattached entirely
amputated arms, hands and fingers, moved and reconnected nerves in
patients with severe pain from nerve injury and helped literally
thousands of people return to normal lives after severe injuries
to their bodies.
BUT early in my career I found that it was not usually the dramatic
operation or the miracle medication that healed them…..
"I discovered that my patients healed optimally in a quieter,
more passive and pain-free way than just through surgery-- and in
many cases actually avoided surgery. This healing process involved
the patient using his or her own belief, much like prayer and the
power of positive thinking, but turned inward! Through approaching
the pain with a different outlook-- being involved with a sense of
control of their own healing, understanding that every human being
is born with the same innate power to heal - given us as birthright,
they healed. Further, through the help of our therapists they learned
self-help techniques, such as massage, life activity modification
and how to eat and exercise better; even how to move and sit differently.
We custom made splints and supports, to rest their injured nerves,
tendons and joints in exactly the right position for them to heal.
Through these incremental and combined measures, I saw tremendous
healing take place.
The Upper Extremity Institute was
founded on the premise that conservative care works for problems
in the upper extremity including orthopaedic, nerve, tendon, vascular
or circulatory, neck and wrist and hand problems. It's our belief
that each treatment program must be tailored to that individual
A NEW STATE OF THE ART PROCEDURE AT THE UPPER EXTREMITY INSTITUTE ˝ NEUROMUSCULOSKELATAL (NMSK) ULTRASOUND
What if there was a way to look inside the body
without having to make an incision.
And evaluate muscles, ligaments, joints, nerves, and blood vessels
And see how they move, stretch and function
And identify injury, inflammation, scar, and arthritisÍÍ
Well we can!
It is called Neuromusculoskeletal Ultrasound
I would like to introduce you to a new and exciting diagnostic tool we are using here at The Upper Extremity Institute. You may be familiar with ultrasound from looking at babies at the doctorÝs office. Well, this is similar, but now the clarity on the scans is such that we can actually see the nerves, muscles, joints and ligaments LIVE and in great detail. It is a study, which can be invaluable in allowing us to successfully identify problems and often avoid surgery. Many times ultrasonically guided injection and/or clinically directed therapy, can result in successful treatment and alleviation of symptoms and pathology.
Musculoskeletal Ultrasound is a well-accepted treatment and diagnostic tool in the radiology and orthopedic community for the treatment and diagnosis of orthopaedic and musculoskeletal injury.
Neuromusculoskelatal (NMSK) Ultrasound is a diagnostic, sometimes-therapeutic technique utilized to evaluate pathology of muscles, nerves, tendons, ligaments and joints. Orthopedic muscle ultrasound allows us to visualize these structures in a noninvasive manner to evaluate the possibility of pathology. This technique is not greatly different than radiographs, MRI scans and other radiology imaging techniques, although images are many times clearer and the pathology can be pinpointed by the doctor who is aiming the probe directly at the are that hurts.
IT GETS EVEN BETTER.....
Dynamic Neuromusculoskelatal Ultrasound
Dr Fried felt that simply looking at still images what not enough to give information about certain problems, like carpal tunnel and thoracic outlet syndrome, where the nerves act and feel differently when the arm is placed in different positions or various activities are performed. In fact, his question was ýcould we see actually what is happening to these nerves in real live time, when the patient has symptoms?ţ This had not been possible before with other standard tests. With dynamic NMSK ultrasound, like surgical arthroscopy, he found this allowed us to evaluate dynamic living moving musculoskeletal pathology but without the need for surgery! In addition, dynamic NMSK ultrasound also allows us to look at nerves and actually see them live as the tissues around them move and how they are affected by scar around them, tendinitis such as in carpal tunnel and compression at the neck and arm as they run through muscle.
The technique is performed utilizing a probe, which emits ultrasonic waves, which then gives us visual pictures of the structures they are aimed through. The movement of the muscle or joint, ligament or tendon, paths of blood vessels and nerves can all be assessed in a real-time fashion. This allows the surgeon to more readily evaluate pathology, observing how the tissues and structures change with movement.
It is a study, which can be invaluable in allowing us to successfully identify problems and often avoid surgery. Many times ultrasonically guided injection and/or clinically directed therapy, can result in successful treatment and alleviation of symptoms and pathology. It also allows us to identify early on pathology that does require more aggressive treatment to avoid progression.
This is especially helpful in rotator cuff injury, carpal tunnel, radial and ulnar nerve injury and brachial plexus (thoracic outlet) injuries. Ligament and tendon inflammation issues, cysts and tennis elbow problems are also well identified at the shoulder, elbow wrist and hand. The muscles, nerves tendon and ligament structures can easily be visualized and static as well as motion images give real time pictures of the actual tissues.
Dr. Scott Fried
Dr Fried, through his practice as a board certified orthopaedic surgeon, fellowship trained hand surgeon and upper extremity surgeon and specialist in treating nerve pain, teaches patients to heal through the use of medical self ˝ hypnosis, medication, nutrition, exercise, lifestyle modification, standard and alternative therapies, and surgery as a last resort. He shows patients how these easier and more permanent treatments fit together in the treatment of orthopedic injuries, and problems like carpal tunnel and repetitive strain injury and RSD, achieving extraordinarily successful and predictable results. Few surgeons in this country are taking such an aggressive approach and stance toward helping patients avoid surgery, and the message is so vital to so many peopleÝs happiness.
Dr. Fried - Upcoming and Recent Appearances
The Upper Extremity Institute
provides traditional and alternative treatment for problems such
|Carpal Tunnel Syndrome
||Repetitive Strain injury
|Thoracic Outlet problems
||Cervical Disk injury
|Ulnar Nerve injury
|Radial Nerve injury
||Reflex Sympathetic Dystrophy
|Median Nerve injury