Mayo Clinic's Physical Medicine and Rehabilitation (PM&R) Hand Clinic is a full team of professionals who treat people with hand, wrist, elbow and shoulder disorders.
A full team at your fingertips
Our commitment to restoring function, preserving stability and increasing ability means that you know you'll receive the best available care at the Hand Clinic. Each person on your team — physicians, procedural technicians, occupational therapists and physical therapists — has specialized knowledge in upper extremity rehabilitation.
You may not have planned on needing a hand specialist, but if you do, our hand team provides expert, nonoperative care for your needs. We are here to help you get back to what you love doing.
Our specialists work in both hospital and clinical settings, and we collaborate with a variety of other areas:
- Partner with orthopedic and plastic hand surgeons.
- Provide a comprehensive exercise program.
- Facilitate a return to function and activities.
- Perform wound care.
- Collaborate with prosthetics vendors.
- Perform pediatric testing (including T-GAP assessments).
- Create custom orthoses, which may include using a 3D printer.
State-of-the-art therapeutic procedures for pain relief
Outpatient injections and releases
Ultrasound-guided injections and releases are offered at all three major Mayo Clinic campuses, in the department of Physical Medicine and Rehabilitation. Our physicians specialize in many hand procedures, including but by no means limited to:
- Dupuytren's contracture treatments. A progressive thickening of the tissue under the palm that can cause thickened cords and nodules, Dupuytren's contracture can lead to trouble trying to complete daily tasks.
- Our PM&R providers can help you understand the risk factors, lifestyle precautions, and treatment options to protect your hands and increase function.
- Nonoperative treatments include needling and use of an enzyme to temporarily dissolve the thickened tissue.
- Trigger finger release.
- More than 2,500 people are treated at Mayo Clinic for trigger finger every year.
- Our PM&R physicians can diagnose trigger finger and create a tailored treatment plan just for you. Plans may include bracing and ultrasound-guided injections.
- For especially resistant cases, we can refer you to a hand surgeon to surgically release the digit.
- Cyst aspiration. A ganglion cyst diagnosis may be confirmed by ultrasound and aspiration, a process in which your doctor uses a needle and syringe to draw out (aspirate) the fluid in the cyst. Performed in the clinical setting, the procedure lets our physicians quickly get you going and on your way.
- Steroid injection. Ultrasound is used to accurately guide needle placement for injecting medications. Steroid injections are a commonly recommended procedure to help in reducing inflammation and pain.
- Botox injection. Using ultrasound guidance, PM&R providers perform Botox injections to temporarily prevent a muscle from moving or to assist in relaxing a muscle.
New advances in physical therapy care: Thread carpal tunnel release procedure
After conservative treatments for carpal tunnel syndrome are not effective, most people are referred for traditional endoscopic or open surgery. However, with ultrasound technique advancements, an innovative thread carpal tunnel release procedure has been developed that reduces recovery time and has excellent success.
Rare expertise in new approaches
Mayo Clinic is one of the few centers in the nation that offer ultrasound-guided intervention for carpal tunnel release. The minimally invasive treatment, which uses a thread to dissect the transverse carpal ligament, is done under local anesthesia.
"Ultrasound-assisted, minimally invasive procedures such as the thread carpal tunnel release have the potential to revolutionize how we treat some common conditions," explains Dr. Brault. "Thread carpal tunnel release is an eloquent and straightforward technique that offers patients quicker pain relief and recovery than conventional open carpal tunnel releases."
Learn more about this new incisionless thread carpal tunnel release procedure at Mayo Clinic’s Medical Professionals website.
New therapy approaches: Minimally invasive tenotomy and percutaneous ultrasound-guided tenotomy
Ultrasound-guided percutaneous tenotomy is a new tool to treat degenerative tissue (often associated with chronic tendinopathy, also called tendinitis). This procedure uses a high-pressure saline jet (percutaneous pressured hydrotenotomy) that allows diseased tissue removal but preserves healthy surrounding tissue.
No hospitalization, and only requires local anesthetic
After being evaluated by a PM&R advanced procedure physician, the minimally invasive tenotomy is completed with a team of physicians, ultrasound technicians and specialty nurses, in an outpatient setting. Only local anesthetic is necessary for the procedure.
"This approach offers greater ease of use than some of the other minimally invasive tenotomy equipment available," explains Dr. Konidis. "Aspiration of both diseased tendon and calcifications, visualized live under ultrasound, is more effective. The length of the tool allows the operator to reach more areas, and the device doesn't clog easily. Additionally, the saline jet is safer to use as it does not inadvertently debride normal tendon."
You can read more about these groundbreaking procedures on Mayo Clinic's Medical Professionals site.
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