What is artificial disc replacement surgery?

Artificial disc replacement (ADR) replaces a damaged cervical or lumbar disc with an artificial implant, preserving natural spinal motion unlike fusion surgery.

Who is a good candidate for disc replacement in New York?

Patients with degenerative disc disease, herniated discs, or chronic neck/back pain unresponsive to conservative treatment. Dr. Brusovanik evaluates each patient individually.

What is the recovery time after disc replacement surgery?

Most patients walk the same day and return to light activity in 2-4 weeks. Full recovery takes 3-6 months with post-operative physical therapy.

Does Dr. Brusovanik perform both cervical and lumbar disc replacement?

Yes, Dr. Georgiy Brusovanik, MD performs both cervical and lumbar artificial disc replacement at Total Orthopedics & Sports Medicine in NYC and Long Island.

What type of doctor treats shoulder pain?

An orthopedic shoulder specialist treats conditions affecting the rotator cuff, labrum, cartilage, tendons, ligaments, and shoulder joint. Persistent pain, weakness, stiffness, clicking, or instability should be evaluated to determine the precise cause.

What are the most common causes of shoulder pain?

The most common causes of shoulder pain include rotator cuff tears, tendinitis, impingement, bursitis, frozen shoulder, arthritis, labral tears, instability, fractures, and biceps tendon injuries. A focused examination helps identify which structure is causing the symptoms.

How can I tell if I have a rotator cuff tear?

Common rotator cuff tear symptoms include shoulder weakness, night pain, difficulty lifting the arm, and pain with overhead movement. An orthopedic shoulder specialist may use an examination, X-rays, ultrasound, or MRI to confirm the diagnosis.

Why does shoulder pain become worse at night?

Shoulder pain may worsen at night because sleeping positions place pressure on inflamed tendons, bursae, or arthritic joints. Rotator cuff injuries, bursitis, frozen shoulder, and shoulder arthritis commonly cause nighttime pain that disrupts sleep.

When should I see a shoulder specialist?

See a shoulder specialist when pain lasts several weeks, repeatedly returns, affects sleep, or limits lifting and movement. Sudden weakness, visible deformity, severe pain, or a shoulder that feels dislocated requires prompt medical evaluation.

Can shoulder pain be treated without surgery?

Many shoulder conditions can be treated without surgery. Depending on the diagnosis, treatment may include activity modification, medication, physical therapy, rehabilitation, or image-guided injections designed to reduce pain and restore movement.

Does a rotator cuff tear always require surgery?

A rotator cuff tear does not always require surgery. Physical therapy, medication, activity modification, and injections may improve pain and function, while surgery may be recommended for traumatic tears, significant weakness, or symptoms that continue despite treatment.

When is shoulder arthroscopy recommended?

Shoulder arthroscopy may be recommended when a confirmed structural injury continues causing pain, weakness, or instability despite nonsurgical care. It can treat rotator cuff tears, labral injuries, impingement, biceps problems, and damaged tissue within the shoulder.

What is the difference between total and reverse shoulder replacement?

Total shoulder replacement recreates the natural ball-and-socket joint and typically requires a functional rotator cuff. Reverse shoulder replacement changes the joint mechanics and may be used for irreparable cuff tears, severe arthritis, complex fractures, or failed previous surgery.

How long does recovery take after shoulder surgery?

Shoulder surgery recovery depends on the procedure, injury severity, tissue quality, age, and rehabilitation plan. Some patients regain useful movement within weeks, while rotator cuff repair, reconstruction, or shoulder replacement recovery may continue for several months.

Can a failed shoulder surgery be corrected?

Some failed shoulder surgeries can be treated with revision surgery, reconstruction, tendon repair, or shoulder replacement. The appropriate treatment depends on the previous procedure, current imaging, tissue quality, bone loss, stiffness, instability, and remaining shoulder function.

Where can I find a shoulder specialist in New York or New Jersey?

Total Orthopedics & Sports Medicine provides specialized shoulder care across New York, Long Island, and New Jersey. Services include diagnosis, physical therapy, image-guided treatment, shoulder arthroscopy, rotator cuff repair, reconstruction, and shoulder replacement.

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Hand & Wrist Specialists in New York & New Jersey

Your hands and wrists make nearly every daily task possible, from typing and gripping to dressing, driving, and sports. Total Orthopedics provides specialized care for carpal tunnel syndrome, trigger finger, tendon and ligament injuries, fractures, arthritis, ganglion cysts, and nerve disorders, with treatment focused on restoring motion, strength, sensation, and dexterity.

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Meet our hand & wrist specialists

Connect with experienced orthopedic specialists who diagnose and treat carpal tunnel syndrome, tendon injuries, arthritis, sprains, fractures, and other hand and wrist conditions.

Showing 4 hand & wrist specialists

Understanding Hand & Wrist Function

The hand and wrist form a highly coordinated system built for both strength and precision. Eight carpal bones connect the forearm to the hand, allowing the wrist to bend, straighten, and move side to side while the fingers perform tasks ranging from firm gripping to delicate pinching.

Movement depends on small joints working together with flexor and extensor tendons, stabilizing ligaments, and specialized hand muscles. The median, ulnar, and radial nerves provide sensation and motor control, while cartilage helps the bones move smoothly with minimal friction.

Because these structures occupy limited space, injury, inflammation, arthritis, or nerve compression can quickly affect dexterity. Wrist pain, finger stiffness, numbness, weakness, swelling, clicking, or reduced grip may originate from different tissues, making an accurate diagnosis essential before treatment begins.

Healthy hand and wrist function relies on:

Effective hand and wrist treatment starts by identifying whether symptoms arise from a joint, tendon, ligament, nerve, or bone.

How Hand and Wrist Problems Begin

Hand and wrist symptoms may follow a single injury or emerge gradually as small joints, tendons, and nerves are repeatedly stressed. The pattern of pain, numbness, swelling, or catching often points to the structure involved.

Falls, Fractures & Ligament Damage

Landing on an outstretched hand commonly injures the distal radius, while a scaphoid fracture may cause persistent tenderness near the base of the thumb. Wrist sprains can also tear stabilizing ligaments, including the scapholunate ligament. Deformity, marked swelling, reduced motion, or continued pain after a fall needs prompt evaluation.

Nerve Compression, Tendon Friction & Arthritis

Carpal tunnel syndrome affects the median nerve, causing nighttime numbness or tingling in the thumb, index, middle, and part of the ring finger. Trigger finger causes catching or locking, while de Quervain tenosynovitis produces thumb-side wrist pain. Arthritis and ganglion cysts may create aching, stiffness, swelling, or restricted motion.

How We Pinpoint Hand and Wrist Problems

Pain location, finger involvement, grip changes, swelling, and symptom triggers provide valuable diagnostic clues. A structured hand and wrist evaluation distinguishes tendon, ligament, nerve, joint, cartilage, and bone disorders.

The Symptom Pattern Matters

Thumb-side wrist pain may suggest de Quervain tenosynovitis or a scaphoid injury, while pinkie-side pain can involve the TFCC, tendons, or ulnar-side joints. Nighttime numbness in the thumb, index, and middle fingers points toward median nerve compression. Clicking, locking, swelling, or reduced grip provides additional clues.

Hands-On Functional Testing

Your specialist examines wrist and finger motion, grip and pinch strength, tendon function, joint stability, and areas of tenderness. Sensation and muscle function are checked across the median, ulnar, and radial nerve distributions. Comparing both hands helps identify subtle swelling, weakness, deformity, or reduced dexterity.

Imaging and Nerve Testing

X-rays assess fractures, arthritis, alignment, and bone changes. MRI evaluates ligaments, cartilage, tendons, and hidden fractures, while ultrasound shows tendon movement, cysts, and certain nerve abnormalities in real time. Electrodiagnostic testing may confirm carpal tunnel syndrome or another nerve compression and measure its severity.

Treatment is selected according to the affected nerve, tendon, ligament, joint, or bone, along with symptom severity, hand dominance, functional demands, and response to previous care.

Custom splinting, motion exercises, tendon-gliding work, and progressive strengthening help restore hand function while protecting irritated or healing tissues.

When appropriate, corticosteroid injections may target the carpal tunnel, an inflamed tendon sheath, or an arthritic joint. Ultrasound guidance may improve placement.

Persistent carpal tunnel syndrome may require surgical release when numbness, weakness, muscle loss, or nerve damage progresses despite appropriate nonsurgical treatment.

Fractures, tendon or ligament tears, joint damage, trigger finger, and symptomatic ganglion cysts may require fixation, repair, arthroscopy, release, reconstruction, or excision.

Hand & Wrist Conditions We Treat

Hand and wrist symptoms may involve nerves, tendons, ligaments, joints, cartilage, or bone. A precise evaluation identifies the affected structure and guides treatment to restore sensation, dexterity, strength, stability, and motion.

Carpal Tunnel & Nerve Compression

The median nerve passes through the carpal tunnel at the wrist. Compression may cause numbness, tingling, burning, or weakness in the thumb, index, middle, and part of the ring finger, often worsening at night. Testing may include sensory and strength evaluation, ultrasound, or electrodiagnostic studies.

Nighttime numbness commonly affects the median nerve distribution
Symptoms may worsen with certain wrist positions or repetitive use
Progressive weakness or thenar muscle loss indicates advanced compression
Treatment may include splinting, injection, or carpal tunnel release

Trigger Finger & Tendon Disorders

Trigger finger develops when a flexor tendon cannot glide smoothly through its sheath, causing painful catching or locking. De Quervain tenosynovitis affects tendons along the thumb side of the wrist and typically hurts during gripping, lifting, or thumb movement. Other tendon injuries may cause weakness or reduced finger motion.

Wrist Fractures, Ligament Tears & Instability

Falls onto an outstretched hand commonly cause distal radius fractures and may also injure the scaphoid or stabilizing wrist ligaments. Scapholunate ligament tears and TFCC injuries can produce pain, clicking, weakness, or instability. Treatment depends on fracture alignment, healing risk, joint stability, and activity demands.

Arthritis, Ganglion Cysts & Contractures

Arthritis can affect the wrist, thumb base, or finger joints, causing pain, stiffness, swelling, and reduced grip or pinch strength. Ganglion cysts commonly arise near joints or tendon sheaths and may change in size. Dupuytren contracture can gradually pull fingers toward the palm and limit extension.

Why Choose Total Orthopedics for Specialized Hand & Wrist Care?

Hand and wrist problems can disrupt sensation, pinch, grip, and fine motor control. Total Orthopedics evaluates how the bones, joints, tendons, ligaments, and nerves work together, then builds treatment around the specific function you need to regain.

What Sets Our Hand Care Apart

Care covers carpal tunnel syndrome, trigger finger, de Quervain tenosynovitis, ganglion cysts, arthritis, fractures, and tendon injuries.
Examinations assess finger motion, tendon gliding, grip, pinch, wrist stability, sensation, and fine motor control.
Numbness patterns are carefully mapped to determine whether the median, ulnar, or radial nerve is involved.
X-rays, MRI, ultrasound, CT, and electrodiagnostic testing are used only when clinically appropriate.
Nonsurgical plans may include custom splinting, tendon-gliding exercises, hand therapy, medication, or targeted injections.
Procedures include carpal tunnel release, trigger finger release, ganglion excision, tendon repair, fracture fixation, and wrist arthroscopy.
Certified hand therapy can address swelling, stiffness, scar mobility, weakness, and loss of finger or wrist motion.
Treatment focuses on restoring practical abilities such as typing, buttoning, gripping, lifting, working, and playing sports.

When Hand or Wrist Surgery May Be the Right Next Step

Surgery may be considered when a confirmed structural or nerve problem continues to interfere with sensation, finger movement, grip, pinch, or daily function despite appropriate nonsurgical treatment. The decision is based on the diagnosis, severity, and expected functional benefit.

X-rays, MRI, ultrasound, or nerve studies confirm the exact hand or wrist structure involved.
Splinting, medication, hand therapy, activity changes, or injections have not restored adequate function.
A repairable tendon, ligament, nerve, fracture, or joint condition is limiting grip, pinch, or finger movement.
Testing confirms that numbness or weakness originates in the hand or wrist rather than the cervical spine.
Your overall health and ability to follow postoperative restrictions support safe healing and rehabilitation.

Hand and Wrist CARE FAQ

Questions About Hand and Wrist Pain, Numbness and Injury

Practical answers about carpal tunnel syndrome, tendon injuries, arthritis, fractures, stiffness, and hand and wrist surgery.

What type of doctor treats hand and wrist problems?

An orthopedic hand and upper-extremity specialist diagnoses conditions affecting the bones, joints, tendons, ligaments and nerves of the hand, wrist and fingers. Treatment may include bracing, therapy, injections or surgery based on the diagnosis.

Why do my hands become numb at night?

Nighttime numbness commonly occurs when carpal tunnel syndrome compresses the median nerve at the wrist. Symptoms often affect the thumb, index, middle and part of the ring finger. Persistent numbness, dropping objects or hand weakness should be evaluated.

Why does my finger catch or lock when I bend it?

A catching or locking finger may indicate trigger finger. This condition develops when the flexor tendon cannot glide smoothly through its surrounding sheath. Symptoms may improve with rest, splinting, medication or an injection, while persistent cases may require release surgery.

What causes pain on the thumb side of the wrist?

Thumb-side wrist pain may result from de Quervain’s tenosynovitis, thumb-base arthritis or a scaphoid injury. Because these conditions affect different structures, an examination and appropriate imaging help determine the correct diagnosis and treatment.

Why does the pinkie side of my wrist hurt or click?

Seek an orthopedic evaluation for significant swelling, bruising, deformity, tenderness or difficulty moving the wrist after a fall. Continued pain near the base of the thumb may indicate a scaphoid fracture, even when the injury initially appears minor.

Can I have a wrist fracture if my first X-ray is normal?

Yes. Certain fractures, particularly scaphoid fractures, may not appear clearly on the first X-ray. If tenderness and pain continue, your specialist may recommend immobilization followed by repeat X-rays, an MRI or a CT scan.

Does a ganglion cyst need to be removed?

Not always. A painless ganglion cyst can often be monitored because some resolve without treatment. Aspiration or surgical removal may be considered when the cyst causes persistent pain, restricts movement, compresses a nerve or interferes with daily activities.

Can hand and wrist conditions improve without surgery?

Many conditions respond to nonsurgical care. Depending on the diagnosis, treatment may include activity modification, splinting, anti-inflammatory medication, hand therapy or a guided injection. Surgery is generally considered when symptoms remain severe or function continues to decline.

When is carpal tunnel release recommended?

Carpal tunnel release may be recommended for persistent numbness, sleep disruption, hand weakness, muscle loss or significant nerve compression. It may also be considered when bracing, activity changes or injections no longer provide sufficient relief.

How long is recovery after hand or wrist surgery?

Recovery depends on the procedure and the tissues involved. Some patients resume light activities within several weeks, while tendon repairs, ligament reconstruction and complex fractures may require months of protection and rehabilitation. Following postoperative restrictions is essential for proper healing.