The cost of medical care has increased significantly in the United States in recent years. Due to changes in health insurance plans, many patients are now responsible for paying a larger portion of the cost associated with the treatment they receive. These out-of-pocket costs cause difficulties for many families. Raleigh Hand to Shoulder Center physicians are aware of the financial burden of medical expenses for patients and strive to reduce costs in several ways.

The Raleigh Hand to Shoulder Center has been committed to providing high-quality and cost-effective treatment for many years. Since the founding of the Center, Raleigh Hand has remained an independent practice in the community. Independent physician practices have been shown to be less expensive than hospital-owned practices in recent studies.

Cost-Effective Treatment Options

Cost-effective treatment begins with providing appropriate, necessary medical care to patients. Conservative treatment options are emphasized at Raleigh Hand to Shoulder. The doctors recommend surgery only when it is necessary. Also, MRIs, CT scans, nerve tests, and other expensive tests are only ordered when required for treatment. Providing value-based care can reduce the overall cost to the patient and community.

Additionally, Raleigh Hand to Shoulder Center offers same day and next day appointments for patients with urgent problems, which reduces the need for costly emergency room visits. Avoiding the ER can save patients both time and money! The physicians are also on-call 24/7 to help triage emergency cases from doctors’ offices, urgent cares, and emergency rooms to expedite patient treatment.

Affordable Outpatient Surgery in Wake County

Raleigh Hand to Shoulder Center physicians perform the majority of their outpatient surgeries at Capital City Surgery Center, which charges a much lower facility fee than local-area hospitals. Additionally, the price of equipment and implants used during surgery has been negotiated with manufacturers to keep these costs down.  Many hand procedures can be performed using local anesthesia only, avoiding the anesthesiologist’s fee. Raleigh Hand to Shoulder Center physicians maintain a low infection rate and low complication rate, reducing the need for secondary surgeries or additional treatment.  Less-invasive surgery is available in many cases, allowing patients a more rapid return to their work and livelihood. Some surgical procedures can be done in the office, which is another major cost savings for patients.

Raleigh Hand to Shoulder Center physicians have been listed as preferred providers by several insurance companies by providing high-quality care at a low cost. They are also part of the high value specialty network by a local health care organization.

Payment plans are available for patients with high deductible insurance plans. Find out more at the Raleigh Hand to Shoulder Center office.

We are proud to announce the addition of Emily Coronado, OTD, OTR/L to the Raleigh Hand to Shoulder therapy department! Emily has undergone extensive training at Duke University Medical Center and has received a doctorate in Occupational Therapy. Emily has experience in occupational therapy, hand therapy, and she is interested in pursuing her certification in hand therapy (CHT). When she is not at work Emily enjoys weight lifting, salsa dancing, swimming, and cooking. Emily is also bilingual and speaks Spanish fluently. Welcome Emily!

All the doctors at Raleigh Hand to Shoulder Center are double board-certified in orthopedic and hand surgery by the American Board of Orthopaedic Surgery. Find out more about the high standards of the board certification process at www.abos.org

The doctors and staff at the Raleigh Hand to Shoulder Center are proud to announce their practice mission statement: “To improve the lives of our patients with compassionate, trusted, and cost-effective care.” We look to this mission statement in our everyday practice as a guiding principle in caring for our patients.

Effective 10/28/2024 we will no longer be open on Saturdays. Our doctors are always on call 24-7 for patients with urgent problems. Call our office at 919-872-3171 and you can speak to a board-certified hand surgeon after hours and on weekends. Our doctors can help triage conditions and treat patients promptly.

Raleigh Hand to Shoulder Center doctors are designated Tier 1 with Cigna and Premium Specialty Status with United HealthCare insurance companies! They have also been designated a high value specialist practice by the WakeMed Key Community ACO. This designation is assigned to doctors and practices who provide high value healthcare for their patients.

Andrea Lueken, OTR/L CHT grew up in Minnesota where she earned her Bachelor of Science in Psychology with a minor in Art. She then received her Masters in Occupational Therapy at Eastern Michigan University in Yspilanti, MI. Andrea moved to Chicago, IL and discovered her passion for upper extremity rehabilitation and orthopedics while working in hospital outpatient programs. Andrea began working for Raleigh Hand to Shoulder Center in 2011. She obtained her Certification in Hand Therapy (CHT) that same year. She enjoys being creative in helping her patients return to their function. When she is not at Raleigh Hand to Shoulder Center, Andrea is driving her two boys to their baseball and basketball games. Andrea also stays busy with her 2 year-old golden retriever Evie who requires constant pets and tennis ball throws! When her boys and dog are finally tired, Andrea mostly enjoys sleeping, reading, playing volleyball, gardening, and baking.

Dr. James Post of Raleigh Hand to Shoulder Center discussed treatment of patients with rheumatoid arthritis involving the wrist. Orthopedic surgery residents, hand therapy, and Raleigh area hand surgeons were in attendance. Watch the video below to learn more about this condition.

Dr John Erickson was raised in El Paso, Texas. His father was an officer in the US Army, and the Erickson family settled in El Paso after his father retired from the military. As a youth, Dr. Erickson developed a love of the outdoors, was active in Boy Scouts, and earned the Eagle Scout Award. He went to medical school at the University of Texas Southwestern Medical Center. He completed his orthopedic surgery residency at the University of Michigan, where he met his wife, Kimberly. He has been with the Raleigh Hand to Shoulder Center since he finished his hand surgery fellowship at Vanderbilt University in 2010. 

While he was deciding where to “hang his shingle” after training, Dr. Erickson was immediately interested in the Raleigh Hand practice. He was impressed with the camaraderie among the surgeons, the integration of hand therapy within the practice, and the friendliness of the staff members. He says, “Our practice is unique. We are a small family – an independent, very specialized group of doctors and therapists, who really care about delivering high quality care to our patients. This is a great place to work.”

Dr. Erickson is double board-certified by the American Board of Orthopedic Surgery in orthopedic surgery and hand surgery. He was president of the North Carolina Society for Surgery of the Hand in 2021. He also helps to organize weekly hand conferences at WakeMed hospital for orthopedic resident education. 

Dr. Erickson’s approach to patient care is straightforward: he treats people as he would like to be treated. Similar to all the doctors in the Raleigh Hand practice, he begins with conservative treatment recommendations for most conditions. 

Dr. Erickson is married to Dr. Kimberly Erickson, a pediatric surgeon at WakeMed Hospital in Raleigh. They have one teenage daughter and a rescue dog. The Ericksons are active members of Christ Church in downtown Raleigh. He has participated in volunteer mission trips in medical school and in private practice. He enjoys spending time with his family, traveling, hiking, and being outdoors. During the COVID-19 pandemic, Dr. Erickson began painting landscape art, and he has turned this into a rewarding hobby.   

Dr John Erickson

Persistent hand pain after carpal tunnel surgery is a common question patients have following surgery. I want to expand on post-operative pain, as the great majority of the time the pain is related to normal healing.  

Let’s start by breaking it down by time following surgery and what is abnormal and what is  normal immediate post-operative pain. This is pain within the first 4-6 weeks of surgery.  Remember that regardless of the technique used to release the structure causing carpal tunnel  syndrome, the ligament being released is a robust structure. You need to realize the transverse  carpal ligament released is roughly as thick as the thickness of a cardboard box. Immediately  after the release, there will be a period of time not only for the ligament to heal in a lengthened  position but also for the bones attached to the released ligament to adjust.  

Normal Pain After Carpal Tunnel Surgery

Two common complaints after surgery are “the base of my thumb hurts” and “when I put  weight on my hand it continues to be sore.”  

Many patients who have carpal tunnel syndrome also have arthritis at the base of the thumb.  After the ligament is released, there can be a transient increase in pain in the area of arthritis or  occasionally new onset of symptoms at the base of the thumb. As the base of the thumb  “adjusts” to its new environment the symptoms will typically resolve without any treatment. If  symptoms persist, treatment with topical medications, splinting or occasional injection are  required. It is rare that the symptoms of the thumb persist after several months.  

Weight-bearing pain in the palm and hand pain with forceful gripping or heavy lifting is normal  as well. This is expected with normal healing post surgery, and gets better over time. We ask patients to avoid weight  bearing if the pain is significant but mild pain with weight bearing is perfectly acceptable. Pain  with heavy lifting and forceful gripping is also normal post-operative healing. We typically tell  you to wait approximately three weeks after the surgery before your most heavy activities are  resumed. Each patient’s symptoms and activities vary so this needs to be addressed on an  individual basis. Patients should increase activities as tolerated at three weeks within their  tolerance.  

Abnormal Hand Pain After Carpal Tunnel Surgery

Now we need to discuss abnormal early post-operative hand pain After carpal tunnel surgery. Keep in mind that these  complications are rare but need to be differentiated from normal post-operative pain.  

Nerve injury related to carpal tunnel surgery is extremely uncommon and is sometimes difficult to  separate from normal recovery of the nerve. Significant increased numbness in the hand or  individual fingers immediately after the surgery is concerning. Local anesthetic is used during  the surgery which causes numbness lasting sometimes 6 hours or more after surgery. Wait  until the effects of the anesthetic have worn off before deciding if there is increased numbness.  If this occurs the physician would want to have you come to the office in a timely manner to  evaluate the hand.  

Infection is another rare complication following carpal tunnel surgery. Patients who develop a  surgical site infection typically have increasing pain, swelling and redness around the incision.  Most patients need few, if any, narcotic pain medications after the surgery. If controlling your  pain requires more narcotics or other meds such as NSAIDs daily rather than less meds, this can be an early sign of a developing infection. Increased drainage from the incision, and fever  are also signs of infection but typically develop later than increase swelling, redness and pain.  If you develop any of these symptoms immediately call the office or physician on call to  discuss. 

Nerve Recovery Pain After Carpal Tunnel Surgery

One other symptom post-surgical that we should comment on is “nerve recovery hand pain” after carpal tunnel surgery. This is  not a complication but can be very disturbing for the patient.

When the ligament is released the chronic pressure on the nerve is removed. In the great majority of cases the patient’s numbness is resolved without nerve recovery pain. In rare cases as the nerve recovers it is painful.

Think about when your leg goes to sleep after sitting too long. The sensation to the  leg and foot is diminished. We get up and move the leg around to “wake it up”. During the  waking up phase you can get a burning or tingling sensation in the foot before it fully recovers.  This odd sensation similar to warming hands that got too cold can be very uncomfortable. This  is similar to what happens in some patients when the pressure is relieved from the nerve.  Fortunately this is transient and is a sign that the nerve is recovering. Most of the time this is  short lived but may have a more protracted course requiring treatment.

Dr. James Post is a member of the American Society for Surgery of the Hand and is board-certified in orthopedic surgery and hand surgery by the American Board of Orthopedic Surgery. Read more about carpal tunnel surgery and many other conditions of the hand and arm on our website.