Dr. Nicholas Fiore, MD

Dr. Nicholas Fiore Hand Surgeon

Dr. Nicholas A. Fiore II is a hand and upper-extremity surgeon providing medical and surgical care for conditions affecting the fingers, hand, wrist, forearm, and elbow.

His clinical work includes carpal tunnel syndrome, cubital tunnel syndrome, trigger finger, arthritis, fractures, tendon injuries, sports injuries, nerve damage, cysts, and other conditions that interfere with hand strength, sensation, movement, or everyday function.

Dr. Fiore practises at Fiore Hand & Wrist in Houston, Texas. His practice is dedicated to upper-extremity care and includes access to occupational therapy for patients who need rehabilitation after an injury, procedure, or operation.

He may provide non-surgical treatment, injections, fracture management, microsurgical procedures, minimally invasive nerve-release surgery, tendon repair, joint reconstruction, and other operations selected according to the diagnosis.

Patients whose arm or hand symptoms may originate from the neck or spinal nerves may also read about Dr. Lan Nguyen’s physical medicine and rehabilitation care.

Doctor Information

Name: Dr. Nicholas A. Fiore II, MD, FACS
Specialty: Surgery of the Hand
Additional Specialty Background: General Surgery
Board Certifications: General Surgery and Surgery of the Hand through the American Board of Surgery
Undergraduate Education: Duke University
Medical School: Ross University School of Medicine
Medical Degree Completed: 1999
General Surgery Residency: University of Medicine and Dentistry of New Jersey, New Jersey Medical School
Residency Period: 2000 to 2005
Hand Surgery Fellowship: Baylor College of Medicine
Fellowship Period: 2005 to 2006
Former Academic Appointment: Assistant Professor in the Division of Plastic Surgery at Baylor College of Medicine
Practice: Fiore Hand & Wrist
Practice Established: 2007
Primary Location: Houston, Texas
Clinical Focus: Hand, wrist, forearm, and elbow conditions
Language Listed: English
NPI Number: 1306865456
Accepting New Patients: Current availability should be confirmed directly with the practice
Occupational Therapy: Available through the practice according to its current website

About Dr. Nicholas Fiore

Dr. Fiore completed his undergraduate education at Duke University, where he also participated in collegiate wrestling.

His interest in hand surgery developed after he fractured his wrist while wrestling and required surgical treatment. His experience with the physical limitations and recovery associated with a hand injury influenced his decision to focus on upper-extremity surgery.

He later earned his medical degree from Ross University School of Medicine in 1999.

Dr. Fiore completed general surgery residency training at the University of Medicine and Dentistry of New Jersey, now connected with Rutgers New Jersey Medical School.

He then completed a hand and microsurgery fellowship at Baylor College of Medicine. Fellowship training in hand surgery includes advanced care involving bones, joints, tendons, ligaments, nerves, blood vessels, skin, and other tissues of the upper extremity.

After fellowship, Dr. Fiore joined Baylor College of Medicine as an assistant professor in the Division of Plastic Surgery.

He entered private practice and established Fiore Hand & Wrist in 2007. His current practice is devoted to conditions involving the hand, wrist, forearm, and elbow.

Hand and Upper-Extremity Services

Dr. Fiore may evaluate and treat concerns such as:

• Carpal tunnel syndrome
• Cubital tunnel syndrome
• Trigger finger
• Hand and wrist arthritis
• Finger arthritis
• Thumb arthritis
• Hand fractures
• Wrist fractures
• Finger fractures
• Joint dislocations
• Tendon injuries
• Ligament injuries
• Sports-related injuries
• Nerve damage
• Ganglion cysts
• Dupuytren’s contracture
• Tennis elbow
• Golfer’s elbow
• De Quervain’s tenosynovitis
• Hand or wrist masses
• Reduced grip strength
• Numbness and tingling
• Pain after an earlier injury

The most suitable treatment depends on the affected structure, severity, symptom duration, previous treatment, and effect on work or ordinary activity.

Not every hand condition requires surgery. Dr. Fiore may recommend observation, splinting, therapy, medicine, injection, or activity modification before considering an operation.

Hand and Wrist Examination

A hand examination may assess:

• Finger and wrist movement
• Grip strength
• Pinch strength
• Joint stability
• Swelling
• Tenderness
• Skin condition
• Tendon movement
• Sensation
• Blood circulation
• Areas of numbness
• Previous surgical scars
• Ability to complete specific tasks

Dr. Fiore may compare the affected hand with the other side.

The pattern of pain, weakness, stiffness, or numbness can help identify whether symptoms involve a joint, tendon, ligament, bone, or nerve.

Testing may include X-rays, ultrasound, MRI, CT imaging, electromyography, or nerve-conduction studies.

Carpal Tunnel Syndrome

Carpal tunnel syndrome develops when the median nerve becomes compressed as it passes through a narrow space at the wrist.

Possible symptoms include:

• Numbness in the thumb, index, and middle fingers
• Tingling at night
• Hand weakness
• Dropping objects
• Difficulty with buttons
• Symptoms while driving
• Discomfort during phone use
• Reduced thumb strength

Symptoms may initially appear only at night or during certain activities.

As compression becomes more advanced, numbness may remain present during the day, and the muscles controlling the thumb can weaken.

Dr. Fiore may assess symptoms, hand strength, sensation, and the response to specific examination techniques.

Nerve-conduction testing may be used to confirm the diagnosis or determine how strongly the nerve is affected.

Non-Surgical Carpal Tunnel Care

Early or mild carpal tunnel syndrome may be managed through:

• Wrist splinting
• Temporary activity modification
• Ergonomic adjustments
• Treatment of contributing medical conditions
• Corticosteroid injection
• Monitoring

A splint is commonly used to keep the wrist in a neutral position, particularly during sleep.

An injection may reduce inflammation and provide temporary relief. It does not permanently create more space within the carpal tunnel.

Surgery may be considered when symptoms persist, weakness develops, testing shows significant nerve compression, or non-surgical care does not provide enough improvement.

Carpal Tunnel Release

Carpal tunnel release divides the ligament forming the roof of the carpal tunnel.

This creates more room for the median nerve.

Dr. Fiore’s practice highlights experience with minimally invasive and endoscopic carpal tunnel surgery.

Depending on the patient and procedure, potential benefits of a smaller surgical approach may include:

• A smaller incision
• Less disruption of surrounding tissue
• Reduced scar sensitivity
• Earlier hand use
• Faster return to selected activities

The nerve may not recover immediately after surgery.

Tingling may improve quickly in some patients, while long-standing numbness or weakness can take longer. Severe or prolonged nerve damage may not completely reverse.

Cubital Tunnel Syndrome

Cubital tunnel syndrome develops when the ulnar nerve becomes compressed near the elbow.

The ulnar nerve supplies sensation to the little finger and part of the ring finger. It also helps control several small hand muscles.

Symptoms may include:

• Numbness in the little finger
• Tingling in the ring finger
• Symptoms while the elbow is bent
• Hand weakness
• Reduced grip
• Difficulty spreading the fingers
• Loss of fine hand control
• Aching near the inner elbow

Symptoms may worsen during sleep, phone use, driving, or leaning on the elbow.

Dr. Fiore may assess sensation, finger strength, nerve stability, and whether the nerve moves abnormally around the elbow.

Nerve-conduction studies can help identify the location and severity of compression.

Cubital Tunnel Release

Initial treatment may involve:

• Avoiding prolonged elbow bending
• Reducing pressure on the inner elbow
• Nighttime positioning
• Activity adjustments
• Therapy
• Monitoring

Surgery may be considered when symptoms continue, weakness develops, or testing confirms significant nerve compression.

A cubital tunnel operation may release pressure around the nerve. In selected cases, the nerve may be repositioned to reduce repeated irritation.

The exact procedure depends on nerve stability, anatomy, severity, and previous treatment.

Trigger Finger

Trigger finger occurs when a finger tendon becomes irritated or thickened and does not glide smoothly through its surrounding tunnel.

Possible symptoms include:

• Clicking
• Catching
• Pain near the base of the finger
• Morning stiffness
• A tender lump
• A finger becoming locked
• Difficulty straightening the finger

The condition may affect one or more fingers.

Treatment may include activity changes, injection, or surgical release.

A corticosteroid injection can reduce inflammation and allow the tendon to move more freely. Surgery may be recommended when locking continues or symptoms return after other treatment.

Trigger Finger Release

Trigger finger release creates more room for the tendon to move.

The procedure is generally performed through a small opening near the base of the affected finger.

After treatment, patients may be encouraged to begin finger movement according to the surgical instructions.

Temporary swelling, stiffness, or incision tenderness may occur.

Hand therapy may be useful when movement remains limited or when the condition had been present for a long time.

De Quervain’s Tenosynovitis

De Quervain’s tenosynovitis affects tendons near the thumb side of the wrist.

Possible symptoms include:

• Pain near the base of the thumb
• Wrist swelling
• Pain during gripping
• Discomfort while lifting
• Pain when opening containers
• Symptoms during thumb movement

The condition may develop through repeated hand activity, although a single clear cause is not always present.

Treatment may include:

• Temporary activity changes
• Thumb and wrist bracing
• Anti-inflammatory treatment when medically appropriate
• Corticosteroid injection
• Therapy
• Surgical release

Surgery may be considered when pain remains significant despite suitable non-surgical care.

Ganglion Cysts

A ganglion cyst is a fluid-filled lump that commonly appears near a hand or wrist joint or tendon.

The cyst may:

• Change in size
• Become more noticeable with activity
• Cause pressure or discomfort
• Interfere with movement
• Produce no symptoms

Some ganglion cysts disappear without treatment.

Dr. Fiore may recommend observation when the diagnosis is clear and the cyst is not affecting function.

Treatment may involve aspiration or surgical removal when pain, nerve pressure, limited movement, or repeated recurrence creates a significant problem.

A wrist lump should be examined before treatment because not every mass is a ganglion cyst.

Dupuytren’s Contracture

Dupuytren’s contracture causes thickened tissue to form beneath the skin of the palm.

The tissue may gradually create cords that pull one or more fingers into a bent position.

Possible findings include:

• Firm nodules in the palm
• Thickened cords
• Inability to place the hand flat
• Fingers that cannot fully straighten
• Difficulty putting on gloves
• Problems reaching into a pocket

The condition commonly affects the ring and little fingers, although other fingers may be involved.

Early disease may only require monitoring.

Treatment may be considered when the contracture interferes with hand use.

Dupuytren’s Treatment

Treatment options depend on the location and severity of the cord.

They may include:

• Injection-based treatment
• Needle-based release
• Surgical removal of affected tissue
• Hand therapy
• Splinting after a procedure when appropriate

Dr. Fiore may discuss the likely benefit, recurrence risk, healing time, and possible effects on nerves, blood vessels, skin, and tendon movement.

Treatment can improve finger position, but the underlying condition may continue or return over time.

Hand Arthritis

Arthritis can affect the fingers, thumb, wrist, and other upper-extremity joints.

Symptoms may include:

• Joint pain
• Stiffness
• Swelling
• Reduced grip
• Difficulty opening containers
• Changes in finger shape
• Pain during pinching
• Reduced movement

Different forms of arthritis include osteoarthritis, inflammatory arthritis, and arthritis following injury.

Dr. Fiore may use examination and X-rays to identify which joints are affected and how advanced the changes appear.

Treatment should reflect symptoms and function rather than an X-ray finding alone.

Thumb-Base Arthritis

Thumb-base arthritis affects the joint where the thumb meets the wrist.

This joint is heavily used during pinching, gripping, turning keys, opening jars, and lifting objects.

Symptoms may include:

• Pain at the base of the thumb
• Weak pinch
• Swelling
• Grinding
• Difficulty opening containers
• Pain while holding a phone
• Reduced thumb movement

Initial treatment may include bracing, medicine, activity modification, therapy, or injection.

Surgery may be considered when pain and loss of function remain significant despite appropriate conservative care.

Finger Arthritis

Finger arthritis may affect the joints near the fingertip, middle of the finger, or knuckle.

Treatment may involve:

• Activity modification
• Splinting
• Medicine
• Injection
• Therapy
• Joint fusion
• Joint replacement in selected cases

A painful joint does not automatically require surgery.

Dr. Fiore may consider the patient’s work, dominant hand, required movement, joint stability, and the amount of pain before recommending treatment.

Wrist Arthritis

Wrist arthritis may develop because of:

• Age-related joint changes
• Previous fracture
• Ligament injury
• Inflammatory disease
• Loss of normal bone alignment
• Other structural conditions

Symptoms may include pain, swelling, stiffness, weakness, and difficulty bearing pressure through the hand.

Imaging can show which parts of the wrist are affected.

Surgical options vary and may aim to remove painful bone contact, preserve selected motion, or stabilise the wrist.

Hand and Wrist Fractures

A fracture may involve the:

• Finger bones
• Hand bones
• Wrist bones
• Distal radius
• Ulna
• Other upper-extremity structures

Possible symptoms include:

• Pain
• Swelling
• Bruising
• Deformity
• Reduced movement
• Tenderness
• Difficulty using the hand

Dr. Fiore may order X-rays and, in selected cases, CT or MRI.

Treatment depends on bone alignment, joint involvement, stability, age, occupation, and whether the skin, nerves, tendons, or blood vessels are also injured.

Non-Surgical Fracture Treatment

A stable fracture with acceptable alignment may be treated using:

• Splinting
• Casting
• Bracing
• Activity restrictions
• Repeat imaging
• Hand therapy

Repeat X-rays may be required because some fractures move after the initial injury.

Patients should follow instructions about lifting and hand use even when pain improves.

Bone healing takes time, and early overload may cause the fracture to shift or heal in a poor position.

Fracture Surgery

Surgery may be considered when a fracture is:

• Displaced
• Unstable
• Rotated
• Open through the skin
• Extending into a joint
• Affecting tendon movement
• Compressing a nerve
• Unlikely to heal in an acceptable position without fixation

Dr. Fiore may use pins, screws, plates, wires, or another fixation method.

The purpose is to restore alignment and provide enough stability for healing and rehabilitation.

Surgical hardware supports the bone but does not make it immediately ready for unrestricted use.

Distal Radius Fracture

A distal radius fracture occurs near the wrist end of the forearm bone.

It commonly develops after a fall onto an outstretched hand.

Possible findings include:

• Wrist pain
• Swelling
• Bruising
• Visible deformity
• Reduced finger or wrist movement
• Numbness

Treatment may involve casting or surgical fixation.

Dr. Fiore may consider:

• Fracture alignment
• Joint involvement
• Bone quality
• Patient age
• Activity needs
• Stability after reduction
• Nerve symptoms

Hand and finger movement may be encouraged during recovery when safe to reduce stiffness.

Scaphoid Fracture

The scaphoid is a small wrist bone near the base of the thumb.

A fracture may cause tenderness on the thumb side of the wrist.

Some scaphoid fractures are difficult to see on the first X-ray.

Additional imaging or repeat X-rays may be needed when examination findings remain suspicious.

The scaphoid has a limited blood supply in certain areas, which can make healing difficult.

Treatment may involve casting or surgery depending on the fracture location, displacement, and likelihood of healing.

Finger Fractures

Finger fractures may affect movement, alignment, tendon function, and grip.

Dr. Fiore may check whether:

• The finger rotates during bending
• The joint surface is involved
• A tendon is damaged
• The fracture is stable
• The nail bed is injured
• The skin is open

Some fractures can be treated with splinting or support from a neighbouring finger.

Others require reduction or surgical fixation to restore useful alignment.

Joint Dislocations

A dislocation occurs when the bones forming a joint move out of their normal position.

Finger, thumb, wrist, and elbow joints may be affected.

Treatment may involve:

• Restoring joint alignment
• X-rays
• Splinting
• Assessment of ligaments
• Therapy
• Surgery for unstable or complex injuries

A joint that appears to move back into place on its own may still have a fracture, ligament injury, or tendon damage.

Medical assessment can help identify these associated problems.

Tendon Injuries

Tendons connect muscles to bones and allow the fingers, thumb, wrist, and elbow to move.

A tendon may be:

• Cut
• Torn
• Pulled away from bone
• Irritated through repeated use
• Trapped by scar tissue
• Damaged during a fracture

Possible symptoms include:

• Inability to bend or straighten a finger
• Weakness
• Pain during movement
• Abnormal finger position
• Swelling
• Loss of normal hand control

Some tendon injuries require prompt repair because delay can allow the tendon to retract or develop scar tissue.

Flexor Tendon Injuries

Flexor tendons allow the fingers and thumb to bend.

A deep cut on the palm side of the hand or finger may damage a flexor tendon.

Possible signs include:

• Inability to bend a finger joint
• Pain while attempting to bend
• A deep wound
• Numbness from an associated nerve injury

Flexor tendon repair is followed by a carefully controlled therapy programme.

Too little movement may cause scar tissue and stiffness. Too much force too early may damage the repair.

Extensor Tendon Injuries

Extensor tendons straighten the fingers and thumb.

Injury may occur through a cut, fracture, jammed finger, or direct impact.

Examples include:

• Mallet finger
• Boutonnière deformity
• Tendon laceration
• Tendon disruption near a fracture

Some extensor injuries can be treated through continuous splinting.

Others require surgery.

The splinting schedule must be followed closely because even brief bending may interrupt healing in selected injuries.

Ligament Injuries

Ligaments stabilise joints.

Hand and wrist ligament injuries may result from:

• Falls
• Twisting
• Sports
• Direct impact
• Repetitive stress

Symptoms may include:

• Joint pain
• Swelling
• Instability
• Clicking
• Weakness
• Pain during gripping

Treatment may include bracing, therapy, or surgical reconstruction.

The decision depends on which ligament is injured, whether the joint remains aligned, and how strongly the condition affects function.

Sports-Related Hand Injuries

Sports injuries may involve:

• Finger fractures
• Dislocations
• Tendon tears
• Wrist sprains
• Ligament damage
• Nerve injuries
• Overuse conditions
• Direct trauma

Dr. Fiore may help determine whether an athlete can continue participating with protection or needs a period of rest, treatment, or surgery.

Return-to-sport planning may consider:

• Bone healing
• Tendon or ligament stability
• Strength
• Range of motion
• Pain
• Sport position
• Risk of repeated injury
• Ability to use protective equipment

Returning only because pain has improved may be unsafe when the injured tissue has not fully healed.

Tennis Elbow

Tennis elbow involves irritation or degeneration of tendons on the outer side of the elbow.

It can occur with racquet sports, lifting, gripping, tool use, and repeated wrist movement.

Symptoms may include:

• Outer-elbow pain
• Weak grip
• Pain while lifting
• Discomfort during wrist movement
• Tenderness near the elbow

Most cases improve without surgery.

Treatment may include activity modification, therapy, bracing, medicine, or selected injections.

Surgery may be considered when persistent tendon damage continues despite appropriate conservative care.

Golfer’s Elbow

Golfer’s elbow affects tendons on the inner side of the elbow.

Possible symptoms include:

• Inner-elbow pain
• Pain while gripping
• Tenderness
• Weakness
• Discomfort during wrist movement
• Symptoms after repetitive activity

Dr. Fiore may assess whether the pain involves the tendon, ulnar nerve, elbow joint, or another structure.

Treatment may include therapy, temporary activity changes, bracing, medicine, injection, or surgery in selected cases.

Nerve Injuries

A peripheral nerve injury can affect sensation, muscle control, or both.

Possible causes include:

• Deep cuts
• Fractures
• Dislocations
• Stretch injuries
• Compression
• Scar tissue
• Tumours or cysts

Symptoms may include:

• Numbness
• Tingling
• Burning
• Electric pain
• Weakness
• Loss of finger control
• Reduced sweating or skin changes

Dr. Fiore may use examination and nerve testing to identify which nerve is affected and whether it is compressed, partly injured, or fully divided.

Nerve Repair and Reconstruction

A divided nerve may require microsurgical repair.

When the nerve ends cannot be connected directly without tension, reconstruction may involve:

• A nerve graft
• A nerve conduit
• A nerve transfer
• Another specialised technique

Nerves recover slowly.

Surgery creates a pathway for possible recovery but does not produce immediate return of sensation or strength.

The final outcome depends on the injury location, severity, time since injury, patient age, and condition of the muscles supplied by the nerve.

Hand and Wrist Masses

A lump may develop from:

• A ganglion cyst
• A tendon-sheath growth
• A bone growth
• Scar tissue
• Foreign material
• Infection
• Another benign or less common condition

Dr. Fiore may assess the lump’s location, firmness, movement, growth, pain, and effect on nearby nerves or tendons.

Imaging or biopsy may be required when the diagnosis is uncertain.

A mass that grows, becomes painful, affects sensation, or changes the skin should be properly evaluated.

Skin Grafts and Soft-Tissue Reconstruction

Some hand injuries involve loss of skin or soft tissue.

Treatment may require:

• Wound care
• Skin grafting
• Local tissue rearrangement
• Flap reconstruction
• Tendon or nerve repair
• Protection of exposed bone or joint

The hand has limited extra skin, and its tissues need to remain flexible enough for movement.

Reconstruction aims to protect deeper structures while preserving as much useful hand function as possible.

Joint Reconstruction and Replacement

Severe arthritis or injury may damage a finger, thumb, or wrist joint.

Depending on the joint and patient’s needs, treatment may involve:

• Joint reconstruction
• Joint replacement
• Joint fusion
• Removal of damaged bone
• Ligament reconstruction
• Tendon balancing

A replacement may preserve movement but may have lifting or durability limits.

Fusion removes movement from the treated joint but can provide stability and pain relief.

Dr. Fiore may discuss which trade-off is more suitable for the patient’s work and daily activities.

Hand Therapy and Rehabilitation

Fiore Hand & Wrist lists in-house occupational therapy for patients requiring rehabilitation.

Hand therapy may help improve:

• Finger movement
• Wrist movement
• Strength
• Scar flexibility
• Swelling
• Sensation
• Tendon gliding
• Fine motor control
• Ability to return to work

The therapy programme depends on the diagnosis and stage of healing.

After tendon, ligament, nerve, or fracture surgery, the timing of movement is especially important.

Patients should follow the programme provided for their specific procedure rather than using general hand exercises without guidance.

Splints and Braces

A splint may be used to:

• Protect an injured structure
• Hold a joint in a safe position
• Reduce nerve pressure
• Limit painful motion
• Support healing
• Prevent contracture
• Guide movement after surgery

Some splints are worn continuously, while others are used only during sleep or selected activity.

An incorrectly fitted splint may cause pressure, skin irritation, or excessive stiffness.

Patients should report discomfort, numbness, skin changes, or swelling caused by a brace.

Injections

Dr. Fiore may use injections for selected conditions such as:

• Trigger finger
• Carpal tunnel syndrome
• De Quervain’s tenosynovitis
• Arthritis
• Tendon inflammation

An injection may contain corticosteroid and local anaesthetic.

It may reduce inflammation and help clarify which structure is causing pain.

The benefit may be temporary, and repeated injections are not appropriate for every condition.

The number and timing should be based on diagnosis, tissue health, medical history, and earlier response.

Minimally Invasive Hand Surgery

Minimally invasive procedures use smaller surgical openings or specialised instruments to limit tissue disruption.

Potential benefits may include:

• Smaller scars
• Reduced postoperative discomfort
• Earlier movement
• Less disruption of nearby tissue
• Shorter recovery for selected procedures

The smallest incision is not always the safest choice.

Open surgery may be needed for complex fractures, extensive tendon damage, nerve reconstruction, severe arthritis, or conditions requiring full visual access.

The surgical approach should allow the condition to be treated properly while protecting nearby structures.

Preparing for a Hand Surgery Appointment

Patients can prepare by bringing:

• A current medicine list
• Previous X-rays
• MRI or CT images
• Nerve-test results
• Earlier operative reports
• Therapy notes
• Injection records
• A list of allergies
• Details of the original injury
• Questions about treatment

It may help to record:

• When symptoms began
• Which fingers are affected
• Whether numbness occurs
• Whether symptoms are worse at night
• Which activities trigger pain
• Whether the hand feels weak
• Whether a joint locks or catches
• Which treatments have already been attempted

Patients should explain how symptoms affect work, school, sleep, driving, hobbies, and ordinary household tasks.

Preparing for Hand Surgery

Preparation may include:

• Medical-history review
• Laboratory testing
• Medication instructions
• Anaesthesia assessment
• Updated imaging
• Transportation arrangements
• Planning for help at home
• Arranging therapy
• Preparing work or school restrictions

Patients should tell the surgical team about:

• Blood thinners
• Diabetes medicine
• Allergies
• Previous anaesthesia reactions
• Heart or lung conditions
• Tobacco exposure
• Current infection
• Prescription and non-prescription products

Medicine should not be stopped unless the surgical or prescribing clinician provides clear instructions.

Recovery After Hand Surgery

Recovery depends on the condition and procedure.

Instructions may cover:

• Dressing care
• Keeping the incision dry
• Hand elevation
• Swelling control
• Finger movement
• Splint use
• Pain medicine
• Lifting restrictions
• Therapy
• Returning to work
• Follow-up appointments

The hand can become stiff after injury or surgery, but movement needs to be introduced safely.

Patients should avoid using the hand more heavily than permitted simply because pain has improved.

Bones, tendons, ligaments, and nerves may still be healing.

Returning to Work

Return-to-work timing depends on:

• Which hand was treated
• The procedure
• Job requirements
• Lifting needs
• Keyboard or tool use
• Wound healing
• Strength
• Therapy progress
• Ability to work with restrictions

A person completing desk-based work may return earlier than someone whose job requires lifting, gripping, climbing, machinery, or repetitive hand use.

Dr. Fiore may provide temporary restrictions or a staged return plan.

Second Opinions

A second opinion may be useful when:

• Surgery has been recommended
• Symptoms continue after earlier treatment
• A fracture has healed in a poor position
• Nerve testing and symptoms do not appear to match
• Several treatment options are available
• A previous operation did not provide the expected improvement
• A complex reconstruction is being considered

Patients should bring complete records and imaging so the second opinion can be based on the same information used in the first recommendation.

Coordinated Upper-Extremity Care

Hand and arm conditions may require cooperation with:

• Primary care physicians
• Neurologists
• Orthopedic specialists
• Physical medicine physicians
• Occupational therapists
• Radiologists
• Rheumatologists
• Neurosurgeons
• Pain specialists

Coordination is useful when numbness may originate from the wrist, elbow, neck, or a broader neurological condition.

Patients needing a general neurological assessment may also review Dr. Fayaz A. Faiz’s neurology profile.

Those with a fracture, shoulder injury, or broader sports-related orthopedic condition may read about Dr. Ryan Siller’s orthopedic and sports medicine care.

Patient-Centered Hand Surgery

Dr. Fiore provides hand and upper-extremity care based on each patient’s symptoms, examination findings, imaging, nerve-testing results, occupation, previous treatment, and functional goals.

His clinical work may include carpal and cubital tunnel treatment, trigger finger release, fracture care, tendon repair, arthritis surgery, nerve reconstruction, cyst removal, sports injury treatment, and rehabilitation planning.

Patients should confirm current appointment availability, accepted insurance plans, procedure locations, occupational therapy arrangements, hospital affiliations, and referral requirements directly with Fiore Hand & Wrist.