Subspecialty precision for the adult hand and arm.

The office aims to call you back within 24 to 48 hours, and new patients are typically seen within 7 to 10 days. Acute injuries and nerve problems that are getting worse are moved up — say so when you call.

You're welcome to call the office directly. Some insurance plans require a referral from your primary care physician before seeing a specialist, so it's worth checking your plan. The office can help you sort that out when you call.

Often not. Many hand and wrist problems improve with splinting, therapy, activity changes, or an injection. Surgery is recommended when it clearly serves your function and your goals, and the reasoning is always explained so you can decide with confidence.

It depends entirely on the procedure. A trigger finger release is days to weeks. Carpal tunnel release usually means light use almost immediately and full strength over a couple of months. Thumb arthritis reconstruction and fracture surgery involve a period of splinting or casting followed by therapy. Nerve surgery is measured in months, because nerves regrow slowly — roughly an inch per month. You'll get a specific timeline for your procedure before you schedule.

Generally once you're out of a cast or splint on the driving arm, off narcotic pain medicine, and able to grip the wheel and react normally. For many minor procedures that's within days; for others it's weeks. Ask about your specific situation, because it also depends on which hand and whether you drive manual.

Desk work is often possible within days of a minor procedure, sometimes immediately with the hand elevated. Jobs requiring gripping, lifting, vibration, or getting the hand dirty take considerably longer. Dr. Irwin will give you specific written restrictions, and the office can complete disability or return-to-work paperwork.

Yes. Work-related hand and wrist injuries are a routine part of adult hand surgery. Mention the claim when you call so the visit is authorized correctly, and bring the claim number and adjuster contact to your appointment.

Frequently, yes — therapy is often where results are won, particularly after tendon transfers, nerve surgery, fracture surgery, and thumb reconstruction. The office works with certified hand therapists near your home so you're not driving to Orlando for every session.

For many hand procedures, yes. Wide-awake local anesthesia avoids general anesthesia entirely, which means no fasting, no breathing tube, and a faster overall day. It isn't right for every procedure or every patient, and you'll discuss which applies to you.

Yes. Revision surgery and second opinions after previous operations are a substantial part of this practice. Bring your operative reports and imaging if you can get them, but come regardless — incomplete records shouldn't delay an evaluation.

Usually not. Long-standing nerve compression, arthritis, old fractures, and childhood differences can often still be improved. What changes with time is which options are on the table, which is exactly what an evaluation sorts out.

Yes. Adults with upper limb spasticity after stroke, traumatic brain injury, or spinal cord injury, and adults living with cerebral palsy, are frequently told therapy and injections are all that's available. Nerve and tendon surgery can produce durable change in hand position, hygiene, and function — often years after the original injury.