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Treatment For Carpal Tunnel Syndrome

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Carpal tunnel syndrome is a condition in which a nerve, the median nerve to be exact, is compressed in the wrist area. To avoid permanent nerve damage, carpal tunnel syndrome should be treated as early as possible by a chiropractic physician or other physician that performs physical medicine. Medication can be prescribed by a primary care physician to relieve symptoms, but may only help the symptoms not necessarily the problem.

Carpal Tunnel symptoms usually begin gradually. Burning, tingling, itching, and/or numbness in the palm, thumb, index, and middle fingers are most common. Symptoms often first appear while sleeping. As symptoms worsen, tingling may be felt during the day. The dominant hand is usually affected first, possibly due to repetitive motion. Repetitive motion such as typing, knitting or twisting of the forearm and wrist might be the culprit for many cases of carpal tunnel symptoms. Such activities can lead to nerve entrapment, which is a major contributing factor to carpal tunnel syndrome.

Nerve entrapment can be caused by many things including the very small carpal bones of the wrist. Did you know there are 27 bones in one hand! If a few of the carpal bones come “out of place” or misaligned they can put pressure on the median nerve which is considered a type of nerve entrapment. Other ways the nerve can become entrapped is through muscle spasms or trigger points.

Treatment can include chiropractic joint mobilization or adjustments and strengthening and stretching of the surrounding soft tissue. Applying cold packs to reduce inflammation may also be helpful as well. Resting the affected hand and wrist, avoiding activities that may worsen symptoms and immobilizing the wrist in a splint to avoid twisting or bending can also be beneficial. Some research suggests certain B-vitamins may relieve the symptoms on a cellular level.

Carpal Tunnel symptoms are often found in women who are pregnant, especially in the third trimester. Some swelling is expected with pregnancy, but sometimes it can get a bit out of hand. The expecting mother's hands, wrists and ankles can begin to swell more and more throughout the pregnancy. When this happens the swelling can cause the nerve entrapment in the wrist and produce similar symptoms to that of carpal tunnel. Usually a few days to weeks after the baby is here the swelling drastically decreases and the symptoms subside. During the third trimester when swelling is most prominent chiropractic care can help with pain management and comfort control. But due to the fact that the symptoms are mainly an effect of the swelling chiropractic care can only do so much.

Although surgery is needed sometimes for carpal tunnel syndrome, nobody wants to go though that. Even the best surgeons will tell you to avoid surgeries at all cost. Tell your friends and family that are experiencing elbow, wrist and hand pain they can be helped by a chiropractor or other health care physician who does physical medicine and hopefully, possibly prevent surgery.

The most common surgical procedure done for this is the open carpal tunnel surgery. During this surgery the transverse carpal ligament is cut to open the space for the impinged median nerve. The surgery is usually done in an out-patient setting with local anesthesia. It is usually recommended to not lift any heavy objects for up to three months after the open carpal tunnel surgery. As always some risk is involved with any surgery, so be sure to go over the risk of your specific situation with your doctor and or surgeon.

Dr. Ryan Marshall

Treatment For Carpal Tunnel Syndrome

If you have received a positive carpal tunnel diagnosis, most doctors will push for cortisone injections and/or surgery, procedures that have poor success rates and ones that should only be performed as a last resort, after all other conservative treatment methods have been utilized.

The following information provides details about what each current procedure entails as well as statistics that reveal why conservative therapy should be implemented over the following invasive treatment methods.

CORTISONE INJECTIONS FOR CARPAL TUNNEL SYNDROME:

Cortisone is medication that treats inflammation only. Often the carpal tunnel pain will subside because the inflammation of the median nerve is reduced from the use of the cortisone, but this is only a temporary effect.

The one main problem with cortisone is that for 21 days following the injection, the tendons have the consistency of rubber and can be seriously overstretched and damaged. This is a common side effect that most doctors fail to tell their patients. If the patient continues overusing and/or stressing their hands and wrists, the tendons can overstretch and cause the structural integrity of the joint to diminish greatly, causing the joint to become loose and sloppy, resulting in an even greater possibility of further injury and damage.

Cortisone can be used wisely as a part of a carpal tunnel treatment program along with the implementation of proper stretches add exercises, the most important tool that can be used to recover from carpal tunnel. If cortisone is utilized, it is good for the patient to take this time, when the carpal tunnel is not inflamed, to be on a conservative therapy program to correct the existing muscle imbalance in the wrist joint and eliminate the carpal tunnel symptoms for good. The problem is that most doctors give the cortisone shot and the patient goes home and either does nothing, or does too much, causing greater trauma to the median nerve within the carpal tunnel and exacerbating the symptoms.

Steroid (Cortisone) Injection Statistic:

*Failure rate (Including "partial success" as failure) is 72.6% after 1-year follow up. Source: Irwin, et al. J Hand Surgery.

SURGERY FOR CARPAL TUNNEL SYNDROME:

Carpal tunnel surgery consists of releasing (severing) the transverse carpal ligament that forms the roof of the carpal tunnel. Surgery is utilized to open and widen the carpal tunnel in order to allow more room for the median nerve, artery and nine flexor tendons to move around. There are several surgical procedures that are utilized to achieve this:

· Open Release Surgery: A local anesthetic is injected into the wrist and/or hand and a 2-3-inch incision is made in the palm and cuts the carpal ligament free from the underlying median nerve. This operation takes about 20-25 minutes.

· “Mini” Open Release Surgery: The mini-open release technique involves an incision that is about 1.5 inches long and can be performed in the doctor's office with only a local anesthetic. The operation takes only about 12 minutes.

· Endoscopic Release Surgery: The Endoscopic technique is less invasive and uses involves one or two .5” inch long incisions in the wrist and or palm, and one or two endoscope (pencil-thin) tubes are inserted. A tiny camera and a knife are inserted through these lighted tubes. While observing the carpal ligament on a television monitor, the surgeon cuts the ligament to free the compressed median nerve.

Carpal Tunnel Surgery Statistics:

*“Only 23% of all Carpal Tunnel Syndrome patients were able to return to their previous professions following surgery.” Source: NIOSH

*“Carpal tunnel surgery has about a 57% failure rate following patients from 1-day to 6-years. At least one of the following symptoms re-occurred during this time: Pain, Numbness, Tingling sensations.” Source: Nancollas, et al, 1995. J. Hand Surgery.

CONSERVATIVE TREATMENT FOR CARPAL TUNNEL SYNDROME:

Conservative therapy is really the only key to preventing carpal tunnel syndrome as well as for the successful recovery and long-term relief of existing carpal tunnel symptoms, even for post-surgery patients that have experienced little relief. Always try conservative therapy first and eliminate future injections and surgical procedures – Try the "Conservative Alternative".

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About Author

Both Ryan Marshall & Jeff P. Anliker, Lmt are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.

Ryan Marshall has sinced written about articles on various topics from . Dr. Ryan Marshall is a and founder of Marshall Chiropractic.. Ryan Marshall's top article generates over 1300 views. to your Favourites.

Jeff P. Anliker, Lmt has sinced written about articles on various topics from Medicine, Other Conditions and Disease & illness. Jeff P. Anliker, LMT, is a Therapist and Inventor of Therapeutic Exercise Products that are utilized by Corporations, Consumers and Medical Facilities around the world.

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