Carpal tunnel syndrome
is a painful condition that is characterized by pain,
numbness, tingling and paresthesia (pins and needles)
in the thumb, index and middle fingers, with advanced
cases revealing loss of strength and coordination.
Carpal
tunnel is the most common nerve entrapment
disorder and is generally caused by a muscle imbalance
in the hand and wrist that results in the compression
and impingement of the median nerve. Other contributing
factors include direct or blunt trauma or injury
to the wrist that can induce swelling, such as sprain
or fracture; over activity of the pituitary gland;
hypothyroidism; rheumatoid arthritis; mechanical
problems in the wrist joint; work stress; repeated
use of vibrating hand tools; fluid retention during
pregnancy or menopause; or the development of a cyst
or tumor in the canal. In some cases no cause can
be identified.
There are many treatments for carpal tunnel syndrome
including medication, exercise, wrist splinting,
cortisone injections but most commonly surgery in
the prescribed remedy. Although surgery is one of
the most common options for treating this condition;
however, it remains a controversial choice and it
is important to fully understand the risks and benefits
involved. Surgery is by far the most invasive procedure
and it merits careful forethought, as the success
rate is not as high as the medical industry would
like people to think. The reason for this misdirection
is often due to the fact that a surgeon will make
between $4-5,000 for each 30-minute surgical procedure,
a sum that is not to be taken lightly.
The statistics listed below provide insight to the
poor success rate often experienced by patients that
are subjected to carpal tunnel surgery:
• ONLY 23% of all carpal tunnel syndrome
patients returned to their previous professions following
surgery, according to the Bureau of Labor & Statistics
and the National Institute for Occupational Safety & Health
(1997-2000 Statistics).
• Up to 36% of all Carpal Tunnel Syndrome
patients require unlimited medical treatment.
• 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.
There are multiple forms of surgery for carpal tunnel
syndrome including “open” and “endoscopic” surgery,
which is a less invasive incision made through the
muscle in the palm that requires less time for post-operative
recovery. Post-surgery symptoms such as pain and
numbness usually begin to improve in two to six weeks,
depending upon the procedure, severity of symptoms,
gender and age of the patient. Muscle coordination,
control, and strength may initially worsen following
surgery, and a return to pre-operative status may
take several months. Significant improvement to pre-injury
status may take as much as two years to achieve,
if it comes at all.
The optimal method of treatment for carpal tunnel
syndrome is simple corrective stretches and exercises.
The vast majority of patients do quite well with
conservative treatment and it is estimated that less
than 1/4 require surgical intervention. Only in severe
cases is surgery recommended, such as when there
is persistent, debilitating pain or muscle atrophy
/ flattening.
The complications associated with surgery as well
as the timeline to substantial recovery make it as
last choice resort for most patients. Thankfully,
there are numerous effective alternatives that are
much less invasive, such as a good balancing exercise
and stretching program for the hand (Flextend, Restore,
Cats Paw, etc.), wrist and forearm. Once the muscles
are in balance, compression of the median nerve is
eliminated and the symptoms disappear.
Be sure to consult your doctor
before starting any type of exercise or therapy
program. |
