Do Most Rehabilitation Products, Exercise Devices And Medical Treatments Currently Being Used For the Treatment of Carpal Tunnel Syndrome And Repetitive Strain Injuries Really Work?

There are a wide variety of treatment options available for Carpal Tunnel Syndrome, Tennis Elbow, Tendonitis, Trigger finger, Cubital Tunnel Syndrome and the many other Repetitive Strain Injuries affecting the upper extremity; but statistics show that most of these products and treatments fall short of even a 50% success rate.

From gadgets to surgery, to squeeze putty and cortisone injections, most all current retail and medical therapies fall short of the non-invasive success of FLEXTEND®. With more than 10-years of experience, the health professionals at BSI have established training programs, injury-specific exercises, treatment protocols and attachment training devices for end users, corporations, clinics and hospitals with phenomenal success.

To date, FLEXTEND® has less than a 4% product return rate and more than a 90% success rate in the treatment of most Repetitive Strain Injuries, including Carpal Tunnel Syndrome, Cubital Tunnel Syndrome, Tennis and Golfer's Elbow and Trigger Finger, which until recently, was an injury that was treated with cortisone injections and surgery only.

Musculoskeletal disorders are the country's most costly category of workplace injuries and illnesses. In addition to spending $20 billion annually on workers' compensation costs due to RSIs, the U.S. spends another $100 billion on lost productivity, employee turnover, and other indirect expenses; The Agency for Health Care Policy and Research .

The information listed below provides a brief outline of the most prevalent conservative and non-conservative treatments, their pros and cons, and their success rates for treating both Carpal Tunnel Syndrome and Repetitive Strain Injuries affecting the upper extremity.


CARPAL TUNNEL SYNDROME:

1. Gripping / Flexion devices:
   
   
   • No.
     
     Activities that require additional stress to the flexor muscles will cause them to become even stronger and more hypertonic (rigid), therefore increasing the muscle imbalance between the flexors and extensors. Sometimes these devices can offer short-term relief due to increased circulation, but long-term use often leads to more pain and discomfort due to increased damage to structures within the carpal tunnel.
2. Free-weights:
   
   
   • No.
     
     The strength imbalance between the flexor and extensor muscles will remain the same because both muscle groups are being exercised simultaneously. (Reverse wrist curls are directed at strengthening the extensor muscles, but you still have to contract the flexor muscles in order to grip/hold the weight.) The outcome is still a strength imbalance and the painful symptoms remain. Dual contraction of the flexor and extensor muscles can actually increase the compression of the carpal tunnel and the structures within. This compression decreases the space within the carpal tunnel, causing friction, inflammation and damage to the flexor tendons and median nerve as the wrist/hand is flexed and extended throughout the exercises.
3. Rubber tubing and resistive exercise bands:
   
   
   • No.
     
     These bands only provide partial range of motion, only 1-3 joints used (depending on finger position), instead of 6 joints. Rubber bands do not allow the fingers to move throughout the full range of motion in either flexion or extension, abduction, or wrist and elbow extension. The combination of all of these motions being performed at once is critical for correcting carpal tunnel syndrome, because they stretch the strong, tight, overused flexor and adductor muscles of the hand, while strengthening the weaker, underused extensor and abductor muscles.
4. Splints:
   
   
   1. Daytime:
      
      No.
      
      Wrist braces and splints hold the wrist in the neutral position instead of the extensor muscles which should be doing it), in order to keep the wrist from moving into forced flexion and impinging the carpal tunnel even more. Using a brace to keep the wrist from dropping into flexion causes the already weak extensor muscles to become even weaker because you do not even have to utilize these muscles to keep the wrist from moving downward into flexion. Using these devices may provide some people with temporary relief for the first few weeks, but long-term use of splints and wrist braces increases the strength imbalance between the flexor and extensor muscles, possibly causing severe damage to the tendons, blood vessels and median nerve within the carpal tunnel.
   2. Nighttime:
      
      Yes.
      
      Using wrist braces and splints at night keeps people from making a "fist" with the wrist in a flexed forward position for 6-8 hours. Holding the wrist in the straight/neutral position is extremely important in order to prevent the flexor muscles from tightening down in a shortened position and impinging the structures within the carpal tunnel.
5. Wrist Splints and Anti-Inflammatories:
   
   No.
   
   Failure rate is 81.6% (Including "partial success") in total alleviation of symptoms. Curative rate following treatment is 18.4%.Source: Kaplan, et al, 1990. J Hand Surgery.
6. Iontophoresis + Splinting:
   
   No.
   
   Failure rate is 42.1% in total alleviation from symptoms. Source: Banta, et al, 1994. J Hand Surgery.
7. Steroid Injection:
   
   No.
   
   Failure rate is 72.6% after 1-year follow up. ( Including "partial success" as failure) Source: Irwin, et al. J Hand Surgery.
8. Surgery:
   
   No.
   
   When surgery is performed, the carpal ligament is severed in order to increase the space within the carpal tunnel, but since ligaments do not contract, it could not possibly cause the carpal tunnel to narrow. It is a combination of the finger adductor muscles and the wrist and finger flexor muscles that cause the carpal tunnel to narrow and impinge the median nerve. Patients who have had carpal tunnel surgery often times develop the same symptoms again because they develop scar tissue within the carpal tunnel due to improper rehabilitation, and the fact that the real disorder was never addressed. Also, patients will always have a weak grip strength because the carpal ligament has been removed, and it acts as a fulcrum point in which the flexor muscles push against for leverage in order to grasp an object or make a fist.

REFERENCE MATERIALS:

• 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.
• Only 23% of all Carpal Tunnel Syndrome patients were able to return to their previous professions following surgery.
• Carpal tunnel syndrome results in the highest number of days lost among all work related injuries. Almost half of the carpal tunnel cases result in 31 days or more of work loss. National Center for Health Statistics .
• Surgery for carpal tunnel syndrome is the second most common type of surgery.
• Approximately 260,000 carpal tunnel release operations are performed each year, with 47% of the cases considered to be work related. National Center for Health Statistics .

REPETITIVE STRAIN INJURIES: