Carpal Tunnel Syndrome (CTS) by John Kalinsky SignUp
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Carpal Tunnel Syndrome (CTS)
by John Kalinsky Bookmark and Share
 

The Carpal Tunnel is an opening into the hand that is made up of the bones of the wrist on the bottom and the Transverse Carpal Ligament on the top. Through this opening, the Median Nerve and the Flexor Tendons run into the hand. The median nerve runs into the hand to supply sensation to the thumb, index finger, long finger, and half of the ring finger. The nerve also supplies a branch to the muscles of the thumb, the thenar muscles. 

Be sure if you have it, and be sure you receive all of your treatment options.

Symptoms

  • Numbness and tingling sensation in one or both hands.
  • Frequently accompanied by sharp pains radiating through the arm or shoulder.
  • Muscle weakness of index and middle fingers and thumb.
  • Discomfort / aching in one or both hands.
  • Lack of feeling in hand may cause person to drop objects.
  • Activities requiring fine hand motor skills may prove difficult if not impossible.

A correct diagnosis is essential before correct treatment can be recommended. It is important to be examined by a knowledgeable physician, preferably an orthopedic surgeon or a neurologist, to make sure you do have carpal tunnel syndrome and not one of the many other conditions that can have symptoms that are similar to those of carpal tunnel syndrome but are treated differently. 

A pinched nerve in your neck, shoulder or forearm can cause numbness and tingling in the hand similar to carpal tunnel syndrome. So can diabetic neuropathy. Arthritis at the base of the thumb or in the hand can also cause similar symptoms. And so on.

Therefore the first step to correct treatment is an exam by an experienced physician to determine the correct diagnosis.

Carpal Tunnel Syndrome is a common problem that affects the hand and wrist. This condition, or syndrome, has become the focus of much attention in the last few years due to suggestions that it may be linked to occupations that require repetitive use of the hands - such as typing.

The Carpal Tunnel is an opening into the hand that is made up of the bones of the wrist on the bottom and the Transverse Carpal Ligament on the top. Through this opening, the Median Nerve and the Flexor Tendons run into the hand. The median nerve runs into the hand to supply sensation to the thumb, index finger, long finger, and half of the ring finger. The nerve also supplies a branch to the muscles of the thumb, the thenar muscles. The Flexor Tendons allow us to move the hand, such as when we grasp objects. The Tendons are covered by a material called Tenosynovium. The Tenosynovium is very slippery, and allows the tendons to glide against each other as the hand is used to grasp objects. Any condition which causes irritation or inflammation of the tendons can result in swelling and thickening of the Tenosynovium. As all of the tendons begin to swell and thicken, the pressure begins to increase in the Carpal Tunnel because the bones and ligaments that make up the tunnel are not able to stretch in response to the swelling. Increased pressure in the Carpal Tunnel begins to squeeze the Median Nerve against the Transverse Carpal Ligament. Eventually, the pressure reaches a point when the nerve can no longer function normally. Pain and numbness in the hand begins.

One of the first symptoms of Carpal Tunnel Syndrome is numbness in the distribution of the median Nerve. This is quickly followed by pain in the same distribution. The pain may also radiate up the arm to the shoulder, and, sometimes the neck. If the condition is allowed to progress, weakness of the thenar muscles can occur. This results in an inability to bring the thumb into opposition with the other fingers and hinders one's grasp.

The Key Concept to remember is that anything which causes abnormal pressure on the Median Nerve will result in the symptoms of pain, numbness and weakness of Carpal Tunnel Syndrome. Recently, physicians have begun to recognize that activities that involve highly repetitive use of the hands can result in Carpal Tunnel Syndrome. This is thought to be caused by inflammation of the tenosynovium due to overuse. 

Treatment options
Wearing splints- Only 3% get better wearing splints.

Wristaleve
Unlike conventional supports that try to reduce swelling through immobilization, Wristaleve works by lifting the roof of the carpal tunnel to relieve the compression of the nerves and tendons running through it. Wristaleve creates its patented lifting and freeing effect by applying focused pressure to two specific points on the wrist. More important, Wristaleve will liberate you from hand and wrist pain without restricting your freedom to work. Look for it in a drug store or pharmacy near you. Or visit their web site:
http://www.niche-inc.com/niche/homepage.html

Reconstructive Therapy 
Wrist instability is commonly mistaken for Carpal Tunnel Syndrome. Reconstructive therapy (also known as sclerotherapy, prolotherapy, and proliferative therapy) offers a biologic alternative, which increases ligament and tendon structures and can strengthen wrist instability up to forty percent.

The main effect of proliferative therapy is increased strength, which results in upgraded endurance. Popping and snapping of the injured joint also decreases with time as the treatment progresses. This therapy is also effective in weakened ligaments, joints, disc trouble and arthritis. When weak joints, tendons, and ligaments are strengthened, the pain is then eliminated. As a result, the joints continue to become stronger. Your endurance level will rise, you will be able to do more activities, and even some activities you couldn't do before. You can usually feel the joint becoming stronger with each treatment.

The therapy is permanent. Since the controlled irritation process produces new tissue, the therapy becomes permanent.  

Chiropractic manipulation 
Chiropractic treats "CTS" with the adjustment of the wrist to align the carpal bones back into their proper place. This alleviates the mechanical pressure in the Carpal Tunnel, and also allows the physiological irritation caused by misaligned joints to resolve. I personally have suffered from median nerve impingement from all the computer work that I do, and I have found that the adjustment of the wrist is the quickest and easiest solution to the problem. My patients also have found that adjusting the wrist when the median nerve is affected is the best solution to their problem...not only taking care of the symptoms, but solving the underlying problem.

Other syndromes have the same or similar symptomatology as does CTS. Tendinitis of the elbow and myospasm of the forearm will also irritate the median nerve above the wrist proper. These two conditions are treated differently than CTS, and probably are much more common. I have had several patients that were scheduled for CTS relief surgery consult with me to find out that the problem was not in the wrist at all, but in the elbow. Upon pressuring their MD to research the problem a little further, they avoided unnecessary surgery. We helped each one of them with their problem by solving the TRUE cause, not just alleviating the symptoms for a while. I have also had a handful (sorry for the pun) of patients who had the CTS relief surgery to no avail, and their problem was also in their forearm/elbow, not the wrist. We were able to solve their REAL problem even after surgery forever altered the biomechanics of their forearm and wrist.

Acupuncture  
As treatment with accupuncture releases the body's endorphins and enkephalines, natural pain-killing chemicals, a very high percentage of people with pain, including Carpal Tunnel Syndrome pain, can benefit. Reported by Maxine Karpen, R.N., "in a study of acupuncture treatment of Carpal Tunnel Syndrome, a positive response was demonstrated in 35 of 36 patients, 14 of whom had been previously treated unsuccessfully with surgery.   

Endoscopic CTS Release   
Endoscopic technique. Through a small 3/4 inch incision at the base of the palm the surgeon puts a small telescope into the tunnel. Using a small knife inside the tube the surgeon then cuts the ligament to release the tunnel. The advantages are a smaller incision. I however do not recommend this technique because there is a higher risk of injury to the nerve because the surgeon cannot see the anatomy as clearly as in the standard technique which already has a small incision and does so well.

Cortisone 
Many doctors say, NO!
Corticosteroids cause osteoporosis or softening of bones, making them weak and more easily fractured. Injection of a steroid into an infected area can cause the spread of the infection.

Vitamin B6 
A vitamin B6 deficiency may be the cause.
You need to take 100mg after breakfast and 100mg after dinner.
You may find improvement in 90 days.
Also, avoid excessive consumption of protein and foods high in yellow dyes.

Researchers looked at the influence of vitamin B6 and vitamin C on carpal tunnel syndrome. 441 volunteers took part in this study. The authors think that a vitamin C supplementation along with low vitamin B6 might have a negative effect on the median nerve leading to symptoms of the hand and wrist. Researchers looked at the influence of vitamin B6 and vitamin C on carpal tunnel syndrome. 441 volunteers took part in this study.

The results showed that the vitamin B6 and C ratio was linked with more pain, tingling, and awakening at night. It was found that that higher blood levels of vitamin B6 were associated with less frequent pain and discomfort. On the other hand, higher vitamin C levels, or a relative deficiency of vitamin B6, was linked with more frequent symptoms.

The authors think that a vitamin C supplementation along with low vitamin B6 might have a negative effect on the median nerve leading to symptoms of the hand and wrist.

Diagnosis of CTS & other disorders
Numbness and tingling sensation in one or both hands.
Frequently accompanied by sharp pains radiating through the arm or shoulder.
Muscle weakness of index and middle fingers and thumb.
Discomfort / aching in one or both hands.
Lack of feeling in hand may cause person to drop objects.

If your physician is not sure you have CTS or nothing seems to help your symptoms, check into these disorders which produce some of the same symptoms.
CTS vs de Quervain's Syndrome
CTS vs Anterior Interosseous Syndrome
CTS vs Pronator Syndrome
CTS vs C6 radiculopathy
Symptoms of Peripheral Nervous System Lupus 

For more details visit
http://www.physicians-background.com/cts.html

20-Aug-2000
More by :  John Kalinsky
 
Views: 1375
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