| Carpal Tunnel Syndrome - The Alternatives to Surgery |
| Written by Dr. Steven Trembecki, D.C | |
| Saturday, 04 October 2008 | |
|
Carpal tunnel syndrome is defined as a condition involving numbness, tingling, weakness, pain and/or muscle wasting of the hand along the distribution of the median nerve. This relates to the thenar or thumb-side of the hand.
Carpal tunnel syndrome is defined as a condition involving numbness, tingling, weakness, pain and/or muscle wasting of the hand along the distribution of the median nerve. This relates to the thenar or thumb-side of the hand. Often surgery is the recommended treatment, it is obviously the most invasive form of treatment. It is also not the only option. The better understand the different options available we need first to look at the different causes of Carpal Tunnel Syndrome. The wrist is formed by four bones, the carpal bones, which make an arch across the back of the wrist. This arch is spanned by a strong ligament, the flexor retinaculum, which forms the front of the wrist. The space between the bones and the ligament is the carpal tunnel. There are then a few structures that travel through the carpal tunnel into the hand. These include some of the flexor tendons for the wrist and the median nerve. With carpal tunnel syndrome, the median nerve undergoes too much pressure being exerted on it, known as compression, leading to a decrease in electrical conductivity in the nerve. The palm of the hand, complete with the thumb, first three and a half fingers, and also the backs of the same fingertips are all supplied by the median nerve. The rest of the hand is covered by the ulnar nerve. Therefore Carpal Tunnel Syndrome can cause symptoms only in the thumb-side of the hand. Any symptoms on the other side are NOT Carpal Tunnel Syndrome. It is ultimately the compression of the median nerve that leads to carpal tunnel syndrome. Medical testing for carpal tunnel syndrome usually entails the use of an electromyelogram (EMG). The EMG is done by sending a small electrical impluse from the forearm to the hand. If the current is decreased when it is picked up at the hand by the EMG probe, then the diagnosis is probably Carpal Tunnel Syndrome. The surgical option is then to cut the flexor retinaculum in order to provide more space in the tunnel for the nerve. It can often be a very effective treatment. But is it the only option. Of course not! There are two main reasons for carpal tunnel syndrome to present itself. The first is a deterioration of the joints between the carpal bones leading to a collapse of the carpal tunnel. The second reason is a swelling of the tendons which pass through the carpal tunnel taking up too much space resulting in compression of the median nerve. The problem with using solely EMG to determine the presence of carpal tunnel syndrome is that it doesn't differentiate between the two causes. This leads to a lack of differentiation of treatment which may, in turn, result in unnecessary surgery. If the cause is swollen tendons (tendonitis) then, I believe, it is better treated by tackling the cause of the inflammation - such as too much stress or tension on the tendons - than by surgery. The most common way for this to happen is to have the muscle tighten too much due to repetitive use of the muscle. Since the tendon is responsible for connecting the muscle to the bone, if the muscle tightens up, so does the tendon. This can result in the tendonitis which can cause the symptoms of carpal tunnel syndrome. In this case, using treatments such as stretching, physiotherapy, nutritional support, soft tissue manipulation, good typing posture, and chiropractic manipulation can be effective. And much less invasive with fewer side effects than surgery. Surgery can certainly work. But my preference is to start with the simpler, less risky alternatives. If having tried those, things are no better, then by all means consider surgery. The Article Author: Tired of suffering caused by carpal tunnel syndrome? Read our other articles by Dr. Steven Trembecki, D.C. on chiropractor treatments. |
| < Prev | Next > |
|---|
