Carpal Tunnel Syndrome - Is Surgery The Only Answer?


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Home \| Health And Wellness Carpal Tunnel Syndrome - Is Surgery The Only Answer? By: Dr. Steven Trembecki, D.C, Posted on: 2007-06-11 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. Although surgery is often the choice of treatment, it is the most invasive form of treatment and is not the only treatment available. To better understand this, one needs to better understand 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. The tendons that bend the fingers, and the median nerve all pass through this tunnel from the arm to the hand. What happens in Carpal Tunnel Syndrome is that, for various reasons, the space in the tunnel becomes overcrowded, the nerve gets compressed, and the result is that the nerve no longer conducts signals as it should. The median nerve supplies the palm side of the hand including the thumb and the first three and a half fingers. It also supplies the tips and the backs of the same fingers. When the nerve gets compressed, it is only in this area that symptoms are felt. So, if you are getting symptoms in your little finger, for example, then that is NOT caused by 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 putting a probe on the nerve in the forearm and again in the hand. A small current is then passed between the two of them to see how good the conduction is. A decrease in conduction means 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! So what causes Carpal Tunnel Syndrome? The first common cause is a deterioration of the joints between the carpal bones. This causes the tunnel to collapse and, in turn, compresses the median nerve. The second cause is a swelling of the tendons. The enlarged tendons take up more space, and so put pressure on the nerve. Unfortunately, an EMG cannot tell you which of these two causes is the problem. And that, in turn, can 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. Repetitive use of a muscle often results in the muscle getting too tight. Since muscles are attached to tendons, this results on the tendon being too tight and that, in turn, can lead to tendonitis and Carpal Tunnel Syndrome. If the symptoms are due to tendonitis in the wrist flexor tendons, the treatment may include stretching, the use of physiotherapy modalities, nutritional support, ergonomics, soft tissue manipulation, and/or adjusting the arm and wrist. These protocols are much less invasive and may have fewer side-effects than surgery. This does not mean that surgery is not a viable option. My preferred method, of course, is to begin with the least invasive form of therapy. If these options do not bring relief of symptoms, then surgery can be looked at. Article Source: http://www.allthebestarticles.com Looking for some relief from carpal tunnel syndrome? Click now for more advice from Dr. Steven Trembecki, D.C. on this and other chiropractor treatments. 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