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Carpal Tunnel Syndrome - The Alternatives To Surgery |
By:
Dr. Steven Trembecki, D.C |
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Carpal Tunnel Syndrome - The Alternatives to Surgery
by Dr. Steven Trembecki, D.C
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.
Surgery is often recommended as the best treatment. However, it is a serious undertaking, and sometimes a more conservative approach might be better. To know what route to take, we first need to have a good understanding of 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.
Through this tunnel pass a number of crucial structures, including the tendons that bend the fingers, and the median nerve. With Carpal Tunnel Syndrome, this nerve gets squeezed and compressed. The result is a decrease in its conductivity, meaning the nerve does not function as it should.
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 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 surgery for this condition would then include cutting some of the flexor retinaculum to allow less pressure on the median nerve by essentially expanding the carpal tunnel. This procedure may often help to decrease the symptoms of carpal tunnel syndrome, but is it the only option? Absolutely 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.
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.
My recommendation is always to begin with the least risky option. If these treatments don't bring the desired relief, then, certainly, surgery can be considered.
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. Click here to get your own unique version of this article.
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Article Source: http://www.statssheet.com/articles/article53931.html |
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