Carpal Tunnel Syndrome, New Treatment & New Ideas for an Old Problem
There is exciting new technology that can help treat Carpal Tunnel Syndrome. First, we need to understand what causes it.
What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is probably the most common repetitive use injury. It accounts for 90% of all entrapment neuropathies and disproportionately affects middle aged women. Because it’s an injury that often results from repetitive positions and motions, some professions increase the risk. For instance, 1% of the general population has carpal tunnel, but up to 5% of workers in manual labor industries do.
There are an array of mitigative approaches to carpal tunnel, but it’s a difficult condition to treat. It’s difficult, if not impossible, to immobilize the affected hand and risk 24/7 for 6-8 weeks. And even if you could, you’re likely going to have to go back to doing the thing that caused it in the first place. As a result, carpal tunnel syndrome treatments tend to fall short. Braces and occupational exercises eventually lead to physical therapy and pain management eventually lead to surgical intervention. It’s not ideal, but it is what it is…
Or is it?
What is the Anatomy that Causes CTS?
The carpal tunnel is a canal through the wrist that several tendons and the median nerve pass through on their way to the fingers. Problems occur when the size of the canal gets smaller and the nerve gets squished.
The carpal tunnel is under a tough ligament called the flexor retinaculum. CTS occurs when the median nerve is being squished at the wrist as it passes under this ligament. Nerves and tendons pass through the tunnel on the way to the fingers. The main nerve is called the median nerve. This nerve makes some of the thumb muscles work, and also makes it possible to feel the thumb and first 3 fingers.
What are the Symptoms of Carpal Tunnel Syndrome?
Symptoms of carpal tunnel syndrome often emerge slowly, as the inflammation, narrowing and compression of the tunnel and the nerve happen progressively from repetitive use. While there are some telltale signs, symptoms tend to vary in manifestation and severity. They include:
- Pain in the hand and/or wrist that may radiate up the forearm
- Reduced hand strength
- Numbness in the thumb and first three fingers
- Reduced range of motion in the thumb
- In advanced cases, paresthesia and muscle atrophy in the thumb
People suffering from CTS report that the pain gets worse with certain motions/movements. Some people report shaking their hands or running them under warm water to alleviate their symptoms.
What are the Causes of Carpal Tunnel Syndrome?
Most often, carpal tunnel syndrome is thought to be caused when undue wear and tear on the tendons in the carpal tunnel cause them to become damaged, seized or otherwise inflamed, compressing the median nerve and causing symptoms. We have learned that what actually occurs is that the tunnel itself can get smaller as the forearm fascia tightens from repetitive strain injuries. Such injuries can come from force, posture, vibration, and pressure.
Researchers have found the most exacerbating movements that contribute to CTS are wrist flexion and extension, which is why so many of us in work-from-home life often feel a twinge in our wrists after a long week of laptop work. Because reducing wrist flexion helps relax and open the carpal tunnel, braces are often an effective way to temporarily relieve the discomfort caused by CTS, and are most important during sleep.
Other things may contribute to carpal tunnel syndrome, though. For instance, any condition that compromises carpal tunnel wall, fluid distribution, tendon health, etc., can be a secondary cause. Some of these conditions include:
- Arthritis
- Rheumatism
- Arterial hypertrophy of the median nerve
- Obesity
- Intratunnel tumor
- Amyloidosis
How is Carpal Tunnel Syndrome Diagnosed?
The most medically respected test for this condition is an EMG – electromyography. During this test, needles are placed in the forearm and electric current is sent to the needles to measure the speed of the electric current traveling through the nerves of the forearm. Carpal tunnel syndrome is a neuropathic disorder; reduced nerve conduction can indicate obstacle or damage to the nerve. This test is uncomfortable.
MRI imaging is another common way to diagnose CTS and does not require any needles. It can be especially useful in cases where there might be a soft tissue obstruction or tissue degeneration.
Another non-invasive test is to measure irregular temperature fluctuations in the forearm and hand. This test is called “infrared imaging” and it is done in our office. It is not painful, and it involves taking pictures of the hand as it warms up after cooling.
Another test is to actually look at the nerve with an ultrasound. You and the doctor can see if your nerve is squished in the tunnel. If it is, and if you have symptoms of carpal tunnel syndrome, there is a brand new treatment that can help you very quickly.
How is Carpal Tunnel Syndrome Treated?
The first treatment is to wear a wrist brace at night during sleep. Also, there is a B-6 vitamin called P-5-P (pyridoxal-5-phosphate) that can be taken once or twice daily to help the injured median nerve to recover from being squished.
There are stretching exercises that can help to relive pressure on the tunnel so the nerve is not squished. Stretching and strengthening exercises can also improve tendon and ligament health and flexibility, which can aid in reducing pressure on the nerve. Useful exercises are described in detail in the book: Winners’ Guide to Pain Relief.
Another treatment is surgery to cut the ligament that goes across the wrist and make more space for the nerve. This treatment is about 50% effective, but if people continue to do the things that caused the problem, it comes back after the surgery! Moreover, 30% of the time, traditional surgery gives unfavorable results.
A New, Natural Treatment to Relieve the Symptoms of CTS
A brand new treatment is to dilate the carpal tunnel from the inside with a simple injection of saline, novocain, and a homeopathic medication that helps the body to decrease inflammation and heal. This injection is done with ultrasound pictures helping to guide the needle and fluid into the carpal tunnel.
The saline surrounds the nerve and separates it from the surrounding tissues, giving it room to move. In clinical settings, this natural therapy for carpal tunnel syndrome can offer complete relief most of the time without the risk of traditional surgery. You can schedule a visit to our Cincinnati or NYC health centers to learn the stretches, get testing for diagnosis, and receive treatment with this new procedure. Carpal tunnel syndrome relief without surgery has just gotten easier.
Does insurance pay for this New Procedure?
With the exception of Medicare, most insurance companies will cover partial reimbursement after pre-authorization, should you have out of network coverage. Because it is a minimally-invasive and comparatively inexpensive procedure, health insurance companies might offer coverage in the hopes you won’t later need a much more expensive surgery.
How Well Does this Procedure Work?
A major study on saline therapy for carpal tunnel syndrome indicated that it successfully relieved symptoms in 85% of patients for up to 6 months. Here are a few reviews from some Blatman Health and Wellness Center patients who’ve benefited from this carpal tunnel injection therapy:
“I am a busy practicing dentist in Strongsville, Ohio. Constant, intense use of my hands is required in my profession. In December of 2008, I began experiencing the effects of carpal tunnel syndrome in my left hand radiating up through my arm. This caused disruption in my ability to do my work. Typical treatment for this condition involves surgery and an approximate recovery time of about a month. Due to the nature of my work, taking time off is not an option. In exploring alternative treatment for my condition I sought out the expertise of Dr. Blatman.”
“Dr. Blatman performed a technique that released the pressure on the median nerve in my left hand. The whole procedure took between 5-10 minutes. He then used ultra-sound testing to validate the effect of the procedure.”
“Once completed, I felt immediate relief of pressure in that area. My down time was approximately 15 hours and that includes a total of 7 hours of drive time. My hand is much better and movement is near normal with little or no pain.”
“My overall experience with The Blatman Clinic was extremely positive and I would by highly recommend this procedure to anyone considering invasive treatment for a carpal tunnel impingement.”
About the Author:
Hal S. Blatman, MD is the founder and medical director of The Blatman Pain Clinic, and a globally recognized specialist in myofascial pain. He is board certified in both Pain Management and Occupational and Environmental medicine. More information is available at blatmanpainclinic.com or by calling 513-956-3200.
© Blatman Pain Clinic, 2002
