Carpal Tunnel Syndrome, New Treatment and 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?

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 is the Anatomy that Causes CTS?

flexor

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.

What are the Symptoms of Carpal Tunnel Syndrome?

• Numbness and tingling in the thumb and first three fingers
• Pain from the hand up to the elbow
• Weakness in the thumb muscles
• Dropping things unexpectedly
• Waking up and wanting to shake the hands to wake them up and get them to stop hurting

What are the Causes of Carpal Tunnel Syndrome?

We have always been taught that inflammation from using the fingers too much causes the tendons to swell and the nerve (median nerve) to get squished. Modern research, however, has shown that this inflammation does not happen!

Another cause is that the carpal tunnel actually shrinks. This has been proven, because there are stretching exercises that open the tunnel and reduce or eliminate the symptoms. These stretches were first described in the medical literature in the 1990’s, and they are explained in detail in the book: Winners’ Guide to Pain Relief.

One of the most important causes of CTS is that scar tissue sticks to the nerve and keeps it from moving freely in the tunnel.

When the wrist is flexed, the tunnel gets smaller. If the wrist can be kept straighter, the symptoms often improve. The best way to keep the wrist straighter is to wear a brace that keeps the wrist straight. The most important time to wear the brace is at night during sleep.

How can a person get Tested for Carpal Tunnel Syndrome?

The most medically respected test for this condition is an EMG. 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. This test is uncomfortable.
A less invasive test is to measure how well the temperature control nerves are working 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 with one of the feet in cold water.
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 make the tunnel bigger so the nerve is not squished. These 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 a temporary fix, because if people continue to do the things that caused the problem, it comes back after the surgery!

A brand new treatment is to dilate the carpal tunnel from the inside with a simple injection of saline, novocaine, 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.

Where can I go to get this New Treatment for CTS?

You can schedule an office visit to learn the stretches, to get testing for diagnosis, and to get treatment with this new procedure. Carpal tunnel syndrome relief 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 if you have out of network coverage.

How Well does this Procedure Work?

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

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