Treatment of Carpal Tunnel Syndrome

wrist wrap for cts

Carpal tunnel syndrome (CTS) is a common condition that can affect anyone who repetitively uses their forearms and hands. Every year, more than 500,000 people in the U.S. undergo CTS surgery, one of the most common surgeries for the hands. Sometimes, the results are good, but often, this type of invasive procedure can lead to scar tissue, worsening symptoms, and chronic disability.

What you think you know about CTS may not be accurate. Here, we discuss the underlying causes of CTS and what is most helpful in treating this condition.

What Causes CTS?

It’s generally accepted that CTS results from repetitive hand and finger motions, leading to inflammation and swelling of tendons running through the wrist canal. This theorized swelling and inflammation then leads to compression of the median nerve at the wrist.  Symptoms may include severe pain, mild to severe numbness, and tingling in the hand and fingers. Treatment can involve work and activity restriction, wrist braces worn at night, and cortisone injections into the wrist canal.

This theorized cause of CTS is not supported by research. Indeed, when the tendon sheaths are closely examined during surgery, the signs of inflammatory cells or reactions are rarely present.

Instead, CTS is caused by a tightening of fascia in the upper extremity. The fascia is a tough tissue that runs contiguously between muscle fibers throughout the body, holding muscles and tissues in place.

Performing a repetitive wrist motion requires a sustained contraction of the bicep muscle to keep the wrist still.  Eventually, the upper extremity fascia tightens so much that the wrist ligament or transverse carpal ligament also tightens, making the wrist canal smaller. The primary nerve of the hand, the median nerve, passes right under this ligament.

The nerves and tendons to the fingers must glide smoothly through the wrist canal, and any adhesions or stickiness cause pulling on the nerve with finger and wrist motion. When the nerve doesn’t glide smoothly under the ligament, finger and wrist movements traumatize the nerve and cause CTS.

Treating CTS

Traditional carpal tunnel surgery involves cutting the transverse carpal ligament. Adhesions or stickiness between the median nerve and the transverse carpal ligament can occur after surgery, which also happens after trauma and with repetitive finger and wrist motions. This can cause CTS to come back after surgery.

At Blatman Health and Wellness Center, we’ve developed a much different and highly effective approach to treating CTS. Our program starts with an office visit to examine the entire body. As part of the initial evaluation, we typically address issues with the upper extremity that may contribute to CTS symptoms.

As part of treatment, we start more conservatively by educating patients on important dietary changes, advising them to refrain from foods that cause inflammation and pain. We also recommend vitamins to support nerve healing and give instructions on how to stretch the entire upper extremity fascia from the chest to the wrist.

Many people experience relief from their carpal tunnel symptoms simply by adopting this program of nutrition, supplementation, and stretching. This regimen alone often helps people maintain wrist health and can help people avoid carpal tunnel surgery indefinitely.

If this initial approach doesn’t yield sufficient results, the next step is a simple but delicate injection using ultrasound guidance to separate the “stickiness” between the nerve and the transverse carpal ligament. The injected fluid dilates the wrist canal, releasing and separating the nerve from the tight ligament. This procedure causes some pressure and a momentary “pinching” discomfort, but it goes away in a few minutes.

With this treatment, most symptoms can resolve by the time patients leave the doctor’s office. Patients should maintain the stretching program for as long as they remain at risk in their work activities. The provider will likely recommend they continue the nutritional supplements and wear a brace at night for a few days after the procedure.

CTS Relief in Cincinnati

If you suffer from CTS symptoms, don’t assume right away that you need surgery. Contact Blatman Health and Wellness Center to learn about less invasive treatment options. If you’re ready to address your CTS and get relief, call the Center to schedule an initial consultation.

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