Do You or Someone You Know Have Carpal Tunnel Syndrome? Read This.

Have you ever felt numbness or tingling in your thumb, index or middle fingers? Or maybe you have worked with a colleague that expressed concern over burning and itchiness in the palm and wrist. It's likely that what you or your co-workers have experienced are symptoms of Carpal Tunnel Syndrome (CTS), one of the most common repetitive stress injuries seen in today's workplace. But what causes CTS? And what can we do about it?

First, we need to understand what causes CTS. The carpal tunnel is a narrow passageway in the wrist, through which blood vessels, tendons and your median nerve passes. A ligament called the transverse carpal ligament (TCL) makes up the roof of the carpal tunnel. The median nerve runs from the cervical spine down into the hand and through the tunnel as well. This nerve is responsible for controlling small muscles at the base of the thumb and also provides feeling to the thumb and first three fingers. When this median nerve is subjected to increased pressure it can cause pain, numbness, and tingling in all of these areas and CTS will result.

Research shows that women are more likely than men to develop CTS. CTS is also common in people with lupus, underactive thyroid, arthritis, and diabetes or other metabolic disorders. But a great many people develop CTS from daily use of vibrating or percussive tools, repetitive movements of the hand and wrist, or on-the-job wrist injuries. Though CTS is not confined to a specific job role or industry, the Center for Disease Control and Prevention has identified it is most common in employees doing meat processing, textile, assembly line, and manufacturing work. 

The surgical approach for carpal tunnel syndrome involves cutting the TCL to relieve pressure on the median nerve. However, the TCL plays an important role in stabilizing all of the little bones (carpals) in the wrist. It also serves as an anchor for several important hand muscles. It acts like a pulley that helps the tendons that flex your fingers get better mechanical advantage. So it is understandable that cutting the TCL can have dire consequences, including instability in the carpal bones, shortened and weakened hand muscles, a bow-stringing effect in the tendons that flex the fingers, and arthritis in the wrist.

It is also important to note that are many risks associated with the invasive surgical approach of CTS treatment. Complications that may result from CTS surgery include lingering pain at and around the area of incision, persistent numbing and tingling, infection and nerve damage. Many patients also experience CTS symptoms post-surgery. In fact, as many as 15% report recurrent symptoms after CTS surgery. Unfortunately, results of subsequent surgeries are typically less favorable than the results of the initial surgery.

There is a different approach to treating carpal tunnel syndrome that doesn’t involve cutting the TCL. Instead, by injecting platelet lysate around the tiny median nerve, doctors can make the environment for the nerve healthier, release scar tissue, and assess why the nerve was under pressure in the first place. For example, many times the problem causing the pressure is rooted in the cervical spine. By assessing the true cause of your CTS, you may be able to avoid risky surgical solutions. The bottom line is this -- whether the problem is rooted in the spine or the wrist and hand, there are interventional orthopedic solutions available that may render the need for invasive surgery unnecessary.

Dr. Orlando Landrum

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