Carpal Tunnel Syndrome Treatments Beatrice NE
Medical School: Univ Of Ia Coll Of Med, Iowa City Ia 52242
Graduation Year: 1989
Family Practice, Emergency Medicine
Medical School: Univ Of Ne Coll Of Med, Omaha Ne 68198
Graduation Year: 1972
Acupuncture Works for Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is a common problem affecting the thumb, hand, and wrist. Symptoms begin when the median nerve gets squeezed inside the carpal tunnel of the wrist. The result is a medical condition known as nerve entrapment or compressive neuropathy. Any condition that decreases the size of the carpal tunnel or enlarges the tissues inside the tunnel can produce the symptoms of CTS. This includes diabetes, kidney failure, rheumatoid arthritis, pregnancy, thyroid disease, and many others.
The main symptoms of carpal tunnel syndrome are wrist and hand pain, finger and hand numbness, tingling, weakness/clumsiness, and nighttime pain. Since the median nerve supplies the thumb, index, middle, and half the ring finger, these are the areas affected most often. Conservative (nonoperative) care can be effective in reducing symptoms and limiting disability. Splints (especially used at night) seem to help. Nerve and tendon gliding exercises can also make a difference.
Some medications are used to reduce inflammation and swelling. Steroid injections given locally into the carpal tunnel have been proven helpful in the short-term, but don't seem to have much long-term effect. Oral steroids are better than nonsteroidal antiinflammatory drugs, but they have some negative side effects. Since there are some adverse effects from steroids, acupuncture is getting a second look as a possible treatment technique.
In this study, the use of acupuncture for mild-to-moderate carpal tunnel syndrome was compared with oral steroid use. Patients were tested with nerve conduction tests to confirm that they really did have a true nerve entrapment causing their symptoms. They were then placed randomly in one of two treatment groups.
The first group received four weeks of daily steroid treatments. The first two weeks were with 20 mg of prednisolone followed by two more weeks with a reduced dosage (10 mg daily). The steroids were administered orally (pill form), which has been shown to be more effective than local steroid injections or oral nonsteroidal antiinflammatory medications. The second group received acupuncture twice a week for four weeks. Everyone was followed for four weeks after treatment with the intention of seeing what were the short-term effects of these two treatments.
Measures used to compare the results of treatment included before and after (individual) ratings of the five major categories of symptoms. When combined together, these ratings form the global symptom score (GSS). The before and after treatment GSS was also analyzed and compared between the two groups. Nerve conduction tests were repeated at the end of four weeks. These tests show how well the median nerve is firing to send motor messages to the muscles controlled by the median nerve.
The results showed that acupuncture is as effective and safe as oral steroids for short-term relief of mild-to-moderate carpal tunnel syndrome. That's good news for anyone lo...
Carpal Tunnel Syndrome
A Patient's Guide to Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is a common problem affecting the hand and wrist. Symptoms begin when the median nerve gets squeezed inside the carpal tunnel of the wrist, a medical condition known as nerve entrapment or compressive neuropathy. Any condition that decreases the size of the carpal tunnel or enlarges the tissues inside the tunnel can produce the symptoms of CTS.
This syndrome has received a lot of attention in recent years because of suggestions that it may be linked with occupations that require repeated use of the hands, such as typing on a computer keyboard or doing assembly work. Actually, many people develop this condition regardless of the type of work they do.
This guide will help you understand
Where is the carpal tunnel, and what does it do?
The carpal tunnel is an opening through the wrist to the hand that is formed by the bones of the wrist on one side and the transverse carpal ligament on the other. (Ligaments connect bones together.) This opening forms the carpal tunnel.
The median nerve passes through the carpal tunnel into the hand. It gives sensation to the thumb, index finger, long finger, and half of the ring finger. It also sends a nerve branch to control the thenar muscles of the thumb. The thenar muscles help move the thumb and let you touch the pad of the thumb to the tips of each finger on the same hand, a motion called opposition.
The median nerve and flexor tendons pass through the carpal tunnel. The median nerve rests on top of the tendons, just below the transverse carpal ligament. The flexor tendons are important because they allow movement of the fingers, thumb, and hand, such as when grasping. The tendons are covered by a material called tenosynovium. The tenosynovium is a slippery covering that allows the tendons to glide next to each other as they contract and relax to move the hand and fingers.
Related Document: A Patient's Guide to Hand Anatomy
What causes CTS?
Any condition that makes the area inside the carpal tunnel smaller or increases the size of the tissues within the tunnel can lead to symptoms of CTS. The carpal tunnel cannot expand so any condition that causes abnormal pressure in the tunnel can produce symptoms of CTS. And any increase in pressure within the carpal tunnel can reduce blood flow to the nerve, leading to loss of nerve function.
Various types of arthritis can cause swelling and pressure in the carpal tunnel. The way people do their tasks can put them at risk for problems of CTS. Some of these risks include
One of these risks alone may not cause a problem. But doing a task that involves several factors may pose a greater risk. And the longer a per...
Older Adults Benefit from Carpal Tunnel Release
Does carpal tunnel release (CTR) work for older adults? The answer is a resounding 'yes' according to this study in 75 patients aged 65 and older. That's good news because carpal tunnel syndrome (CTS) seems to be more common and more severe in older adults.
CTS is a nerve condition caused by pressure on the median nerve as it passes through the wrist. The bones and ligaments of the wrist form a natural opening or tunnel. The nerve passes through this tunnel. Anything that reduces the size of the carpal tunnel can put pressure on the nerve and cause painful symptoms. Changes in the nerve itself can also bring on CTS.
All patients included in the study had to be 65 years of age or older in good mental and physical health. Symptoms, motion, and strength were measured before and after surgery. Use of the hand and wrist was also measured at home and at work.
Patients reported numbness and pain was much better. Symptoms went from severe or very severe to mild or none. Grip and pinch strength improved. Overall 83 percent of the patients were happy with the results of the CTR.
It's true that younger patients have better results after CTR compared to older patients. But this study shows that older patients can get good results after CTR.
Robert A. Weber, MD, and Malcolm J. Rude, MD. Clinical Outcomes of Carpal Tunnel Release in Patients 65 and Older. In The Journal of Hand Surgery. January 2005. Vol. 30A. No. 1. Pp. 75-80.