If you have been diagnosed with Carpal Tunnel Syndrome (CTS), you may be wondering – what next? Below you will find information regarding the most common (not the best) treatment options currently in use in the medical industry and their success and failure rates.
If you have received a positive carpal tunnel diagnosis, most doctors will push for cortisone injections and/or surgery, procedures that have poor success rates and ones that should only be performed as a last resort, after all other conservative treatment methods have been utilized.
The following information provides details about what each current procedure entails as well as statistics that reveal why conservative therapy should be implemented over the following invasive treatment methods.
Cortisone Injections For Carpal Tunnel Syndrome
Cortisone is medication that treats inflammation only. Often the carpal tunnel pain will subside because the inflammation of the median nerve is reduced from the use of the cortisone, but this is only a temporary effect.
The one main problem with cortisone is that for 21 days following the injection, the tendons have the consistency of rubber and can be seriously overstretched and damaged. This is a common side effect that most doctors fail to tell their patients. If the patient continues overusing and/or stressing their hands and wrists, the tendons can overstretch and cause the structural integrity of the joint to diminish greatly, causing the joint to become loose and sloppy, resulting in an even greater possibility of further injury and damage.
Cortisone can be used wisely as a part of a carpal tunnel treatment program along with the implementation of proper stretches add exercises, the most important tool that can be used to recover from carpal tunnel. If cortisone is utilized, it is good for the patient to take this time, when the carpal tunnel is not inflamed, to be on a conservative therapy program to correct the existing muscle imbalance in the wrist joint and eliminate the carpal tunnel symptoms for good. The problem is that most doctors give the cortisone shot and the patient goes home and either does nothing, or does too much, causing greater trauma to the median nerve within the carpal tunnel and exacerbating the symptoms.
Steroid (Cortisone) Injection Statistic: Failure rate (Including “partial success” as failure) is 72.6% after 1-year follow up. Source: Irwin, et al. J Hand Surgery.
Surgery For Carpal Tunnel Syndrome
Carpal tunnel surgery consists of releasing (severing) the transverse carpal ligament that forms the roof of the carpal tunnel. Surgery is utilized to open and widen the carpal tunnel in order to allow more room for the median nerve, artery and nine flexor tendons to move around. There are several surgical procedures that are utilized to achieve this:
- Open Release Surgery: A local anesthetic is injected into the wrist and/or hand and a 2-3-inch incision is made in the palm and cuts the carpal ligament free from the underlying median nerve. This operation takes about 20-25 minutes.
- “Mini” Open Release Surgery: The mini-open release technique involves an incision that is about 1.5 inches long and can be performed in the doctor’s office with only a local anesthetic. The operation takes only about 12 minutes.
- Endoscopic Release Surgery: The Endoscopic technique is less invasive and uses involves one or two half inch long incisions in the wrist and or palm, and one or two endoscope (pencil-thin) tubes are inserted. A tiny camera and a knife are inserted through these lighted tubes. While observing the carpal ligament on a television monitor, the surgeon cuts the ligament to free the compressed median nerve.
Carpal Tunnel Surgery Statistics:
- “Only 23% of all Carpal Tunnel Syndrome patients were able to return to their previous professions following surgery.” Source: NIOSH
- “Carpal tunnel surgery has about a 57% failure rate following patients from 1-day to 6-years. At least one of the following symptoms re-occurred during this time: Pain, Numbness, Tingling sensations.” Source: Nancollas, et al, 1995. J. Hand Surgery.
Conservative Treatment For Carpal Tunnel Syndrome
Conservative therapy is really the only key to preventing carpal tunnel syndrome as well as for the successful recovery and long-term relief of existing carpal tunnel symptoms, even for post-surgery patients that have experienced little relief. Always try conservative therapy first and eliminate future injections and surgical procedures – Try the “Conservative Alternative”.
About the Author: Jeff P. Anliker, LMT, is a Therapist and Inventor of Therapeutic Exercise Products that are utilized by Corporations, Consumers and Medical Facilities around the world. Balance Systems, Inc. Photo by Dave Parker.