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Carpal Tunnel Syndrome # Is Surgery Really Necessary? Print E-mail
Carpal tunnel syndrome generally results in tingling, pain, numbness, and wasting of the muscles on the thumb side of the hand # the area that is supplied by the median nerve.

Often today, surgery is the most frequently recommended treatment, but it is obviously the most invasive form of treatment. It is also not the only option. To better understand the different options available we need first to look at the different causes of Carpal Tunnel Syndrome.

The carpal tunnel is made of two rows of four bones, called carpal bones, which sit in a semi-circle at the back of the wrist.  This forms one side of the tunnel.  The opposite side of the tunnel is formed by a strong ligament, the flexor retinaculum, which completes the carpal tunnel.

The tendons that bend the fingers, and the median nerve all pass through this tunnel from the arm to the hand. What happens in Carpal Tunnel Syndrome is that, for various reasons, the space in the tunnel becomes overcrowded, the nerve gets compressed, and the result is that the nerve no longer conducts signals as it should.

The median nerve supplies the palm side of the hand including the thumb and the first three and a half fingers. It also supplies the tips and the backs of the same fingers. When the nerve gets compressed, it is only in this area that symptoms are felt. So, if you are getting symptoms in your little finger, for example, then that is NOT caused by Carpal Tunnel Syndrome.

Diagnosis of Carpal Tunnel Syndrome is usually done by EMG (electromyelogram) which measures the conductivity of nerves. If the median nerve is compressed (as in Carpal Tunnel Syndrome) then this will show up on the EMG test.

The EMG is done by sending a small electrical impluse from the forearm to the hand. If the current is decreased when it is picked up at the hand by the EMG probe, then the diagnosis is probably Carpal Tunnel Syndrome.

The treatment most commonly recommended is the surgical cutting of the flexor retinaculum so as to provide more room for the nerve in the tunnel. This often works very well - but it is by no means the only solution.

Carpal Tunnel Syndrome is commonly caused by one of two things: either the collapse of the bony arch owing to deterioration of the joints between the small carpal bones, or else swelling of the tendons which then take up more space in the narrow tunnel and so put pressure on the nerve.

The problem with using solely EMG to determine the presence of carpal tunnel syndrome is that it doesn't differentiate between the two causes.  This leads to a lack of differentiation of treatment which may, in turn, result in unnecessary surgery.

If the cause is swollen tendons (tendonitis) then, I believe, it is better treated by tackling the cause of the inflammation # such as too much stress or tension on the tendons # than by surgery.

Too much repetitive use of the muscles in the forearm cause them to tighten up. This then makes the tendons tight too, and that can cause them to become inflamed and swollen # an unfortunately common cause of Carpal Tunnel Syndrome.

Treatment for tendonitis can include physiotherapy, stretching, ergonomics (eg typing posture), chiropractic manipulation, nutritional support, and so forth. These are all much less invasive and have fewer side effects than surgery.

Surgery can certainly work. But my preference is to start with the simpler, less risky alternatives.  If having tried those, things are no better, then by all means consider surgery.

#-Are you fed up with of suffering from carpal tunnel syndrome? Read more articles by Dr. Steven Trembecki, D.C. on  alternatives including chiropractor treatments. Get your own personal version of this article at http://www.uberarticles.com/articles/?id=831
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