I could certainly do blogs about my treatment philosophy concerning carpal tunnel, trigger finger, Dupuytren's contracture, ganglion cysts, and other common hand surgery problems.
Here is a little something about carpal tunnel:
Carpal tunnel syndrome (CTS) is a common condition that occurs when the median nerve in the wrist is compressed:
Carpal tunnel syndrome | |
Symptoms | Numbness, tingling, weakness, or pain in the wrist or hand, especially in the thumb, index, and middle fingers |
Causes | Swelling in the wrist, repetitive hand movements, pregnancy, or other factors |
Risk factors | Women, aging, obesity, diabetes, alcohol addiction, fibromyalgia, and hypothyroidism |
Treatments | Rest, wrist splints, cortisone injections, surgery. |
Symptoms of CTS usually begin gradually and often occur at night. They may also occur during the day when holding something with a bent wrist, such as while driving, reading, or using a phone. Early on, shaking out the hands may help relieve symptoms.
CTS is a progressive condition that can worsen without proper care. As the condition worsens, symptoms may occur more frequently or may persist for longer periods of time.
Treatment for carpal tunnel syndrome (CTS) depends on the severity of the condition and whether other treatments have helped.
Conservative treatments
For mild to moderate cases, conservative treatments include:
Wearing a wrist splint or brace at night.
Steroid injections
Practicing good ergonomics, such as improving wrist positioning or using wrist supports
Avoiding repetitive wrist and hand motions
Avoiding vibratory tools
Surgery
If there is no improvement with conservative care, or if the CTS is severe or there is nerve damage, surgery may be considered. I almost always order a nerve test, or EMG/NCV before surgery is done, in order to confirm the diagnosis and make sure we are not missing anything, such as diabetic neuropathy. There are several different types of surgery - I perform a "mini-open carpal tunnel release."
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