How To Know If You Need Carpal Tunnel Surgery

When confronted with the word “surgery” most people think of hospitals, anesthesia, stitches, long recovery, complications, etc. and that is why the thought of needing carpal tunnel surgery can be a scary thought. However, surgery is not the only option to relieve carpal tunnel pain, and even if you do need carpal tunnel surgery, you can take advantage of a minimally invasive, no-stitch technique called endoscopic release.

Causes of Carpal Tunnel Syndrome

First things first, let's talk about the causes of carpal tunnel syndrome (CTS) to better understand this condition and its treatment options. CTS is caused by pressure on a nerve called the median nerve at a specific location on your wrist that is known as the carpal tunnel. Like its name implies, this is a tunnel or space in your wrist that houses certain tendons – known as the flexor tendons – as well as the median nerve.

When the flexor tendons that pass through the tunnel outgrow that space, pressure builds up around the median nerve and this ends up causing pain and discomfort. People with CTS require one of two solutions: decrease the pressure created by the flexor tendons inside the tunnel, or increase the tunnel space to allow for the flexor tendons to fit comfortably. The former one can be achieved with carpal tunnel surgery.

There is no one activity that leads to developing CTS, but there are certain risk factors that increase the chance of a person developing this condition such as: previous injuries, inflammatory illnesses, repetitive movements, and pregnancy.

Symptoms of Carpal Tunnel Syndrome

You might be suffering from CTS if you experience the following symptoms:

  • Wrist pain that may radiate to the forearm, arm, neck, or shoulders.
  • Numbness and tingling on certain fingers.
  • Weakness of grip.
  • Severe nighttime hand pain.

Diagnosing Carpal Tunnel Syndrome

Before you can start looking into treatments and surgery options, you need to be sure that you really suffer from CTS.

The first step is to see a hand surgeon, also known as a hand specialist or orthopedic hand surgeon. It is very important that you talk to a hand surgeon about your symptoms, as opposed to talking to a primary care physician, because hand surgeons have the expertise required to properly diagnose CTS or identify your hand problem as a different, perhaps less known condition if that is the case.

Diagnosing CTS is not a straightforward task. Since this condition is a syndrome and not a disease, it can not be diagnosed based on a single criteria or test, this is one of the many misconceptions about carpal tunnel syndrome.

CTS is diagnosed based on your medical history, a physical examination, and additional testing. Then, the hand surgeon will put all the pieces together to deliver a diagnosis.

Some of the physical tests that can be performed to help determine if you have CTS are:

  • Tinel's test: the hand surgeon will tap over the median nerve to record any tingling or shock in the fingers as a result of the tapping.
  • Carpal tunnel compression test: the hand surgeon will hold pressure on the median nerve to see if it causes a tingling sensation in the fingers.
  • Phalen's test: the hand surgeon will ask you to bend your wrist 90 degrees to see if you feel tingling in your fingers.

Other testing used to aid in the diagnosis are:

  • Electromyelogram / Nerve Conduction Velocity (EMG / NCV)
  • Ultrasound
  • MRI
  • Diagnostic steroid injections

Once a clear diagnosis has been reached, it is time to start considering the treatment options with the help of your hand surgeon.

Carpal Tunnel Surgery and Other Treatments

As mentioned before, the course of treatment for relief depends on each individual's needs and should be determined with the help of a trained hand surgeon.

Non-surgical treatments usually aim at reducing the inflammation inside of the tunnel. Some non-surgical treatments are:

  • Splints.
  • Non steroidal anti-inflammatory medications
  • Oral steroids
  • Steroid injections
  • Physical or Occupational therapy

Non-surgical treatments, however, do not treat the root of the problem and therefore do not needarily resolve the symptoms for certain people.

Surgery can be performed in two ways, as an open procedure, or as the minimally invasive no stitch release.

Endoscopic Carpal Tunnel Release Surgery

  • Performed with a small endoscope.
  • Does not require stitches.
  • Leaves a small scar, about three to four millimeters.
  • Little to no post op pain.
  • Use of the hand on the same day.

Open Carpal Tunnel Release Surgery

  • Performed by making a large incision of about three to four inches.
  • Requires staples or stitches.
  • Leaves a scar.
  • Potential post op pain.
  • Usually needs one to three months of therapy to fully heal.

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What Are Hand Surgeons?

There is a unique and fragile relationship between all the structures of our hands. An injury or disease affecting any of the bones, ligaments, tendons, nerves, skin, joints, or blood vessels can completely restrict the use of our hands, wrists, forearms, and even our elbows. Knowing the multitude of purposes they serve, including eating, dressing, and performing our jobs, when trauma occurs it can be disabling and frustrating. Injury can be caused by work-related accidents or repetitive use of the fingers and extremities. If spending time doing hobbies or performing normal daily routines are interrupted by extremity pain, it is probably time you seek medical advice from hand surgeons.

An estimated 16 million people in the US seek out care for fist-related injuries each year. These hand surgeons are required to obtain an additional year of specialized training beyond their board certificates for orthopedic surgery, plastic surgery, and general surgery. The need for this exclusive medical training dates back to World War II, when many soldiers sustained hand-related injuries and required military surgeons to obtain additional training. Up until this point, injuries and wounds rarely seriously damaged due to a lack of appropriate care.

A majority of these doctors also carry expertise in dealing with issues related to the arms, shoulders, and elbows. Common ailments these doctors treat are

– Sports-related injuries of the extremities and wrists
– Fractures, including in the wrists and forearms
– Tennis elbow
– Amputations
– Creating fingers from toes and other joints
– Carpal Tunnel Syndrome
– Arthritis, including that of the wrists and elbows
– Lumps on the hands and arms
– Tumors causing tingling, pain, and numbness
– Injuries to the nerves and tendons
– Congenital limb differences (birth defects)

A common misconception is that this field deals strictly with surgery. Hand surgeons try to heal a patient without resorting to surgery and often recommend non-surgical treatments including splints, physical therapy, injections, ice therapy, rest, and medications. Should surgery be necessary, it can be performed under either general or regional anesthetics. Over 90 percent of these procedures are performed under local anesthesia, where you receive an injection in your arm or upper chest area to numb the nerves running to the arm. Delays in both diagnosis and treatment can cause a reduction in your range of motion and even long-term disability. The gravity of these injuries is because as soon as pain or discomfort is felt in any of the lower extremities, you should consult a doctor.

Despite the high demand for these doctors, it is not an attractive surgical field of study. For a newly graduated medical students, the best route to landing positions as hand surgeons by working within that related medical environment. Additionally, internships often lead to secured positions within this field because the candidate has already gained insight into this specialty. These doctors are employed either in a private practice or within hospitals or clinics.

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Healing Arthritis Pain With Herbs

“It is just too difficult to get out of the bed in the morning.” This is a common complaint from my yoga students. Should we believe that it is a disorder for only the elderly? No. I have seen young people suffering from arthritis pain. When acid wastes accumulate in the fluid, which lubricates our joints, they get swollen and the ends of the bones become rough and stiff. The cartilage becomes dry, brittle after the secret dries up completely, and the bones rub against each other. In this condition, the body becomes stiff in our joints and muscles and the pain starts. This pain is, 'Arthritis' pain.

Actually, arthritis is a chronic syndrome of inflammation of the joints, which slowly increases the destruction of these structures. It does not appear to be one disease. It looks as if a person is suffering from many physical disorders. Doctors say they first have to diagnose it as arthritis, because there are many different diseases, which we described as arthritis. There are two most common types, one is osteoarthritis and the other is rheumatoid arthritis.

Arthritis is an inflammatory condition, also known as a degenerative condition where a bone or joints of the body are affected. In this condition, the infection attacks the surrounding of the lubricating fluid in the joints. The entire structure is affected and it creates swelling, fatigue, stiffness, and fever, pain in fingers, wrists, knees, ankles and spine. It sometimes may bring a crippling condition too.

The second condition is osteoarthritis, which has been related to the wear and tear of aging and deterioration of the cartilage at the end of the bone. This causes acute pain. This mostly applies to one area of ​​the body such as the neck, knee, and sometimes hips.

Yoga helps eliminate arthritis pain, breathing exercise, and meditation help calm the mind, emotions, mental and physical pains.

Early in the morning, drink one liter of water sitting on a chair. Water is a wonderful cleanser and excellent moisturizer. Repeat this water therapy in the evening again two hours before eating your dinner every day. Do not drink water late as it may interrupt your sleep. For arthritis patients, it is important to sleep through the night, because the body repairs itself while sleep. Water will lubricate your joints reducing your discomfort. We all need to drink a lot of water, because human body contains 70% of water, and if we do not drink adequate portion of water in a day, our body cries for it.

Recipe to eat :

· Consume half a teaspoon of Giloye powder and one teaspoon of Amla powder with warm water first thing in the morning and before going to bed daily.

· Swallow one teaspoon of Triffla (a mixer of dried baherha, amla, and hararh powder – these are fruits, grown in India, and are available at Oriental and Indian stores) with water first thing in the morning and at bedtime. It detoxifies the human body and sets metabolism.

· Take one teaspoonful of castor oil, mix with one teaspoon of ginger powder, and swallow this with warm water at bedtime. You may put the mixture on the tongue and swallow with warm water each night. Continue this process for three weeks and this will clean your intestines.

· Ajwain powder

(Indian wild celery seeds powder) t tsp

Turmeric powder t tsp

Yellow mustard seeds powder t tsp

Ginger powder 1 tsp

Gurh (raw sugar) 1 tsp

Mix the first four ingredients well. Put gurh in a pan, heat with a few drops of water; add mixed ingredients when gurh melts, and stir continuously. Turn off the heat and make three tiny balls, when cold. Swallow one herbal tiny ball with water three times a day. Make it in bulk so that you may consume it for one week or one month and continue this process for at least six months. Use either, first two or last two recipes at a time, whatever convenient.

Nature Cure is a slow process, but 100% natural with no side and after effects. These are simple remedies to heal pain in the body, instead of contaminating our immune systems, using harsh chemicals.


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Carpal Tunnel Stretch

What is a Carpal Tunnel?

This article will describe how to perform a carpal tunnel stretch to help alleviate the symptoms of carpal tunnel. I call it the fist stretch. First let's talk about what carpal tunnel syndrome actually is. There is an actual tunnel that goes through the wrist. This is a passageway that allows the nerves and tendons to pass through the wrist. There are eight carpal bones (wrist bones) that are shaped in a “C” or horseshoe. This makes up three of the four sides of the carpal tunnel. The fourth side is comprised of a wide and thick ligament that extends from each end of the horseshoe to form the roof of the tunnel. The width of the tunnel is about the size of an index finger. The contents of the tunnel includes the median nerve along with nine tendons.

What Causes My Symptoms?

Due to pressures including repetitive movements the eight carpal bones can lose their health alignment. When this occurs it causes pressure or pinching of the median nerve entrapping it between the bone and the thick ligament forming the roof. This will produce symptoms such as pain, numbness, tingling, and burning symptoms into the fingers of the hand. It may also cause decreased strength and a loss of grip strength in the hand. Performing this carpal tunnel Stretch will help alleviate these symptoms.

How to Get Relief

This carpal tunnel stretch (the fist stretch) is a good procedure to treat the carpal tunnel syndrome pain. The wrist should be placed in a neutral and relaxed position. Keeping it straight slowly close your hand into a full fist, bending all the knuckles, and you keep it relaxed. You're not squeezing the fist trying to perform a superman grip. You are opening and closing the fist in a relaxed manner. Now the most important aspect is that when you open the fist make sure you extend and stretch your fingers as far as you can. Visualize your fingers are cables that are being pulled tight stretching them out as far as you can. You want to hold the stretch for about 3-5 seconds. Perform the exercise for 10 repetitions and can be done multiple times through the day or when the wrist feels tight. This will stretch the webs of the fingers, tendons and ligaments in your hand. You should feel this stretch. This exercise will improve the circulation and increase the flexibility in your wrist relaxing the muscles.

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