In this post I am going to review a very common disorder of the wrist called Carpel Tunnel Syndrome or CTS. With all the time we spend on our home computers we are all at risk for this annoying problem. I am also going to suggest the cure for carpal tunnel syndrome...and I don't mean surgery!

What is Carpal Tunnel Syndrome (CTS)?

CTS is a condition where the main nerve going into your hand is irritated or compressed. This nerve is called the Median Nerve and it accounts for 4/5 of the function of your hand. It travels through the Carpel Tunnel of your wrist into your hand.

According to the Bureau of Labor Statistics this malady is usually seen in people who repeatedly use their hands (that's you and me as computer nerds:). There are over 3 million Americans with this condition. It is the most common nerve compression syndrome.

Women are much more commonly effected than men. It clusters in families (which means there is a genetic tendency to develop it). Furthermore, people with Diabetes Mellitus, Thyroid disease, Rheumatoid Arthritis, and Pregnancy have a higher chance of getting this annoying condition.

What are the symptoms of CTS?

When the Median Nerve is irritated or injured you may notice a numbness, stiffness, weakness, and "tingling" pain in the wrist or hand. The pain can even radiate up the arm. There may be certain activities that make it worse like typing, or using the mouse for your computer, or operating machinery that vibrates.

If the symptoms go on untreated you may develop permanent symptoms in your hand (like "shrinkage" of your hand muscles called atrophy). At that point many of the therapies that we will be discussing may not work. It is important to not ignore the symptoms. You should be evaluated by your Primary Care Physician (PCP) if these symptoms occur.

What kind of testing will my PCP perform or order?

Your PCP will perform a thorough history and physical. He or she may tap on the underside of your wrist to see if a "lightning pain" is generated (called Tinel's Sign). This will mean you have CTS.

For the purpose of proving the diagnosis, your PCP may order an Electromyogram/Nerve Conduction Study (EMG/NCS). It is an uncomfortable study where fine needles are pierced into your skin and a low electrical current is used to stimulate a muscle or nerve. It is not my favorite test for obvious reasons.

How effective are the treatments for CTS?

If your History, Physical Exam, and EMG/NCS are consistent with CTS, your PCP will probably begin conservative therapy. That usually constitutes anti-inflammatory medication, a wrist splint, stretching exercises for the wrist, and instructions on what activites to avoid.

If your symptoms persist for more than 4 weeks with therapy your PCP will refer you to a surgeon who specializes in a procedure called a Carpel Tunnel Release. This is a fairly simple surgery where the Transverse Carpal Ligament of the wrist is cut and the tendons compressing the Median Nerve are "released". This relieves the pressure on the Median Nerve and your symptoms usually resolve.

While many people will get relief of their symptoms with these therapies, there are several drawbacks:

Anti-inflammatories have many side-effects (ie. stomach ulcers, kidney disease, etc.). They cause up to 17,000 deaths each year in the U.S. from Gastro-intestinal hemorrhage. These medications do nothing for the main problen in CTS...the narrow Carpal Tunnel.

Wrist exercises may help temporarily but do not correct the main cause of the nerve entrapment...a narrow Carpal Tunnel.

A wrist splint may help by allowing the wrist structures to rest. If a splint doesn't improve your symptoms in 2-4 weeks it probably isn't going to work. You see...it doesn't change the narrow Carpal Tunnel.

Surgery will definitely enlarge the Carpel Tunnel. However, you will have to face the risk of a surgical procedure, some form of anesthesia, a permanently painful incision on your hand (up to 60% of patients) and your symptoms may recur anyways. What is a person to do?

The Cure for Carpal Tunnel Syndrome...

If I was going to create the perfect treatment for something I would make it effective, have few side effects, be affordable, and be able to be repeated conveniently. There is actually a therapy that satisfies all my criteria...it is called the CTrac.

The CTrac was developed in the U.S. by 2 Doctors who practice pain management. The device inflates on the undersurface of the wrist and stretches the Transverse Carpal Ligament...enlarging the Carpal Tunnel. It is worn 5 minutes, 3 times per day. Within 2 weeks 70-80% of patients have significant relief. After using the therapy for 1 month 75% of the patients no longer required surgery.

I have reviewed the symptoms, signs, tests, and usual therapies for CTS. The CTrac is an excellent alternative to surgery. If the symptoms persist then surgery is still a viable option. You cannot lose choosing CTrac as your first choice to cure your Carpel Tunnel Syndrome (click here for a link).