CARPAL TUNNEL SYNDROME
Carpal Tunnel Syndrome (CTS) has become one of the leading sources of lost productivity and occupational dysfunction in this country. Blue Cross/Blue Shield of California has estimated that the relative cost of the average singular case of CTS is $86,000 including pre-operative procedures, the surgery, and post-operative care. The problem is allopathic success rates in the treatment of CTS are extremely low (between 3-27%) as reported by BC/BS of California. CTS is a peripheral nerve impingement condition, specifically, the Median nerve. The problem with CTS is that the nerve has many entrapment sites and they must all be assessed.
68% of CTS occurs in women, particularly those who are pregnant, taking oral contraceptives (oral-contraceptives leach Vit-B6 from the body) or menopausal and in patients on hemodialysis. Overuse, trauma, swelling, rheumatoid arthritis, and less commonly systemic diseases (leukemia, diabetes, multiple myeloma, hypothyroidism, acromegaly, and sarcoidosis) can cause CTS. Many men experience CTS as well. Cardinal signs of CTS include: wrist/hand pain or numbness, lack of opposition (flexing the pinky finger to touch the thumb) strength, and in more severe cases dropping objects. In many cases, symptoms are worse at night. Symptoms increase by maintaining wrist flexion for 60 seconds and are often relieved by slight wrist extension. In almost all cases studied there is evidence of vitamin B6 deficiency, which acts to decrease inflammation and protect nerve sheathing in the distal extremities.
The problem with surgical treatment of CTS is it assumes there is only one entrapment site & it also assumes the entrapment site is at the wrist. This is usually wrong on both counts. In one study performed on over 500 cases of CTS only two solely involved median nerve entrapment at the carpal tunnel (wrist).
This is however, is typically the exclusive location where the surgery is performed. This explains why CTS patients
usually re-experience the symptoms within one year following the surgery. Additionally, surgery usually
creates more scar tissue in the soft tissue region and frequently aggravates the nerve.
The more common sites of CTS nerve entrapment (listed from proximal-distal) are; (1.) at the C5/C6 cervical junction (where the median nerve originates) (2.) between the anterior & middle scalene muscles of the neck (this is especially common in people with poor posture or those who have sustained a whiplash type injury). (3.) at the brachial plexus (the area where the nerves branch apart going down the arm).
(4.) At the pronator quadratus muscle of the forearm. The nerve has to go directly through the belly of this muscle & it is often entrapped here. (5.) At the carpal tunnel, formed by the carpal bones.
Although the symptoms are all felt at the same location the source of the problem can be an entirely different region. My methods of diagnosing the location of entrapment are honed from many years of successful experience, seminars and patient case studies.
My success ratio is drastically higher than the conventional method while also being much safer, economical, and faster in achieving success.
Proper CTS treatment begins with proper diagnosis. Then, therapy may consist of hot moist packs, cryotherapy, interferential electrical stimulation, ultrasound, manual release methods to ease spastic muscles and precise gentle manipulation to relieve pressure from the nerve.
If you or someone you know suffers from Carpal Tunnel Syndrome tell them to call Dr. Clendenin, your Carpal Tunnel Expert.