May/June 2011 News from the Valley’s Integrated Health Community
What is Carpal Tunnel Syndrome? By Jon G. McLennan, M.D.
Each year, millions of Americans slowly develop debilitating pain in their hand(s) that causes sleepless nights and weak- ness of grip limiting the use of their hand or even the ability to work. Usually not related to injuries, the pain evolves slow- ly over time in one or both hands. There may be painful numbness or tingling sensations that come and go based on the position or usage of the hand during daily activities. This condition is known as Carpal Tunnel Syndrome (CTS).
CTS is caused in the wrist by compres-
sion of the median nerve from swelling of the flexor tendons. It is commonly seen in people in their 40’s and 50’s (but may occur at any age), and more frequently in wom- en. CTS may occur after injuries such as fractures, sprains and strains of the wrist, after pregnancy or in various medical condi- tions, but typically evolves from the chronic over-use of the hand. It has been associated with certain activities and/or types of work, referred to as re- petitive or occupational stress syndromes.
Diagnosed by symp-
toms, physical examina- tion and at times by nerve conduction and electromyography (or NC/EMG), CTS is usually first diagnosed by one’s primary care physician or an internist. Treatment consists of bracing, anti-in- flammatory medications, stretching of the muscles of the palm and ergonomic changes to activities, work-stations and other objects the hand may hold. Con- servative treatment may take months to resolve symptoms. If treatment fails, patients are referred to an orthopaedic surgeon.
Treatment by an orthopaedic surgeon
may include injection of the carpal tun- nel, continued bracing, medications, physical therapy and the addition of NC/ EMG testing if it has not been complet- ed. Should symptom management fail, surgery is recommended.
Carpal Tunnel Syndrome surgery re-
leases the ligament at the base of the palm that is compressing the tendons which flex the fingers. This surgery usu- ally involves minimally invasive tech- niques known as endoscopy or arthros- copy, and is completed in less than 20 minutes (surgery time) in a surgery cen- ter or hospital’s outpatient unit. If CTS is apparent in both hands, the surgeon may recom- mend operating on both hands simultaneously.
Patients are encour-
aged to use the hand right way, avoiding overuse. Bracing may be contin- ued and physical therapy initiated. Most individu- als return to standard daily activities within 2 weeks and to work when the wounds are healed (depending on the type of work.)
Early Carpal Tunnel
Syndromes may resolve over several months. Symptomatic treatments may also be effective. When this is not the case, minimal invasive surgery is predict- able, the outcomes excellent and recur- rence rare.
Dr. Jon McLennan specializes in Ortho- paedic Surgery and Sports Medicine and is located at JFK Orthopedics in La Quinta. Dr. McLennan can be reached at 760.777.8282. Visit www.OrthopaedicS-
portsMedicineLaQuinta.com
Medical News
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www.evansmedicaleyecare.com
www.orthopaedicsportsmedicinelaquinta.com
www.DesertHealthNews.com
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