TREATMENT OF CARPAL TUNNEL SYNDROME SURGERY DRUGS AND YOGA

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What does carpal tunnel syndrome feel like? You're working at your desk, trying to ignore the tingling or numbness you've had for months in your hand and wrist. Suddenly, a sharp, piercing pain shoots through the wrist and up your arm. Sounds like carpal tunnel syndrome. It's likely you have carpal tunnel syndrome, not just a passing cramp. Carpal tunnel is a painful progressive condition caused by compression of a key nerve, the median nerve, in the wrist.



Drugs for carpal tunnel. Medication can ease the pain and swelling associated with carpal tunnel syndrome but drugs are no panacea. Chronic carpal tunnel probably needs more than drug treatment. Nonsteroidal anti-inflammatory drugs (NSAIDS), such as aspirin, ibuprofen, and other nonprescription pain relievers, may ease symptoms that have been present for a short time or have been caused by strenuous activity.Long term NSAIDS can irritate the stomach lining and even cause ulcers. Corticosteroids (such as prednisone) or the drug lidocaine can be injected directly into the wrist or taken by mouth (in the case of prednisone) to relieve pressure on the median nerve and provide immediate, temporary relief to persons with mild or intermittent symptoms. (Caution: persons with diabetes and those who may be predisposed to diabetes should note that prolonged use of corticosteroids can make it difficult to regulate insulin levels. Corticosterioids should not be taken without a doctor's prescription.) Additionally, some studies show that vitamin B6 (pyridoxine) supplements may ease the symptoms of carpal tunnel syndrome.



Exercise. Stretching and strengthening exercises can be helpful in people whose symptoms have abated. These exercises may be supervised by a physical therapist, who is trained to use exercises to treat physical impairments, or an occupational therapist, who is trained in evaluating people with physical impairments and helping them build skills to improve their health and well-being.



Alternative therapies. Acupuncture and chiropractic care have benefited some patients but their effectiveness remains unproved. An exception is yoga, which has been shown to reduce pain and improve grip strength among patients with carpal tunnel syndrome.




Treatments for carpal tunnel include:

Splints for the wrist

Medicines like ibuprofen to reduce inflammation

Corticosteroid injections or Steroids

Physical therapy and exercises

Ultrasound therapy

Surgery (2 kinds) to relieve the pressure in the carpal tunnel



There are two kinds of surgery for carpal tunnel. Endoscopic surgery, where the surgeon works through a small opening and uses a camera and instruments to guide and cut and Open Surgery

Endoscopic surgery



Endoscopic may allow faster functional recovery and less postoperative discomfort than traditional open release surgery. The surgeon makes two incisions (about ½" each) in the wrist and palm, inserts a camera attached to a tube, observes the tissue on a screen, and cuts the carpal ligament, the band of tissue over the top of the tunnel. This two-portal endoscopic surgery, generally performed under local anesthesia, is effective and minimizes scarring and scar tenderness, if any. One-portal endoscopic surgery for carpal tunnel syndrome is also available.



See

CARPAL TUNNEL SYNDROME REPETITIVE WORK DIAGNOSIS AND WHO GETS CARPAL TUNNEL

Yoga Based Intervention for Carpal Tunnel Syndrome

Open release surgery



The older procedure used to correct carpal tunnel syndrome, consists of making an incision up to 2 inches in the wrist and then cutting the carpal ligament to enlarge the carpal tunnel. During carpal tunnel release surgery, the surgeon cuts the band that forms the top part of the carpal tunnel. This takes some pressure off the nerve. Carpal tunnel release surgery can be done through a cut in the palm of your handThe procedure is generally done under local anesthesia on an outpatient basis, unless there are unusual medical considerations.



Although symptoms may be relieved immediately after surgery, full recovery from carpal tunnel surgery can take months. Some patients may have infection, nerve damage, stiffness, and pain at the scar. Occasionally the wrist loses strength because the carpal ligament is cut. Patients should undergo physical therapy after surgery to restore wrist strength. Some patients may need to adjust job duties or even change jobs after recovery from surgery.

Carpal Tunnel Syndrome Fact Sheet