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Treating Carpal Tunnel Syndrome
Posted on 12-06-2024 in Hand & Wrist by Dr. Steven Kronlage
Posted on 12-06-2024 in Hand & Wrist by Dr. Steven Kronlage
Open vs. Endoscopic CTS
An endoscopic carpal tunnel release is a surgical procedure that requires your surgeon to use an endoscope to visualize the median nerve and release the transverse carpal ligament. Unfortunately, there is no proven benefit from undergoing an endoscopic carpal tunnel release versus a mini-open carpal tunnel release. The only proven treatment for significant carpal tunnel syndrome is to release the transverse carpal ligament.
It does not matter how it is released—open, mini-open, endoscopic, or two portal (Chow) technique. While there are claims of significant improvements in recovery time with an endoscopic carpal tunnel release, there is little consensus on this. In addition, endoscopic CRT has a higher rate of recurrence due to an incomplete release of the transverse carpal ligament.
We perform a mini-open carpal tunnel release with local anesthesia for the vast majority of our patients. We have found this to be the safest and most predictable procedure for carpal tunnel syndrome by a wide margin.
“Microinvasive” Carpal Tunnel Release
Carpal tunnel syndrome is a neurological condition. The consensus approach for treating carpal tunnel syndrome once it has become progressed to the point that it is moderate in severity is to release the transverse carpal ligament. Doing so requires your surgeon to divide the ligament, which takes time to heal surgically. Furthermore, there is no such thing as a non-invasive surgical procedure. By its very nature, surgery requires a trained surgeon to access, visualize and repair anatomical structures from within your body.
In recovery, the median nerve must regenerate its outer covering (the myelin sheath), which has been damaged by the compressive forces of the carpal tunnel, and the divided transverse carpal ligament must repair itself in an elongated position. Until these things occur, you will have symptoms.
After surgery, most patients can go back to clerical work in a day or two, but they will not be able to participate in heavy manual labor for about a month. Return to aggressive activity too early will lead to scar formation instead of healing and may necessitate a more involved surgical procedure to reverse the scarring. Carpal tunnel release surgery is one of the most common procedures performed by hand surgeons. They have additional fellowship training above and beyond a five-year surgical residency (orthopedics or plastic surgery) and should be trusted to correct this condition.
Visit Carpal Tunnel Syndrome for additional information, including symptoms and diagnosis details.
With National Family Health History Day approaching next week on Thanksgiving, it’s an ideal time to consider family health history’s role in your orthopaedic and sports medicine care. While many people think of family health history in relation to heart disease or cancer, a family history of orthopaedic conditions like arthritis, osteoporosis and other joint and bone issues can also impact your own risk and health management. Understanding and documenting your family health history can empower you and your orthopaedic provider to proactively manage or prevent conditions that could affect your long-term mobility and quality of life.
October is recognized as Physical Therapy Month, a time to highlight the essential role physical therapists play in improving the lives of patients dealing with orthopaedic conditions and sports injuries. At North Florida Bone & Joint Specialists, we provide comprehensive physical therapy services designed to help our patients recover faster, avoid surgery, and regain their mobility.
The United States is currently fighting an opioid epidemic on a scale never before seen in the history of our nation. Billions of dollars have been spent in an attempt to mediate the devastating effects of the rampant overuse of prescription opioids, including fighting the heroin addictions that often arise when prescription pills become too expensive for addicted patients. In the last two years, impacted states like Ohio and West Virginia have banded together to sue the large pharmaceutical companies that profited off of the sale of opioids even after knowing about their damaging side effects, mirroring the legal strategies that took down Big Tobacco in the 1990s. The resulting settlements have ranged from hundreds of millions to many billions of dollars, and there are more to come. In fact, plaintiffs recently rejected one of the largest settlement offers to date after investigators revealed that the Sackler family, owners of Perdue Pharma, one of the largest profiteers of the opioid crisis, transferred $10 billion out of the company and into overseas accounts as pressure began to mount on the company and its role in perpetuating the devastation.