Is Carpal Tunnel Surgery Always Necessary And Can Surgery Be Avoided?
Maple, ON – Many people complain of wrist pain and hand numbness. Often times patients come into my office and say they were already diagnosed with Carpal Tunnel Syndrome (CTS).
CTS occurs when repetitive strain and stress to the wrist causes tissue irritation and inflammation. This causes swelling in the part of the wrist called the Carpal Tunnel (CT), which is made up of 8 wrist bones called carpal bones and one tough ligament. Travelling through this small-spaced tunnel are 9 stringy, rigid tendons of the forearm and one soft nerve called the median nerve.
The median nerve emerges also from the forearm, starting at the elbow through the carpal tunnel and branching into the palm side of the hand. The median nerve only goes to part of the palm side of the hand (the palm side of the thumb, palm side of the second finger, palm side of the third finger and half of the palm side of the fourth finger, as well as a the outer half (approx.) part of the palm itself.
Irritation of the tendons in the carpal tunnel will cause wrist pain, inflammation and swelling. This will ultimately lead to a decrease space in an already small tunnel and therefore compress the sensitive median nerve. Nerves don’t like the be irritated and when they are the are painful. Nerve pain typically results in numbness and tingling. This is why people with CTS complain of tingling and numbness in parts of the their hand.
Many people try all sorts of therapy like massage, acupuncture and physiotherapy to relieve the wrist pain and the hand numbness/tingling associated with carpal tunnel. CTS can be debilitating and cause disability, often preventing someone from doing their work. When these types of therapies don’t give desired improvements in CTS symptoms, carpal tunnel syndrome surgery is then considered.
I have seen many patients who have had CT surgery however, they still complain of wrist pain and hand numbness/tingling. This always concerns me and I question if the surgery was successful if patients still show post-surgery symptoms. There are many people who have had good results from CT surgery, but the next question I have is this – can CT surgery be avoided?
A 1995 study by Nancolles et al looked at the long-term results of carpal tunnel surgery.1 They found that although 87% of people reported good or excellent overall outcome from the surgery, 30% of people reported poor to fair strength and long-term scar discomfort. They also found that 57% of people reported a return of pre-surgery symptoms (pain) after, on average, 2 years post-surgery.
So, how effective is carpal tunnel syndrome surgery if 57% of cases studied reported a return of pre-surgery wrist and hand symptoms? Surgery is always an invasive procedure even if it’s only the wrist we are talking about. And the body needs to repair from the surgical incisions.
Now, I understand this is a dated study, but still it raises the question about CT surgery effectiveness. Perhaps new studies are due by the doctors who perform these surgeries to really assess the long-term outcome of CT surgery.
Is it possible that wrist and hand pain associated with carpal tunnel syndrome is not originating from the wrist area alone? This is a fair question to ask because the nerves that feed into the median nerve of the forearm and wrist emerge first from the lower part of the neck. So, is it possible that there could be an underlying problem with the alignment of the neck that could be affecting the nerves of the forearm and wrist? What if there are two nerve compression problems, one in the wrist and one in the neck?
This is why I always recommend a chiropractic spinal check-up for anyone that suffers of arm pain, forearm pain, wrist pain or hand pain and especially anyone that has been diagnosed with CTS. Why? Because the chiropractor will work on discovering the underlying problem that is causing the arm and wrist pain and work on correcting the underlying cause of the problem, without surgery.
Chiropractors are experts are detecting and correcting spinal misalignments. This is an important part of assessing CTS because the pain in the wrist and hand may not always be starting in the wrist and hand. It could be starting in the neck. There could a spinal misalignment in the neck that is compressing or stressing the nerves that feed into the forearm and neck. Correction of neck misalignments with specific, scientific, chiropractic adjustments will relieve tension on the nerves of the neck allowing for proper healing to occur in the structures that are innervated by those nerves, including the forearm, wrist and hand.
A chiropractor can also provide adjustments to the forearm and wrist which helps to improve the mobility of the the forearm and wrist bones and naturally release the compression on the median, without surgery.
Chiropractic care can be effective approach to managing and correcting the cause of carpal tunnel syndrome. Chiropractic care should be considered as an alternative approach and to avoid unnecessary surgery that can give poor long-term results.
1. Nancollas MP et al. Long-term results of carpal tunnel release. J Hand Surg Br. 1995 Aug;20(4):470-4.
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By: Dr. Walter Salubro
Maple’s Family Wellness Chiropractor
Dr. Walter Salubro is a family wellness chiropractor who has been serving the Maple and Vaughan community for over 13 years.
Dr. Salubro provides chiropractic care to people all age groups. He has completed many post-graduate courses in techniques applicable to both children and adults. In addition to offering specific spinal adjustments and posture corrective techniques,
Dr. Salubro offers an extensive line-up of health and wellness workshops, exercise classes and a run-walk club to his patients.
Dr. Walter Salubro is dedicated to providing the highest quality chiropractic care for all of his patients. He is a 1999 graduate of the National College of Chiropractic and certified from the Academy of Chiropractic Family Practice and the Council on Chiropractic Pediatrics (C.A.C.C.P.). Dr. Walter Salubro is Webster Technique Certified, certified and recognized by the International Chiropractic Pediatric Association (ICPA). Dr. Salubro caters to the specialized care of infants and pregnant mothers.
Maple & Vaughan’s Family Wellness Chiropractic Centre
A Village of Maple Chiropractic Clinic