Carpal Tunnel Syndrome and Treatment

What is the Carpal Tunnel?

The carpal bones of the hand form a "C" shaped ring that is covered by a ligament. There are eight of these bones that vary in size and shape to make up the wrist area. This ligament and bony structures form the carpal tunnel through which the median nerve and nine tendons pass. These tendons flex the fingers and thumb. Any condition that affects the size of this tunnel can lead to carpal tunnel syndrome.

What Causes Carpal Tunnel Syndrome?

There are several factors that lead to the condition. Most commonly, it is thought that the syndrome is genetic, while repetitive, strenuous use of the hands often worsens the symptoms. Other conditions that can cause or worsen carpal tunnel syndrome include fractures, masses, severe bruising. Conditions that are associated with this condition include hypothyroidism, infections, arthritis, pregnancy, and diabetes.

How is Carpal Tunnel Syndrome Treated?

The first line of treatment is non-operative. Wrist braces, activity modification and anti-inflammatories are usually the first step and can be helpful in many early cases. Surgery is often considered when you do not gain relief from these treatments. Worsening symptoms indicate a nerve at risk of permanent damage. The decision is based mostly on the severity of your symptoms and your desire to return to normal functioning. In the most severe cases, surgery is done much sooner because the other treatment options are not likely to help. Also, long-standing cases often require surgery when the disease has resulted in constant numbness and wasting of the thumb and finger muscles.

Surgical Treatment

Carpal tunnel release surgery is one of the most common operations performed on the upper extremity and is among the safest and successful surgeries performed. During the surgery, the doctor will make a small cut in the palm of your hand. This will allow him to see the transverse carpal ligament of the carpal tunnel and divide this structure to increase the size of the tunnel and decrease the pressure placed on the median nerve. Once this is done, the skin is closed and the ligament will start to heal and grow across the divided area. This new growth actually heals the ligament and more space is available for the nerve and flexor tendons. Once this is done, the skin is sutured and a sterile bandage is applied. The sutures will need to be removed in seven to ten days.

The endoscopic method for carpal tunnel release allows the doctor to visualize the ligament with a small camera and the procedure results in a more speedy recovery. Other benefits of this procedure are less postoperative pain, earlier return to work, and earlier return of grip strength.

What Should I Expect during Recovery?

Immediately following your carpal tunnel release surgery, you will be instructed to frequently elevate your hand above your heart and move your fingers as well. This is done to prevent stiffness and reduce swelling. There is some pain, swelling and stiffness to be expected after the surgical repair. The dressing is removed in 3-5 days and normal use of the hand is allowed once you are comfortable. Minor soreness of the palm region is common but reliably improves over time.

Hypnosis As A Cure for Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a common disorder of the colon and the entire digestive system, which leads to discomfort, abdominal pain, bloating, constipation and diarrhoea. The exact causes are unidentified but most experts agree it's linked to an increased sensitivity of the gut. The symptoms of IBS tend to come and go in bouts, often after eating certain types of food or during times of stress. Since 1980 a number of studies have shown that hypnosis has helped IBS patients for whom standard treatment has failed. Indeed, it seems IBS patients can obtain genuine relief through hypnosis.

Standard treatments for IBS are targeted at preventing constipation or diarrhoea. They include changes in diet, fibre supplements and drugs. For many, this approach proves effective. However, some patients do not respond well to conventional treatment. For them, psychological therapies may be appropriate, namely hypnosis and cognitive-behavioural therapy.

As a treatment for the symptoms of IBS, hypnosis does not have to take place in specialized medical centres. The latest study on the subject shows that hypnosis can be effective even when done by therapists in the normal conditions of a consulting room. And tests have shown that patients undergoing hypnotic therapy had a marked drop in the symptoms of pain and bloating.

This study tracked two different procedures for treating the symptoms of IBS. The first procedure was hypnosis in a private clinic. The second procedure required the patients to meet with psychologists in a hospital gastroenterology department. It turned out that the first procedure was as equally effective as the second. An added advantage was the better availability of private therapists, compared with the limited number of hospital specialists. This made the first procedure a genuine "real world" solution. These tests also support the fact that self-hypnosis techniques, applied at home can also provide an effective solution to dealing with IBS.

Cognitive behavioural therapy aims to change a patient's patterns of thinking and behaviour that contribute to health problems. The idea of using hypnosis to treat the symptoms of IBS is to give individuals a sense of control over their digestive tract. Luckily, modern technological advancements offer cost-effective solutions for self-hypnosis at home, and the internet provides a vast resource for further exploring the subject as well as learning about other people's experiences with hypnosis. With modern technology, we can feel lucky that a great number of alternative treatments are being made available that don't cause the side effects of medication. Do take some time to learn more about them!

Are New Wonder Drugs Only for the Select Few?

These days you cannot pick up a newspaper without reading of some new wonder drug that has been discovered. Scientists have made great leaps in their knowledge and understanding of the body's DNA and the results are outstanding.

A few decades ago certain cancers were almost considered to be a death sentence but now they are curable, or at the very least controllable. And as a result we can now expect to live not only a longer life, but also a better life too.

Obviously this has to be seen as a good thing for all of us. Or, does it actually present more problems than we realise?

The cost of these new drugs seems to be getting higher and higher all the time. Although, to be honest, it is not surprising when you consider what it takes to get any new drug onto the market.

The big drug companies have to invest colossal amounts of money into research and development. They spend years testing new drugs to make sure they comply with all the various regulations and discover what, if any, the side effects are.

So by the time a new drug reaches the market an enormous amount of money has been invested on it. And obviously this money has to be recouped - plus enough profit to pay the shareholders and fund any new research. And this money is be paid by us, the patients, either directly over the pharmacy counter or through any social security or health insurance payments we make.

And this is really where the problems begin.

Not that many years ago once a patient was diagnosed with cancer it would not be too long before they, unfortunately passed away. That was because there was no means of detecting a lot of cancers until it was almost too late.

But now with early detection of cancers we have a much better chance of survival. So, unlike our parents generation, if we are diagnosed with cancer we stand a very good chance of carrying on living well into our old age.

But this comes at a cost - and the cost is that we live for many years consuming large quantities of very expensive drugs.

When my father was diagnosed with prostate cancer his consultant informed him he needed to go on a particular course of tablets, and gave him a note to pass onto his doctor. Once his doctor saw what the tablets were his eyes widened and he turned to my father and said, "Do you know how much these tablets are going to cost me?"

But, as we all live that much longer the cost of keeping us alive has risen alarmingly. In the UK the job of the National Institute for Health and Care Excellence (NICE) seems to be to look into the cost effectiveness of new drugs and deciding whether or not they can he used in the National Health Service. There have been a number of drugs they have classified as being far to costly, one in particular was for Alzheimer disease much to the annoyance of those patients and their families.

So is this the way modern medicine is heading? Will there be drugs and treatment for those who can afford it, and no drugs - and perhaps not even any treatment - for those who cant? This really does conjure up an image of a two-tier health system - one for the rich and one for the poor.

So what is the point in all these new wonder drugs if the majority of people they were designed to help cannot afford to benefit from them?

Perhaps now is the time to look at more natural ways to keep ourselves healthy and try to prevent many of the more serious illnesses taking hold of us in the first place.

Unless of course you happen to be extremely rich that is!

Morton's Neuroma Differential Diagnosis - Distinguishing From Other Conditions With Similar Symptoms

Morton's neuroma is a common condition that affects the third space between the toes. The condition is also referred to as interdigital neuroma. This painful foot condition is due to enlargement of the nerve of the foot.

There are a number of conditions that can be mistaken for neuroma. Read on to learn about the differential diagnosis of Morton's neuroma.

A stress fracture may be mistaken for neuroma. This is actually a small crack in the bone that can develop from overuse or can also be from weakening of the bone by conditions such as osteoporosis. Symptoms of stress fractures are pain, swelling, tenderness on a specific spot, and continued pain at rest as the fracture damage progresses.

Tarsal tunnel syndrome occurs from abnormal pressure on a nerve in the foot. Usually, the symptoms are vague pain in the sole of the foot, burning, or tingling sensation. The pain gets worse with activities such as walking long distances or standing for long periods. It is occasionally mistaken for Morton's neuroma because the pain and tingling may also occur on the toes.

Peripheral neuropathy, like Morton's neuroma, is due to nerve problems. In neuropathy, the pain is described as tingling or burning. There can be extreme sensitivity to touch, lack of coordination, or muscle weakness. The pain may also spread upward to the legs.

A ganglion is also another differential diagnosis for neuroma. This is like a balloon that arises under the skin. Although often seen on the wrist, the cyst also frequently develops on the foot. In contrast to neuroma, a ganglion cyst may have a noticeable lump. If the cyst is touching a nerve, this causes burning or tingling sensations.

Arthritis of the feet may occasionally be mistaken for neuroma. Osteoarthritis is wear and tear arthritis, resulting to swelling, inflammation, and pain. Some people with rheumatoid arthritis may also have pain in the heels because of plantar fasctiis. The symptoms may also appear in several joints on both feet. The toes may also begin to stiffen. To differentiate arthritis, range of motion tests or x-rays may be done.

Another very common condition that leads to foot pain is bursitis. Again, this may also be mistaken for Morton's neuroma. A bursitis is inflammation of the bursal sac, which contains fluid to lubricate and reduce friction between two surfaces in the body. With bursitis, the top of the toes can be very tender, red, and slightly swollen. Most of the time, pain is relieved when the shoes are removed.

The various differential diagnoses of neuroma must be carefully considered to exclude these other common conditions of the feet. When a definitive diagnosis of Morton's neuroma is made, conservative management can be tried from three months to one year.

Causes and Symptoms of Anterior Knee Pain

The kneecap (patella), located at the front of the knee, gives leverage and power to the leg muscles. When the knee is overstressed, an individual may feel a dull, aching pain in the front of the knee. This is known as anterior knee pain, runner's knee or patellofemoral joint syndrome. Anterior knee discomfort tends to occur in overweight individuals, athletes, children, young adults and senior citizens who over-stress their knees.

Anterior Knee Pain in Females
Anterior knee pain occurs at a higher rate in females. This is due to the size of the female pelvis. Females have wider pelvises, which creates a pointed angle where the thigh and leg bone join. This can lead to kneecap misalignment, which results in pain. In addition, females ligaments are generally more slack, and muscles that support the kneecap tend to be weaker than males.

Causes
Causes of the pain vary, but often come from tendonitis and the breakdown or irritation of the cartilage at the base of the kneecap. These conditions result from improper knee movement that causes the kneecap to rub against the lower portions of the thigh bone. Causes of improper movement include pes planus (flat feet), misalignment of the kneecap and femur (patellofemoral joint), tight or weak muscles on the front and back of the thigh and overexertion of the kneecap during exercise or sports activities. Frequent inactivity leads to the loss of muscle tone around the knee, which can lead to anterior knee discomfort.

Additional causes include cycling, rowing running and walking down hills or stairs, arthritis, cartilage injury and dislocation or fracture of the kneecap. In some cases, pain occurs from prolonged sitting or getting in and out of a vehicle. Pinching of the synovial membrane (knee's inner lining), referred to as synovial impingement or plica syndrome, also causes discomfort.

Symptoms
Individuals often experience knee pain behind, below or on the kneecap. The pain can be worse at night or during activities that bend the knee. Snapping, popping or crackling sounds may accompany the pain when climbing stairs, standing up, or walking after prolonged sitting. Individuals may feel a dull, aching pain in the knee from a change in activity level or intensity. Other symptoms include partial locking, buckling, tenderness, swelling or sensitivity in the knee. Ice, rest, simple knee exercises and non-steroidal anti-inflammatory drugs may ease the discomfort. Never self-diagnose. Consulting a licensed health professional helps determine the exact cause of the pain and exclude other problems.

A Common-Sense Approach to Neuropathy Treatment

One of the things that we see in the office all too frequently is when a patient presents with neuropathy symptoms, sometimes for many years.
Too often, neuropathy patients search for answers without actually engaging in any effective treatment. And too often real answers as to what may be responsible for your neuropathy never come.
All the while however, the actual conditions underlying or aggravating neuropathy are going untreated.
The consequences of this are dangerous. The longer you delay proper treatment, the more difficult effective treatment could actually be.
This is not to say every case of neuropathy is curable; unfortunately, it is not.
But we now understand the impact of things like lifestyle, cigarette smoking, and body weight have on most forms of peripheral neuropathy, and related disorders such as fibromyalgia.
Many types of chronic pain respond exactly the same way.
So here's the best advice I can give you: If you believe you may be suffering from neuropathy, it is important to get proper treatment that targets the overall improvement of your health-early.
Keep in mind that very rarely do drug-only therapies provide a lasting answer. In fact, drug-only therapy can mask underlying causes of neuropathy, and make your condition progress faster.
At the same time, work with healthcare professionals that understand all possible underlying causes.
Identify any correctable things such as poor diet, cigarette smoking et cetera. Above all, it is important to take responsibility for your own care, in your own health.
Jump on any new injury or illness with pain as soon as possible. It is vital with any new condition or injury to reduce pain quickly, and as much as possible with non-drug methods.
This is why seeking therapy soon after injury or onset of a condition like shingles or neuropathy--or even headaches and back pain--can produce much better long-term treatment results! Use every non-drug tool available as soon after the onset of injury or illness as possible.
Neuropathy and chronic pain are not one-size-fits-all disorders. Peripheral neuropathy patients who do the best realize this-and take action every single day.
Learn all you can about things like gluten- and dairy-free diets.
Be sure to get regular physical activity as tolerated. Explore proper physical therapy and treatments such as neurostimulation and laser.
Listen to your body. Pay attention to what it is telling you. Years from now, when you are still enjoying your health, you'll be glad you did.