CARPAL TUNNEL SYNDROME


Carpal Tunnel Syndrome is thought to be the result of excessive pressure on the median nerve as it passes into the wrist on the bottom and the transverse carpal ligament on the top. Any condition which causes irritation or inflammation of the tendons can result in swelling, and inevitably, pressure on the median nerve. Eventually, this pressure impairs normal nerve function and is followed by pain and numbness in the hand.

For those suffering from this repetitive stress injury, the pain, numbness, tingling and burning sensations, weakness or loss of grip, and loss of sleep due to discomfort can be a serious and debilitating impairment. Most often, this is an injury which develops over time rather than suddenly. However, in some cases, it can be due to a previous injury which caused some slight misalignment of the wrist bones. Awkward or repetitive movements often aggravate such an injury.

Comparison of Traditional Surgery vs. New Non-Surgical Treatment

Dr. Bliss' Protocol

Rationale
Accumulation of injuries from falls, repetitive motion and awkward positions of the wrist result in rotation of a carpal bone into the U-shaped carpal tunnel. This causes more pressure in the tunnel, which compresses the most sensitive component of the tunnel - the median nerve.

Confirmable by Carpal Tunnel view X-ray, plane wrist X-ray and MRI.

Treatment
Involves manipulation of the carpal bone out of the tunnel to remove the pressure. Treatment with physical therapy to reduce adhesions, reduce swelling and facilitate manipulation.

Rehabilitate the wrist flexibility and strength to create stability and allow healing.

Support the patient nutritionally to reduce swelling and maintain the presence of products necessary for healing the damaged nerve and joints.

(The treatment directly addressed the cause of the problem. It returns the tunnel pressure to normal by removing the bony compression.)

Risk
Failure of the treatment does not make the condition more severe. The risk of damage from individual procedures is very small.

Surgical Treatment

Rationale
Accumulation of use and repetitive motion in the wrist cause a chronic swelling of the tendons running through the carpal tunnel. This results in scar tissue surrounding the tendons taking up space in the tunnel, putting pressure on the nerve.

Unsupported by diagnostic X-ray, post-surgical studies or MRI research.

Treatment
Involves surgically cutting the transverse ligament to relieve the pressure in the tunnel.

(The treatment does not address the possible cause of the pressure, which is stated to be tendon swelling and scar tissue).

Risk

  1. Standard surgical risks of failure to heal, infection, and anesthesia reaction.
  2. Failed surgery is not a malpractice case but results in increased worker's compensation costs.
  3. Scar tissue causes further non-operable nerve compression and permanent disability.
  4. Cutting the ligament or support for the wrist causes permanent instability, and loss of strength.

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