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------------------------------ Date: Sun, 3 Dec 2000 12:48:18 -0800 Subject: Next Sugery!! Hi Everyone, Saw the new WC doc on Wednesday, the results of the left hand nerve study still showed positive for CTS. She wants to operate on my dominant hand (right) before she opens the left AGAIN!! She said that she does not like to do the endoscropic releases because she feels she cannot see it well therefore she is not comfortable with them. I had surgery my left on June 27, 2000. I am still having problems. Some days are worse than others. They stopped PT?? The previous doc wanted to go back into the left hand and do another release and get rid of the excess scar tissue that has build up. But she wants to do the right hand ASAP. So surgery is scheduled for the 12th. What if the same thing happens with the right? Great, I will be even more useless during the holiday season. I never thought that anything like this would happen to me. I am having problems with my neck also, sharp burning pain. Can't wait for this nightmare to end!! Will it?? By the way my occupation for the past 12 years was on the computer or 10key. 8 to 10 hours a day 6 days a week. I am now using voice recognition software. There cannot be anyone in the room when I use it. It doesn't like other voices. Thanks for listening, Lysa ------------------------------ Date: Sun, 3 Dec 2000 16:48:51 EST Subject: Re: Next Sugery!! Lysa- IMO, I feel you should weigh the surgical decision carefully. I will play the devil's advocate here. Why have someone do the other hand when the first one didn't work? If you are having sharp neck pains, chances are HIGH that carpal tunnel is NOT the only thing going on. If, for example, you have TOS (Thoracic Outlet Syndrome) then the carpal can be but a secondary symptom. Many RSI symptoms begin with the fingers and work their way up the arm to the shoulders and neck. By the time the pain cathes up too many people have had botched or unsuccessful surgeries. If the problem is higher up why would carpal tunnel surgery make sense? Also, the more surgery you have the higher your chances for developing RSD. (And you thought carpal tunnel was painful!) Surgery is forever. IMO, you should have your neck/shoulder problems checked out before you jump into surgery. If the problem does not lie in the wrist, then the surgery is useless. Sounds like you "could" have a double crush going on. (Compression at the neck, which can result in compression in the elbow or wrist.) So, as the devil's advocate, I will go ahead and say that surgery sounds very risky and it also sounds like carpal is NOT your only condition going on. Also, it sounds like you began having more problems once PT was stopped. Clearly, the dr and/or the insurance co aren't giving you adequate care. Do you really want to have the same set up on the second go around? Four months post-op is NOT a long time. Sometimes it can take 6 months or more to definatively know if the surgery was in any way successful. Get through the holidays, do tons of research, get the neck/shoulder checked out completely and then make an educated decision about surgery. Knowledge is power. Again, FWIW and IMO, Anne ------------------------------ Date: Sun, 3 Dec 2000 19:44:16 -0400 Subject: Re: Next Sugery!! Hi Anne I agree totally with you here .. this was basically my story too ... right hand , the dominant and *mouse* (grr) hand was gone cold and dead. I had fought with this since 92 ... GP said no more cortosone shots in the wrist ... Neorosurgeon said do CTS Release to right hand first then left, (left was not as bad mind you) .. right healed up after open CT release ... still upper arm/shoulder problems ... was TOS of course... I did the better nutrition thing .. more water ... yoga myofascial release therapy had trigger points in every single muscle... stretching ... swimming .. whirlpool bath installed ... skating .. off to the gym for more cardio and develop some muscle tone ... I was up to comfortably doing shrugs with 45 lb dumbells and 90 min workout three times a week. I was feeling great and more fit at 40 then ever!!! Summer came and no time for the gym .. was feeling great anyway right ... muscle tone decreased ... shoulder muscles no longer holding everything up and in it's proper place ... fall arrives and guess who is having trouble again ... circulation down .. inflamation ... pain .. tingling in fingers and both hands ... things were looking grim!!:< However, (pregnant pause .. drum roll ...) the gym had shown me the secret!!! PT, my MD, and vascular specialist agree ... decrease in muscle tone and general fitness level means decrease in circulation for me. My PT tells me my shoulder is supposed to float above the ribs on muscles ... deflate those muscles and we have a problem! No more forgetting about the gym ... it's either stay fit or stay in pain! Recovering muscle tone now .. next try to build some endurance into those muscles. So I have a home gym setup now, new treadmill machine, blood circulating through my arm again ... less right hand finger tingling everyday ... try to stay clear of the computer and especially the *mouse* (that still hurts) ... and am fast on the road to recovery and a better lifestyle ... even if it was not by choice! My arm is informing me I am done typing now! hth ------------------------------ Date: Sun, 3 Dec 2000 17:11:26 -0700 Subject: Re: Next Surgery!! Hi Lysa; Me too, or me three! Post-op for the holidays sounds like no fun at all. What's the big rush? More to the point, as Anne & Steve has so eloquently expressed, the experiences of many other Sorehanders indicate that your misgivings are well-founded. CTS on both sides? Sharp pain in your shoulder? These could very well be indications that hand/wrist surgery misses the site of the injury altogether. The Sorehand FAQ has the names of several books that have sections you might want to share with your doctor. Also, I urge you to visit http://www.rsiprogram.com and start with the section for patients. On Sorehand, we often say, "Listen to your body". In this case, I want to say, "Listen to your head". Don't let anybody -- but especially a new doctor whom you barely know -- stampede you into surgery unless you really and truly believe that surgery is your best option. Since she is a new doctor, maybe if you read up, and bring in relevant materials (preferably by doctors or from medical journal articles) and lobby hard, maybe she would reconsider the PT and order you some more sessions. All IMO, FWIW. cheers, Penney ------------------------------ Date: Sun, 3 Dec 2000 19:03:06 -0600 Subject: Re: Next Sugery!! I want to add my .02 to the answer about the surgery. WAIT and wait some more. I had good success from my two surgeries but having some upper neck/shoulder pain at times. My family doctor told me in May I had better start moving this ole body. Surgeries were last Oct and Dec. Since I started Fittness classes, with PT's on hand, I have gained strength in my arms, at least sitting. The legs are a bit weak due to bad disks more than three years ago. They are trying to strengthen them with lots of exercises. In June I could hardly lift my leg and now I can wear a 7 1/2 lb weight on the leg and have toe pointing out and lift my legs..can walk on the treadmill and doing other weights for good muscle tone, also to looooossseee weight.. I think it was probably August that I could do a pushup using my hands on the mat rather than just using my arms bent at the elbow. So there is hope. The Donut Fryer ------------------------ Carol Buente ------------------------------ Date: Mon, 4 Dec 2000 05:43:04 -0800 Subject: To recut or not? Lysa, I have to agree with Anne also, surgery may not be way to go. I too had surgery originally (to each side, I also am right dominant). And 2 yrs. later am still having severe problems. However, even though i tested positive for CTS STILL, the scar tissue of a second surgery would only make it even worse. My doctor originally thought surgery may help, then he decided I'll only be worse off. I am due to start PT soon, my 1st appt. is tomorrow. Yes, it's been really hard, and I'm not giving up on getting this fixed. I still feel PT will only treat symptoms, and not correct problem. That's gonna take working on to get someone else to listen and not just expect me to "deal with it". Part of me DID want to try the surgery, but I had another friend I've been emailing to for awhile now, she did go and have it and she's worse than I'd ever thought was possible. Her nerves ended up bunched up to one side of her arm and p! inched. I don't think I could handle being worse than I am!!! If the 1st one didn't help, the second won't necessarily help either. More scar tissue to deal with, more sensitivity to the site.... nah... tough decision, but there's got to be another way. I'm going that route if at all possible. Good luck and hang in there. Hasn't been easy but eveyone here has been my support, my sounding block. Best wishes Jennifer ------------------------------ Date: Mon, 4 Dec 2000 02:19:23 -0800 Subject: Re: Next Sugery!! Lysa, I for one have had 3 CTS, one on the right hand, {the first one I had } and 2 on the left hand 18 months apart, the last one done this past March 13th. The right hand, I have never had a problem since it was done I think its been 6 years now, it may of been 7 now. The left hand has been a different story. I now have more problems with it , and at this point there is nothing more that can be done for my CTS and I now have Cubital Tunnel ,also. The 2nd one done was an open release,but I still have all the old problems plus new ones.All the old scar tissue also was thought to be the problem.Ask all the questions you can, and think of more. I know how painful this condition can be, but I also know you can end up with more problems. I live that truth every day now. Look for other answers first, you can always have the surgery after you have tried other things first. Once you have that 2nd surgery you can't take it back. I wish I could. Best of luck and please let me know how it goes. D.J. -------------------------------- Date: Sat, 9 Dec 2000 17:29:42 EST Subject: Re: Carpal tunnel surgery,looks like After having two carpal tunnel surgeries, one on a hand/wrist that was approaching severe, and one on the other hand that was moderate pain,parastesia,etc., I can tell you that some of your inclinations about surgery being successful depends on many things, but one is certainly how long you've suffered from it and how severe it is. My first surgery was done 10/99, and I still have some problems with it at times. Although, I do have to say that the problems I still have are nothing to the burning pain I experienced all hours of night and day. My other hand operated on (CTS release) 10/00, was mild to moderate CTS and is doing great. Except for still a small amount of tenderness around the scar area which continues to lessen, it feels great, much better than the other hand which was more severe. Just one person's perspective. Jan ------------------------------ Date: Sat, 23 Dec 2000 22:47:47 -0800 Subject: Re: surgery tips, please? Nan, Not a surgery tip but a plea for you to try another treatment first. Bowen technique has helped my clients with Carpal Tunnel symptoms. you could get a couple of sessions done in the first week of January and see if it didn't make a big difference (which I think it will). Ed Zabilski is one of the twenty Bown Instructors in North America and he is located in Dartmouth Mass. He travels to see his clients in a large area, so he may be closer than I think. Please give him a call and discuss this with him. I just want to save you a surgical intervention and recovery. His number is 508-636-9211. Happy Holidays. Kevin ---- ------------------------------ Date: Tue, 16 Jan 2001 22:07:09 EST Subject: any help with this hi all, i had a carpal tunnel surgery in sept.2000... and now im have what they r calling RSD..... i've had ganglion, and throcic blocks ( they didnt work) MRI that shows my tunnel is still blocked,, i've had nerve tests done and it in my median nerve,, now the worker's comp ins, whats to send me to another dr... as of my dr watns to do a spinal cord stimulartion... done to help me with my pain ,,, now i just sit here and wait ,,, also my RPT is only ice on my wirst 3x's a week for 15mins ,,,, any help would be welcome ,,,,, thanks karen ---------------------- "Sharon J. Butler" Re: Thumb pain revisited >Status: RO > >David writes: > >>Recently there have been quite a few letters re. painful thumbs. I too >have a problem with my thumb. Before surgery I had a triggering of the >thumb due to a nodule on the tendon. (polar flexus?). This was corrected >by surgery to remove some of the tendon sheath near the nodule so that >"the snake didn't have to swallow the golf-ball" as my surgeon put it. I >also had a release of the transverse ligament at the same time (open >surgery). Now two years after surgery I have been experiencing a great >deal of pain at the base of the thumb. Xrays show a narrowing of the >cartilage at one side of the joint and spurs begining to show at the other >side. My doctor (new doctor) said there was sclerosis of the bone present >also. When I compare my hands to each other the one with the thumb problem >looks as though the thumb is shifted in position toward the arm. Also one >of the small bones of the wrist near the thumb seems to protrude more on >the palm side of the hand when the wrist is bent backwards to it's >extreme. >< > >I have a few theories about what is happening in your thumbs and wrists, >David. It may not be terribly good news for you. > >First, go to a library and look at an anatomical drawing of the wrist. Find >the transverse ligament, also known as the flexor retinaculum. It is located >under the palmar portion of the extensor retinaculum. You should be able to >see from the drawings that the flexor retinaculum attaches to the tissues at >the base of the little finger and also to the trapezium bone (part of the >wrist) which shares the joint with the first thumb bone. Also attaching to >the flexor retinaculum are many of the fibers that form the fleshy pad at the >base of the thumb. > >I believe that the role of the flexor retinaculum is to stabilize the bones >of the wrist. Basically, the wrist bones form an arc that is closed by the >flexor retinaculum. When this tissue is cut during carpal tunnel surgery, I >believe that it leaves the opportunity for the wrist bones to start >migrating. > >To test this theory, I checked with several of my Hellerwork clients who are >medical doctors (anesthesiologists). They said that there are more and more >cases of unstable wrists showing up and there is not much that can be done to >help restabilize them. I think that the migration of the wrist bones that is >happening in David's hand is due to this phenomenon. > >Also, if the flexor retinaculum is cut, it would make sense that the portions >of the thumb muscle that attach to this tissue will now be unattached to >anything (other than the free-floating portion of the cut tissue). With this >situation, these tissues cannot be expected to work and I would suspect that >they just become non-functional and atrophied over time. The remaining muscle >tissue at the base of the thumb looks as if its function is to pull the thumb >toward the palm because the fibers go straight down the thumb and into the >wrist. If these are the only functional tissues left in the thumb, it would >follow that the thumb would begin migrating toward the wrist, narrowing the >joint space there. > >These occurances in the wrist post-CTS surgery might account for the 57% of >carpal tunnel surgery patients considering their surgeries to have been >unsuccessful after five years. This statistic is from the Journal of the >American Medical Assoc., January, 1992 issue. > >Like I said at the beginning, these are my theories alone. I just remember my >shock and dismay when I went to my first medical meeting on carpal tunnel >surgery and saw what they actually cut. At the time, I couldn't imagine how >it could ever have long-lasting results so I am very happy for those who have >had the surgery and feel that they have benefited. > >The last point I'd like to make is that if you have had surgery, then it is >even more important that you practice some form of consistent stretching to >keep the joint spaces and wrist tissues as loose and fluid as you can. >Restriction in these tissues over time may start pulling the bones out of >alignment or limiting the range of motion of the wrist. > >Sharon Butler >Author: "Conquering Carpal Tunnel Syndrome and Other Repetitive Strain >Injuries: A Self-Care Program" >"Book of the Month" at: >http://web-star.com/alternative/books.html > > donlau wrote: > After carpal ligament "roof" is cut, consequences for your hand? Complete > loss of grip control, for example? Etc.? ------------------------------ Date: Sun, 18 Feb 2001 14:26:33 -0500 Subject: Re: unnecessary Carpal tunnel surgery? This reminds me: In my case, CTS and allergies were linked. Allergies cause a puffyness to tissues that contributed to the whole inflamed mess. So I had to address both. ------------------------------ Date: Sun, 18 Feb 2001 17:24:46 -0600 Subject: Re: unnecessary Carpal tunnel surgery? I do get behind on reading some of the messages that come to my mailbox, but, support for surgery is available, even if it comes from neurologists, orthopedic surgeons, and nurses. I even had a chiropractor tell me he could help me no further. After more than a few years of pain you look for a cure to take away the pain. My pain is gone, also I switched from the deli to the bakery. I wanted to ask about the ghost tingling and burning pain--what is that?? I don't have those symptoms. I had the severe burning pain before the surgery, nothing now, or does that come further on down the road??? The debate will continue as long as this forum stays in the computer. We all have to accept each others symptoms, learn from them and move on, other people will have the same surgery I did and could end up with complications. Was I just fortunate to have a good surgeon, yes, and I Know God was guiding his hands to fix mine, for whatever reason I do not understand, maybe someday. I think looking for articles and sharing them, learning that not all states are created equal and all pain is not created equal. But continue the search for answers. Try new methods and if they work fine, but we can't degrade another person because those methods didn't work for them. Have a good day. The Donut Fryer ------------------------------ Date: Sun, 18 Feb 2001 17:39:54 EST Subject: Re: carpal tunnel surgery In a message dated 02/18/2001 3:01:43 AM Eastern Standard Time, LISTSERV@ITSSRV1.UCSF.EDU writes: << Larry, were those individuals still actively analyzing and changing their personal habits and therapy regimen? This was the conclusion of my message: not that impinged nerves should be ignored, but that non-invasive treatment is generally effective when dilligently pursued, and that time can pass during this process without permanent damage. The body heals if you work with it. I guess once you can add no more to theraputic movement and reduce exacerbating activities no further, that's a time to consider this surgical procedure. Of course, most RSI patients are experiencing multiple and related causes. I could find little support for the surgery when I went to the medical library to find it. I found the statement that it often leads to ghost tingling or burning, and often has no effect. In your wife, it caused permanent numbness. Habits cause the inflammation, and it's primarily habits which reduce it. If it took 20 years to get to unmanageability, it needs time (perhaps years) to get back, and if NCVs report reduced signal strength during this time, this is not a strong argument for surgery. >> John, Here's another perspective on the CTS surgery. I did my own search for information before having cts surgery in 99'. From many research studies I looked at, the most favorable surgery outcomes occured when the surgery took place within 3yrs of the onset of medium severe carpal tunnel. I had surgery on a severe case first and the results are 50-75% better than prior to surgery. Everyone has to decide for themselves, and it's certainly not easy, but for many people, carpal tunnel surgery, done right by a good hand surgeon, offers a chance for less pain and muscle damage. I just thought I'd weigh in on this discussion and say that the surgery, while not easy recuperation period, was a good decision for me. Jan --------------------------------- Date: Sun, 18 Feb 2001 15:31:17 -0700 Subject: Re: unnecessary Carpal tunnel surgery? John Dempsey wrote: > >I could find little support for the surgery when I went to the medical >library to find it. I found the statement that it often leads to ghost >tingling or burning, and often has no effect. In your wife, it caused >permanent numbness. Habits cause the inflammation, and it's primarily >habits which reduce it. If it took 20 years to get to unmanageability, it >needs time (perhaps years) to get back, and if NCVs report reduced signal >strength during this time, this is not a strong argument for surgery. > The success rate for CTS surgery is not as high as other surgeries for threee key reasons: 1) The person never had CTS. 2) The person has multiple factors giving the symptoms and the local CT issue was not the most significant 3) It was done too late. Yup, that's right, too late. Maybe because people with severe anti-surgical biases talked them out of that route. Maybe because they had a doc who was too conservative. Maybe because they never even got "conventional" medical treatment until the local witch doctor was done with them (don't get me wrong, witch doctors do a lot of good work, but they also delay access to other treatment). Your ideas above are not consistent with the progressive nature of disease and seemed to be based on a theory of the innate healing capacity of the body that suggests that no matter what has happened it can get better. Well, it ain necessarily so (that would be a great name for a song!!). Once nerve tissue is in a situation where fibrotic changes begin, it very likely that permanent damage will quickly become the case. The sooner the surgery thebetter - is that the best scenario? No, but it is the real scenario. As for the nasty side-effects of surgery you refer to, it's just like when all the stats are tossed about (with impossible variances in the numbers 48,000 - 98,000) about people who die in medical care, there is no discussion about circumstances. For instance, someone comes to the hospital in cardiac arrest, is resuscitated, given a quadruple bypass, develops pneumonia while in hospital and dies. So, in the case of CT surgery, person presents with a fibortic nerve that is entangled with scar tissue and other soft tissue elements, has complete numbness and loss of motor function, has the surgery and ends up with ghost tingling - is that an artifact of the surgery? Finally, your assertion that you could find "little support" for the surgery in the medical library is spectacular in its implausibility. Just do a search on Medline, saves a trip to the library (although the exercise is good). Greg ---------------------------------------------------------------------- Date: Sun, 18 Feb 2001 10:26:01 -0400 Subject: Re: unnecessary Carpal tunnel surgery? > I don't ever regret having CTS Oct & Dec '99. All pain is gone in > the hand, no electrical shocks, no burning pain. I can sleep all > night. I had worn splints for years, I worked in a deli, now I work > bakery. I'm sure good PT can help lots of people, it has helped me > with sore neck/shoulder and bad knees, good exercise has helped > too, but now discovering I might have asthma induced by exercise. > What a twist, doctor sends you to exercise to help strengthen the > muscles and you experience a new set of problems. > ------------------------ > Carol > Bonfield, IL Hi Carol Are you exercising in the cold then??? Remember that crazy little Apple Cider remedy I use ... it takes care of my asthma for me ... basically it helps keep my health level way up ... it's when my health level falters that my asthma comes back on me. I also make sure to use a remote car starter as our winters involve some mighty cold days ... cold air and asthma are a bad combination. p.s. My right hand had gone so far it was cold and dead .. the open release worked great for me ... my left hand was due to be done next but I am almost symptom free on that one now so that operation is not likely to be needed. hth Steve ------------------------------ Date: Mon, 19 Feb 2001 22:47:38 -0500 Subject: Re: alternatives to surgery Greg, Penney, and all, I totally agree with Greg, and the article Penney sent on nerve glides. I have had severe CTS symptoms in both wrists since last March. TOS was only diagnosed two months ago. My PT examined my wrists and feels the symptoms are originating in the shoulder area. He has been doing nerve glides and stretches on me after finding out just how little stretching I can do on my own. Last week, he started myofascial therapy too. After 2 months, I can move my arms just alittle better than when I first started. No, my wrists aren't any better, but I'll bet if I stick with the therapy long enough, they will be. Maybe not back to normal, but better. However, if my doctor, who is knowledgeable of RSI, had told me I needed CTS surgery, I would have considered it; even knowing the "stats" on surgery outcome that is posted on this list. Joanne ------------------------------ Date: Sun, 18 Feb 2001 18:06:58 -0700 Subject: long term results of CTR Thought this article might interest some Sorehanders. cheers, Penney J Hand Surg [Br] 1995 Aug;20(4):470-4 Long-term results of carpal tunnel release. Nancollas MP, Peimer CA, Wheeler DR, Sherwin FS Department of Orthopaedic Surgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, USA. To determine the long-term results of carpal tunnel release, we retrospectively reviewed 60 cases, an average of 5.5 years after surgery. 87% reported a good or excellent overall outcome; the average time to maximum improvement of symptoms was 9.8 months. However, 30% reported poor to fair strength and long-term scar discomfort, and 57% noted a return of some pre-operative symptoms, most commonly pain, beginning an average of 2 years after surgery. We found no correlation between pre-operative symptoms or extent of surgical dissection (internal neurolysis) and outcome. Carpal tunnel syndrome was job related in 42%; of these, 26% changed from heavy to lighter work following surgery. Although occupational cases were slower to improve and remained off work longer, the long-term subjective results were the same for both groups. We found significant morbidity from the surgical scar and decreased strength, and often considerable delay until ultimate improvement, especially in patients with job-related carpal tunnel syndrome. Comment in: J Hand Surg [Br]. 1996 Apr;21(2):286-7 PMID: 7594985 ------------------------------ Date: Tue, 6 Mar 2001 10:33:30 -0500 Subject: Re: Any info, studies, etc. comparing endoscopic CTS/RSI surgery to "standard" CTS? Don, when reviewing literature comparing open release vs endoscopic you will need to differentiate which endoscopic procedure the authors are comparing. Be advised there is a two-portal procedure commonly referred to as the Chow procedure. There is a single-portal procedure that is commonly called the Agee procedure. The Chow procedure has the more distal incision (mid palm) in addition to the proximal incision at the wrist. There have been many, many studies comparing the open release vs the endoscopic release (ECTR). I would direct you to: Agee, JM, McCarroll HR, Tortosa R, et al: Endoscopic release of the carpal tunnel: A randomized prospective multi-center study. J Hand Surgery (Am) 17:987-95, 1992 Brown RA, Gelberman RH, Seiler JG, et al: Carpal tunnel release. A prospective randomized assessment of open and endoscopic methods. J Bone Joint surg Am 75: 1265-1275, 1993 Palmer DH, Paulson JC, Lane-Larsen CL, et al: Endoscopic carpal tunnel release: A comparison of two techniques with open release arthroscopy 9:498-508, 1993 All three studies confirm that endoscopic release is as equally effective as open release in relieving symptoms of paresthesias and nocturnal pain. There were additional advantages of less perceived weakness and pain with ADL's for the ECTR cases cited in the Palmer study. All three studies show pnts treated endoscopically had quicker recovery of pinch strength and less palmar scar tenderness compared to the open group. Return to work data favored the endoscopic group with mean differences between open and endoscopic methods of 21.5 days (Agee et al), 14 days (Brown et al), and 23.4 days (Palmer et al) using the single portal technique and 16.2 days using the two portal approach. Reported complications were rare in these three studies. Of a total of 328 ECTR and 199 open release pnts, the most common complication was transient ulnar paresthesias in 21 of the ECTR pnts and 5 of the open cases. Six pnts had persistent median nerve symptoms after ECTR; 2 of these were felt to be secondary to an incomplete release. One pnt sustained a partial laceration of the superficial palmar arch and another a contusion of the digital nerve. In the open release group, there was 1 deep motor branch injury, 1 case of bowstringing of the flexor tendons, and 2 wound dehiscences. Most if the case reports of injuries from ECTR have occurred using the original transbursal Chow technique or the original Agee device that did not allow direct visualization of the blade's point of entry (Nath RK, MacKinnon SE: Ulnar nerve transection as a complication of two-portal endoscopic carpal tunnel release: A case report. J Hand Surg (Am) 18:896-98, 1993. Adams BD (J am Acad Orthop Surgeons, 2:179-184, 1994) reported on several large, multicenter surveys of ECTR and noted that nerve injury rates ranged from 0.3% to 0.8% of the cases. ------------------------------ Date: Fri, 9 Mar 2001 07:18:48 -0800 Subject: Re: Sore hands I'm looking for the same. I really don't want to go in blind and take my chances. I have had trouble with my hands for about 9 years, but have been reluctant to seek professional help. My husband has had 5 different surgeries, with little relief. I wear braces on both hands just to be able to sleep most of the night. I am still reluctant, but my job may be ending soon and I want to start this while I still have insurance, or before the company goes under. Any help would be appreciated. Thanks, pat ------------------------------ Date: Tue, 16 Jan 2001 12:15:37 -0600 Subject: Carpal Tunnel Syndrome
I have a question that I hope someone can help me with. I've had three EMGs and Nerve Conduction tests since 1993. The latest one was last Friday. I've also recently had an MRI of my left wrist. All three of the EMGs, etc. have indicated carpal tunnel syndrome. The MRI report indicated an inflamed median nerve, flattened at the carpal bone, consistent with carpal tunnel syndrome. I also have tendinitis in my elbows and other RSI's. My question is, "Is carpal tunnel syndrome the only diagnosis that can be made based on the test results, or are there other possibilities?" I had CTS surgery in '93 and I still have CTS. Thanks for any help you can provide.
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