OOS, RSI, CTS?

May 18, 2005 10:28 AM

I've been diagnosed a Carpal Tunnel Syndrome. Is the surgical solution the best? Can it guaranty a full recovery?

I try to gather as much documentation as possible on the subject and have found many useful resources. AskMe has also provided two good threads on this subject. However, I've almost forcefully obtained an appointment with a specialist in three weeks, and I can't wait still there. How much good is a diagnosis on these types of diseases? Is surgery the better solution for Carpal Tunnel Syndrome? Can I expect a 100% recovery? I know, I know it's MedicFilter stuff, but any information and/or sites with shared experiences on RSI and CTS are welcomed.

posted by nims to health & fitness (14 comments total)

The Taoist Tai Chi instructor for my Continuing class says that some of their exercises have provided relief to sufferors of CTS. Might be worth a try if you're not in a hurry
posted by Pressed Rat at 10:40 AM on May 18, 2005

I know in pain, but keep in mind that it's almost never a good idea to rush into a surgical solution.

As you've seen, there are lots of alternative treatments out there. I had a nasty case of tendonitis in the past (not the same thing, I know, but another typing RSI from typing). I was advised that surgery can sometimes help with these things, but there are always side effects.

Keep in mind also that RSIs are cumulative trauma injuries, so even surgery won't "cure" you if you don't reexamine your work habits and ergonomics.

I had a lot of luck with physical therapy and stretching exercises. I tried acupuncture as well, which was mostly useful to me as a time to relax and rest during the day (YMMV). In the end, a combination of physical therapy and better work habits/ergonomics worked for me.
posted by shaun at 11:16 AM on May 18, 2005

Er. I know *you're* in pain.
posted by shaun at 11:17 AM on May 18, 2005

After several years of pain, a friend of mine decided to see a chiropractor. She needs to see him a few times a year now, but other than that she feels great all the time. You might want to give that a try before going down the road to surgery.
posted by pwb503 at 11:42 AM on May 18, 2005

Your doctor will probably recommend night splints and, if they don't clear it up, corticosteroid injections. There are stretches you can do, too. Others will recommend acupuncture. If these work, good on you.

If they don't, as they didn't in my case, seriously consider getting the surgery. My own melodramatic story is that I decided to tough it out instead of getting surgery, so for three years the condition continued to get worse, the symptoms changing from numbness at night to constant pain in my hands and strange pinprick sensations in my fingertips. Depression. For two years I was a wreck.

I'm not trying to scare you here. It was worse in my case than it is in the vast majority. My point is only that I was an idiot for not getting the surgery as soon as I knew the other treatments weren't going to work.

Ultimately, I had endoscopic carpal tunnel release surgery in both hands. The right hand was done first, then three weeks later the left. Wore a cast on the hand in between. Operations lasted about 30 minutes apiece, and the whole thing, including recovery, was less painful than a root canal. It took basically two months out of my summer to recover, and it was annoying not to be able to wipe myself, but Christ, it was the best thing I've ever done in my life.

Recovery is about 99% percent. For all intents and purpsoses you will probably be "cured" by the surgery, but you will occasionally (once a month?) have odd sensations that come and go in a couple minutes. I'm told it gets better and better as time passes (I'm about a year out of surgery).

Find a good doctor, make sure they're doing the new surgery, rather than the old one. Make sure they don't let you use your hand while it's recovering. Plan to be on vacation for awhile. I'm available in e-mail if you have questions.
posted by Hildago at 11:54 AM on May 18, 2005

As well, I've heard of people getting physiotherapy up their arm to reduce stress, or acupuncture. Visit your closest naturopath for a consultation.
posted by dflemingdotorg at 12:01 PM on May 18, 2005

I had the surgery, but it turned out my problem wasn't actually CTS. (I had tendinitis as well as problems going up to my neck and chest.) So it didn't help, but I didn't have any negative side effects beyond not being allowed to use my hand for a solid month.

I'd recommend stretching, particularly Active Isolated Stretching (see The Wharton's Stretch Book) or the stretches from Conquering Carpal Tunnel Syndrome : And Other Repetitive Strain Injuries. Also, try to figure out what you have done to cause it and what you can change to alleviate the cause. If that doesn't work, and if you're sure you have CTS, the surgery seems pretty successful. Go to the best surgeon you can, of course.
posted by callmejay at 12:20 PM on May 18, 2005

My massage therapist gf recommends seeing a massage therapist and chiropractor before persuing surgery. Sometimes nerve trouble farther up the arm (usually elbow or shoulder) can mimic the symptoms of CTS.
posted by schyler523 at 12:53 PM on May 18, 2005

unfortunately schyler523 it seems a lot tougher. My symptoms are violent pain in the right hand, cold right hand, and a pain moving from the right hand to the shoulder and then moving to the left hand. Causes, I guess, are pretty straightforward: I use a keyboard and I am a programmer, I have had a lot of deadlines recently, and typed way two much during the last months.
posted by nims at 1:17 PM on May 18, 2005

My understanding was that the causes for CTS are probably genetic (based on the fact that they can't prove it's anything else) but that overuse can bring on symptoms.

There are obvious first things to do: get an ergonomic keyboard, and try out a trackball or left-handed mouse setup to see if that helps. Take breaks during which you stretch your hands. There are a number of free break-timer programs that run in memory and will halt your computer at preset intervals to make sure you're not marathoning it.
posted by Hildago at 1:58 PM on May 18, 2005

Some other little tips to add to those above. Keep well hydrated. Try not to get too stressed. Don't work through the pain - find alternative input methods or stop working - otherwise things can quickly get out of hand. Make sure your back and abdominal muscles are all strong enough to support you properly.
posted by urban greeting at 4:15 PM on May 18, 2005

Anecdote:
About 10 years ago my mum was diagnosed with carpal tunnel syndrome. Her doctor had her in splints at night and prescribed cortisone injections, neither of which did any good. He kept pushing her into trying surgery. She insisted on referrals from patients. Doc said sure and kept giving her referrals from people who had recently had the surgery. Mum kept pushing for people who had the surgery at least a year in the past, if not two. Doc couldn't provide such referrals. Anyway, she finally ended up with a fibromyalgia diagnosis - she never had carpal.

If I were you I'd get at minimum a second opinion. Surgery on your hands is not something to go into willynilly (not that you are, just sayin').
posted by deborah at 6:29 PM on May 18, 2005

RSI, and Carpal Tunnel are so complex I hesitate to even start. (I've got (now manageable but not cured) Pronator Teres Syndrome, for 7 years now. The 3 things that helped me most, in order, were
1. the resources and advice from SOREHAND, the list-serv discussion, go to
SOREHAND
poke around, search the recent and not so recent archives.

2. read Pascarelli's newer book
Dr. Pascarelli's Complete Guide to Repetitive Strain Injury : What You Need to Know About RSI and Carpal Tunnel Syndrome
. It's from 2004, his earlier book with Deborah Quilter was one of the 2 'Bibles' on Sorehand, for years. Check the archives and see what people say about this one.

3. Sharon Butler's book mentioned above by callmejay. She now has downloadable PDF courses targeted at different categories of injuries - I recently used part of the TOS course and it was helpful. see
http://selfcare4rsi.com
She often posts to Sorehand and answers specific questions. I do one of her stretches every day, it made a huge difference.

If you search Sorehand you'll find lots of experience and advice about surgery. A lot of knowledgeable people. Ideas on improving your computer setup, software, stretchbreaks, mice, etc. In general, the advice used to be, try less invasive methods first, if you can. some people have great results, and some don't. There's a ton of information available.

I've been doing Tai Chi since before my problems, and there are some things that definitely help, but I wouldn't rely on it alone.
posted by judybxxx at 6:42 PM on May 18, 2005 [1 favorite]

Thanks all for your answers.
posted by nims at 12:42 AM on May 19, 2005