carpel tunnel problems

[Mark Pruitt]

I've had CTS for a while now, been 3 years since "official" diagnosis and although I wear the brace every night it's now getting noticeably worse. Next week I'm going to the doc to talk about--and schedule--the knife job. This being my dominant hand, I am trying to envision what life is going to be like for a week w/o the use of it. Won't be pretty, for sure.:eek:

Those of you who've had the knife for CTS, did it work for you? How long did you have to keep your hand immobilized?

[Cliff Rohrabacher]

I had it really badly. Both hands couldn't steer my BMW ( power steering) without lots of pain, couldn't shift gears couldn't write, etc. I refused to abide by advice of the physicians who wanted to put me in braces and then talk about cutting me up. This not because I didn't trust 'em but because I had my own ideas about why I had it and what might help. OK I really didn't trust 'em.

I didn't trust 'em because I believed then and still do that the conventional cure of immobilization was a bad idea because immobilization would only weaken the tendons and ligiments and muscles. Crappy physical condition was why I believed I had the problem in the forst palce.

My thinking (entirely anecdotal mind you) was that not more than a decade ot two back things like tennis elbot tendonitis and carpal tunnet were almost unheard of outside the small and elite class of rich white folk who would lay about doing nearly nothing all week long then go try to be John Macenro on the tennis court etc.

The folks who actually worked every day with their hands seemed entirely unaffected. Secretariies hammering all day on mechanical typwriters, carpenters before the advent of the skillsaw, machinists, plumbers - you name it - they worked pretty damn hard and performed boatloads of repetitive activities.
Further back in time those ailments simply didn't exist. People worked brutally hard in agriculture doing the most beastly repetitive things like picking cotten etc.. Yet there are almost no records of folk medicines or treatments for the range of tendon ailments.

It got me to thinking that if these ailments didn't exist in those halcion days that maybe just maybe something existential had changed. It had. We don't work all day every day doing nearly the same level of hard work so we are in comparatively lousy phisical condition. Our grand parents were ten times sturdier than us. We eat better but they were stronger because they had to be.

ERGO: I tried exercise for my wrists.
First I tried weights. That turned out to be bad idea. Too much too fast. It only hurt like hell and likely tore things up more than they were.

Then I tried stretching. Another overly excessive mistake. Too much too fast. Lots of pain and no gain.

Then my wife gave me a squeezie ball. She picked it up at some conference and gave it to me 'cause she thought it was cute. It was the kind that was full of regular sand in a plastic strechy sack. I started using it.
Again I over did it. I was squeexing the thing as though I were trying to build muscle. Too much too fast -= again.

I backed off. I' got to a point where I'd hold the ball in my hand all day and ever so gently wrap my fingers around it giving it the tiniest of little squeezes. I'd hold the pressure- what little pressure there was - on the ball and then a second or two lated apply another little finger tug, I did this in tiny increments all the time whenevver I didn't need the hands for other things.

A couple months of that and two things happened. the stupid squeezie ball becam a habit and the CTS went entirely away. It's just gone.

What made the CTS go away is not a question I can answer with any medical certainty. I think it was the squeezie ball.

[John Kain]

I had it really badly. Both hands couldn't steer my BMW ( power steering) without lots of pain, couldn't shift gears couldn't write, etc. I refused to abide by advice of the physicians who wanted to put me in braces and then talk about cutting me up. This not because I didn't trust 'em but because I had my own ideas about why I had it and what might help. OK I really didn't trust 'em.

I didn't trust 'em because I believed then and still do that the conventional cure of immobilization was a bad idea because immobilization would only weaken the tendons and ligiments and muscles. Crappy physical condition was why I believed I had the problem in the forst palce.

My thinking (entirely anecdotal mind you) was that not more than a decade ot two back things like tennis elbot tendonitis and carpal tunnet were almost unheard of outside the small and elite class of rich white folk who would lay about doing nearly nothing all week long then go try to be John Macenro on the tennis court etc.

The folks who actually worked every day with their hands seemed entirely unaffected. Secretariies hammering all day on mechanical typwriters, carpenters before the advent of the skillsaw, machinists, plumbers - you name it - they worked pretty damn hard and performed boatloads of repetitive activities.
Further back in time those ailments simply didn't exist. People worked brutally hard in agriculture doing the most beastly repetitive things like picking cotten etc.. Yet there are almost no records of folk medicines or treatments for the range of tendon ailments.

It got me to thinking that if these ailments didn't exist in those halcion days that maybe just maybe something existential had changed. It had. We don't work all day every day doing nearly the same level of hard work so we are in comparatively lousy phisical condition. Our grand parents were ten times sturdier than us. We eat better but they were stronger because they had to be.

ERGO: I tried exercise for my wrists.
First I tried weights. That turned out to be bad idea. Too much too fast. It only hurt like hell and likely tore things up more than they were.

Then I tried stretching. Another overly excessive mistake. Too much too fast. Lots of pain and no gain.

Then my wife gave me a squeezie ball. She picked it up at some conference and gave it to me 'cause she thought it was cute. It was the kind that was full of regular sand in a plastic strechy sack. I started using it.
Again I over did it. I was squeexing the thing as though I were trying to build muscle. Too much too fast -= again.

I backed off. I' got to a point where I'd hold the ball in my hand all day and ever so gently wrap my fingers around it giving it the tiniest of little squeezes. I'd hold the pressure- what little pressure there was - on the ball and then a second or two lated apply another little finger tug, I did this in tiny increments all the time whenevver I didn't need the hands for other things.

A couple months of that and two things happened. the stupid squeezie ball becam a habit and the CTS went entirely away. It's just gone.

What made the CTS go away is not a question I can answer with any medical certainty. I think it was the squeezie ball.

Cliff, I am happy to hear that your CTS improved over time.

That said, much of what you said could be damaging to other individuals.

CTS involves the median nerve which supplies neural impulses to the small intrinsic hand muscles going to the thumb, index and middle fingers. It also relays sensation from much of the palmer aspect of the hand. When the median nerve is compressed within the carpal tunnel, it doesn't send signals well which, in turn, leads to many of the symptoms you all noted. Furthermore, if CTS progresses it will eventually cause atrophy of the thumb muscles causing poor dexterity and weakness. Many times this becomes irreversible.

CTS occurs due to inflammation within the carpal tunnel or is due to a congenitally narrow carpal tunnel. Individuals who have certain health ailments are at higher risk....diabetics...etc. For some, immoblization is enough to improve symptomology. For others, activity and exercises seem to help. But for a select group, no amount of activity or rest will help; only surgical decompression of the carpal tunnel will arrest any further development of the syndrome and cease the sensation and muscle wasting which can be very severe.

Do not be afraid to see a medical profession about ongoing symptoms.

The proper method in treating CTS, once diagnosed, is through partial immobilization (like wrist splints). If no improvement is noted, or ANY thumb muscle atophy is noted, the patient should have a nerve conduction test/EMG performed by a neurologist. If the test shows significant CTS, then many surgeons (Neurosurgeons, some General surgeons, most Orthopedic surgeons, specialized hand surgeons) can perform a procedure to open the tunnel and relieve the median nerve from compression.

Remember, this is YOUR HAND we are talking about. Don't take any chances.

To answer the question, no immoblization is required after surgery. Granted, your hand will be pretty bandaged up. You really only have to worry about taking it easy in order not to stretch stitches loose. Some MDs perferm the procedure with an endoscope and require only a couple or no stitches at all.

[Mark Pruitt]

John,

Thank you for this informative and helpful response. I work in a hospital environment and am not the least bit apprehensive about seeking help. It may be that my CTS is still relatively mild, as I do not have any pain whatsoever in my affected hand--only a tingling sensation. The nerve conduction test was done, with a resulting dx of CTS. What has changed recently has been that, whereas I slept with the brace at night and had no noticeable symptoms during the day, now I am feeling the aforementioned tingling and some occasional numbness in my thumb. Colleagues are saying "get the surgery ASAP." So, I'm off to the Ortho surgeon's office next Tuesday, and hopefully will have the knife the next week.

What I am hoping to hear in this forum is the experience of other woodworkers who have "been there done that" and could give me some idea of when I can expect to resume normal shop activities.

Thanks again,
Mark

[Rick Doyle]

hi,

i had cps in both hands - and surgery on one. it started in my left hand and gradually progressed to my right hand. tingling, numbness and pain in my arms especially at night - enough to wake me up. i went to my doctor, had the specialist tests at the hospital done by a neurologist and the diagnosis was confirmed.

a few months later i had the surgery on my left hand - a plastic surgeon did that. i had to wear a tensor bandage for a week and i was told not to lift anything too heavy. it was awkward but i was still able to do some woodworking o.k. the next surgery was scheduled for about 6 months to give the left hand time to heal completely.

i guess i ignored the doctor's advice and did a bit too much outside in my yard - like building a rock waterfall for our backyard pond. bingo - the cps symptoms returned to my left hand(the surgically repaired one) big time. same as before. the doctors said i had probably caused more inflammation of the area and that if it didn't return to normal i may have to have more surgery - yikes!!

anyway, i decided to cancel the operation on my right hand and just wait. that was about 6 months ago and guess what? my left hand has returned to about 98% normal and is improving while my right hand is now 100% normal - just by waiting!

my feelings on all of this? suffer through the pain and incovenience, do light exercise with a squeeze ball, wear a splint at night and give it some time to see if it improves. knowing what i know now, i would only go for surgery as an absolutely last resort.

[Sparky Paessler]

I had CTS in both hands for years and finally had the surgery on both at the same time. Wore the bandages for several days and then wore the braces when working for a couple of weeks. (light work). I now have no problems with either hand! It is great to be able to paint or drive screws without my hands going numb and dropping the brush or drill. Also since I write software for a living it is nice to be able to operate a mouse without the pain. For me the surgery worked wonders that exercise and sleeping in braces could not.

[Joe Tonich]

I had it in both hands, and had both cut, in 2 week intervals. Hands were numb almost all the time, pain was bearable. I dreaded having to put anything together as I never could tell if I was holding the screws n nuts or not. I'd get so frustrated things flew. When he went in, he said the nerves were almost white, thank God they went pink as soon as he did the release. My tips are still a bit numb, and he was surprised they came back at all. My opinion, and that's ALL it is, is get it fixed. I had the block, where you stay awake during the surgery, which I liked. Hate gettin put out. Just make sure they put in enough of the local....DAMHIKT!! :eek:
I was back to work full duty in 6 weeks from the second surgery. Turned a couple of things 1 week after the first hand got done. Good luck in your decision, no matter which way ya go. Carpal Tunnel SUCKS!

[Fred Voorhees]

Interesting post since I am in the throws of my own carpel tunnel woes. I have had it for years. No, I've never had it diagnosed, but it is obviously the problem and I attribute it to the nearly thirty years of typing that I did as a auto racing reporter and columnist as a hobby. It has been getting worse over the past six months or so and would really like to get it checked out and finally fixed. The problem has really affected my fishing, my tasks at work and in general has made life miserable. I am constantly waking up at night with painful arms and without fail in the mornings, I have numb hands and quite often can't even turn my alarm off.

A question or two for those who have been there with the operation. (1) How long were you out of work? Were you able to have both hands operated on at the same time and is it worth it to be "disabled" this way with both hands fairly inoperable for a short while? Boy, there are a few things that I wouldn't want my wife doing for me and I'm pretty sure that she will refuse to perform anyway.:D

[John Kain]

Fred, you should never have both hands done at the same time. Only in extreme cases would any MD really even consider it.

[Jerry Olexa]

My young daughter (then in her mid 20's) got it in both hands we think from lots of computer and typing time at her law firm. All the MD's said surgery and quick!! She had an appt with a natural Western medicine chiro etc and he said he thought he could cure it without surgery. She gave it a try. Lots of intensive exerciae and after about 10 weeks, its gone (cured). Occassionally, it starts to come back and she starts again the exercises and she's OK. It worked for her...Don't rush for the Knife IMHO.HTH

[Aaron Koehl]

John,

Thanks for all the info! I always read these threads intently..