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Carpel Tunnel Syndrome. Numbness and tingling in thumb, index, and middle fingers Aching sore hands Shooting pain which travels to elbow inability to hold or grip objects Hand becomes numb when holding a book Loss of strength in forearm muscles Restricted circulation to fingers Swelling .

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Numbness and tingling in thumb, index, and middle fingers

  • Aching sore hands
  • Shooting pain which travels to elbow
  • inability to hold or grip objects
  • Hand becomes numb when holding a book
  • Loss of strength in forearm muscles
  • Restricted circulation to fingers
  • Swelling
what is carpal tunnel syndrome
What is Carpal Tunnel Syndrome?
  • Carpal tunnel syndrome results from pressure on a nerve (median nerve) leading to your hand and fingers.
  • The carpal tunnel is a narrow passageway on the palm side of your wrist which protects the median nerve.
  • Pressure on the median nerve may cause pain in the wrist and forearm, numbness and tingling in the fingers and weakness in the hand.
diagnosis
Diagnosis

EMG/Nerve Conduction Study

  • The electromyogram (EMG) measures the electrical activity of muscles at rest and during contraction, and the nerve conduction study measures how well and how fast the nerves can send electrical signals.
  • The results from these tests will show if the median nerve is actually injured at the wrist and the extent of the damage.

(Musculoskeletal ultrasound is another diagnosis method)

treatment methods
Treatment Methods
  • Bracing
  • Injections
  • Special therapy release and exercise methods
  • Surgery
  • EXTRACORPOREAL SHOCKWAVE THERAPY (ESWT)

(The severity of the damage to the median nerve will determine the type of treatment)

evidence based results i won t bore you with the fine print
Evidence-based Results (I won’t bore you with the fine print)
  • Many studies support the effectiveness of ESWT
  • At the very least, some studies concluded ESWT to be as beneficial as local steroid injections without the evasiveness.
extracorporeal shockwave therapy
Extracorporeal Shockwave Therapy

Contraindications

Side-effects

Minor pain and discomfort at site during and immediately following treatment

Reddening of skin in treated area

A small number of patients reported headaches after receiving treatment involving the upper extremities

These side-effects typically disappear after twenty-four hours

  • Cancer
  • Pregnancy
  • Polyneuropathy in case of diabetes mellitus
  • No NSAIDS one week prior to treatment
  • No cortisone six weeks prior to treatment
  • No ice post treatment
  • No anti inflammatory post treatment
treatment procedure
Treatment Procedure
  • Treatment typically consists of four visits with an initial assessment and three treatment sessions.
  • Treatments are administered once a week over a three week period.
  • Approximately two thousand shockwaves are delivered via a hand held applicator in conjunction with a conductive gel.
  • Treatments last for five to seven minutes.
  • Treatments can be adjusted to maximize the patient’s comfort.
  • Many patients experience significant improvement after one treatment, while others may require three.
it s in the details
It’s in the Details
  • ESWT has been used in the UK for the past ten years to treat athletes
  • Costs approximately $480 to receive one round of treatment
  • Insurance does not cover ESWT because it’s considered an optional or experimental treatment, even though it’s FDA approved