carpal tunnel

[Pompal 09.]

I went into school with carpal tunnel in both hands.. not too bad, but it would irritate if I typed or wrote too much. Going through school, my hands and arms got so strong that the carpal tunnel never bothered me anymore. These last six months, due to financial things, I've been working in a law office, on a computer all day and it is making my hands progressively worse. The other nite, I fell, and landed all my bodyweight onto my right hand and it is worse than ever. I've heard that one MT's have the surgery to correct c.t., they can no longer massage...anyone know if this is true? Also, anyone have any recommendations on how to help my hands get better? I'm hoping to open my own office soon and want to actually be able to practice before my hands get so bad that I can't anymore! HELP!!!

 

[AJ Rawr Chomp Grr]

From my experience, and from my physical therapy background, I do not recommend anyone having the surgery. I would see if there is a chiropractor in the area that specializes in adjusting joints. Mainly because when you have a good fall, if nothing is broken or torn, the force has to end up somewhere, possibly dislocating one of the carpel bones. I would also strip the forearm flexors, especially on the ulnar aspect.

As for the surgery, they slit the flexor retinaculum which is the tendinous band that prevents all the tendons from bow stringing. After it heals, scar tissue builds up and adheres the tendons into place putting pressure back on the carpel tunnel. This is a one time only surgery, once it is cut they can't go back in there to clean up the scar tissue, it won't be effective to release the tendons.

Mainly I would do what you can to assess the location of the carpels, and see if there is a nerve entrapment, have it adjusted, and strengthen the muscles that support the hand and foream.

 

[celery7]

I have to disagree about the surgery there...I had a carpal tunnel release about a year before I went to massage school. That was the best thing I have ever done...there has been no more numbness, coldness, or pain into my hand and fingers. I can also massage, actually have no trouble at all with it, and usually do three one hour sessions back to back, never any trouble. I also do a 5 hour chair massage gig every week...and chair is tough on the therapist...no hand problems whatsoever.

I do agree that you cannot have this surgery more than once, so make sure you do your homework and find a doctor who specializes in carpal tunnel release.

If you do decide to have the surgery, you will be out of work for a very long time...the initial healing time for me was two weeks where I couldnt do anything...not even hold a toothbrush. Then the stitches were removed and my strength slowly started coming back, within 6 months I had the majority of my strength back and a year after the initial surgery I was in massage school with NO problems. I made sure to do my hand/arm strengthening exercises and when massaging I always remember proper hand/wrist alignment and body mechanics.

I agree the surgery is not for everyone, although I do know it helps people that have true carpal tunnel syndrome...and other methods have failed first.

Just my opinion....dont bash me for it!
Renee

 

[Lucie [we can be heroes]]

I've been a MT for 8 years and at one point my chiro told me he thought I had CTS and Brachial Plexus Syndrome. Of course I told him to bite his tongue! I wasn't going to accept that. LOL
In addition to what Muriel mentioned, I'd check to see how much B6 you have in your diet... DCs often recommend supplementing the diet of those with CTS or other RSI.
I've read in the past that something like 80 percent of people with CTS have a problem up higher in their neck or shoulders. So, definitely get checked out by a good DC or DO. So, if you're able to get some good massage work done on your neck, upper back, arms and pecs... you should see some relief. And of course, it's important to have proper rest between massages! You may even need to scale back the # of massages you do per day.
I like to run cold water over my forearms after I've done a lot of massage, and sometimes I use essential oils of cypress, sandalwood and lemon to help reduce swelling in my forearms.
You might want to consider a "CTS brace" for when you are not massaging. You might need to wear it even while sleeping.
Also, my chiro recommended that I not lift heavy things for awhile. (My carpal bones kept slipping out of alignment.)
In our line of work, I feel particularly if we're doing a lot of Deep Tissue, we must be very careful that we're not putting to much pressure into our wrists. The chiro always has to adjust my fingers, wrists, elbow, shoulder and neck... as the line of tension is transferred all the way to my neck. The same would be true of the trauma of a fall no doubt.
I know someone in their seventies who in the last couple of years had to have a second CTS surgery performed on both her wrists. So I think they can do a second surgery... but I don't think they can keep the scar tissue from forming again. Some people are just more prone to scar tissue build up than others I think. *shrug*

 

[clueless??]

I cannot disagree with you more.
CT surgery is perfectly fine if it is true CTS.
I would examine every other conservative route first before surgery.

Sometimes surgery really should be done.
I have seen men with palms so hypertrophic their soft tissue practically spilled out with the first incision. Soft tiisue changes sometimes are beyond our control. It was like seeing a tube of toothpaste splitting.

We have redone a few carpals. I know they wont go back after doing it twice.

It was enlightening in school to learn that many people who aren't yet dx'd with CTS or "think" they have it(not seen a Dr) can find relief with forearm stripping, releasing pecs, scalenes etc.

As far as returning to work post op. It should be no problem. PT and MT will get you back to normal.

Self care for us is a biggie. Everyone always was so concerned about my back because I have a crap back but it has been my hands that I tend to nurse the most.
ICE ice baby.....and lots of selfcare.

Robyn

 

[big bob]

GREAT!

Thank you all for the wonderful input. I haven't been to a Dr. yet, but the pain in my hands is something i've been dealing with since high school. It's only just recently gotten to where it wakes me up at night sometimes. I have no intention of doing the surgery unless it is a LAST RESORT and nothing else has worked. I guess I'll just have to wait and see what a doctor says, but in the meantime I will definitely start getting bodywork done. Again, thank you all so much! All your information has given me a lot to think about!
Peace!
Jessica