"The Non-Surgical Solution for Carpal Tunnel Syndrome" (tm)

Carpal DMT®, or Carpal Decompression Mobilization Therapy, is a new procedure in carpal tunnel syndrome research and treatment. This advanced procedure works to reduce the compression of the median nerve at the wrist, remove the inflammation, and restore normal, pain free functioning of the hand and wrist. Carpal DMT® helps stop the progression of permanent nerve damage.

Carpal Decompression Mobilization Therapy (Carpal DMT®) can help decrease the severity of symptoms and increase proper mobility and function. CTS sufferers may experience a decrease in pain or discomfort and an increase in grip strength and hand movement. Carpal DMT® is conservative, safe, non-surgical and non-invasive.

Treatment lasts approximately 4-8 weeks depending on severity. Chronic suffers should allow for an extension of treatment time. There is no “post-surgical healing period” and most patients can quickly resume day-to-day home and job activities during treatment, with minor modifications.

Carpal DMT® is safe, non-invasive and non-surgical corrective-care for carpal tunnel syndrome sufferers. Carpal DMT® can reduce the severity of symptoms, facilitate healing and may improve wrist and hand function. Carpal DMT® is also highly recommended for women with pregnancy-induced CTS.

Most patients can return to normal day-to-day activities within the first few treatments, or in some cases, almost immediately if special care is taken to avoid additional repetitive stress on the injury.

This is a tremendous benefit over CTS surgery, which studies showed an average return-to-work time among workers compensation patients at 71 to 78 days after surgery. Carpal DMT® has no post-procedure healing period, allowing for a dramatic decrease in time-off from work and normal activities.

"Maybe it will just go away."

These words could be harmful to your health and lead to a permanent debilitating disorder if CTS is not treated. CTS can cause serious nerve damage, shrinking of the hand muscles, permanent hand weakness, numbness, and/or long-term pain if left untreated. Delay in Carpal DMT® treatment may result in persistence of some symptoms despite adequate decompression of the carpal tunnel.

A diagnosis of carpal tunnel syndrome should be acted upon quickly. Undergoing Carpal DMT® procedures in the earlier stages of the syndrome usually produces the fastest results. Sufferers who have had wrist problems for longer periods should allow for extension of treatment time.

Other treatments for carpal tunnel syndrome

Splints are used to keep the wrist and hand in neutral position. Splints normally decrease the muscle-pumping actions of the hand, which can lead to fluid accumulation and inflammation, possibly leading to an increase in painful and bothersome symptoms over time.

Anti-inflammatory medications (NSAIDS) are commonly used to reduce inflammation and decrease pain. These medications may provide temporary symptomatic relief of minor pain associated with CTS. However, medications can mask the symptoms and may allow for continued nerve degeneration.

Corticosteroid injections may also provide temporary symptomatic relief, however recurrence of symptoms is common. Risks of these injections include permanent nerve damage, if the needle contacts the nerve. Injections also masks symptoms and may allow for additional nerve damage and degeneration.

Surgical decompression (open or endoscopic) permanently alters the hand and wrist by cutting the transverse carpal ligament. Aside from the usual risks of surgery (infection, scalpel damage to nerve, ligaments, tendons, vessels, etc.) healing time is slow (up to four months). Scar tissue may later form in the permanently altered wrist, leading to further pressure on the median nerve and likely reoccurrence of carpal tunnel syndrome symptoms.

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FREQUENTLY ASKED CARPAL TUNNEL SYNDROME QUESTIONS

What is carpal tunnel syndrome?
You're working at your desk, trying to ignore the tingling or numbness you've had for months in your hand and wrist. Suddenly, a sharp, piercing pain shoots through the wrist and up your arm. Just a passing cramp? More likely you have carpal tunnel syndrome, a painful progressive condition caused by compression of a key nerve in the wrist.

Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (although not the little finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move. The carpal tunnel - a narrow, rigid passageway of ligament and bones at the base of the hand ¾ houses the median nerve and tendons. Sometimes, thickening from irritated tendons or other swelling narrows the tunnel and causes the median nerve to be compressed. The result may be pain, weakness, or numbness in the hand and wrist, radiating up the arm. Although painful sensations may indicate other conditions, carpal tunnel syndrome is the most common and widely known of the entrapment neuropathies in which the body's peripheral nerves are compressed or traumatized.

What are the symptoms of carpal tunnel syndrome?
Symptoms usually start gradually, with frequent burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers. Some carpal tunnel sufferers say their fingers feel useless and swollen, even though little or no swelling is apparent. The symptoms often first appear in one or both hands during the night, since many people sleep with flexed wrists. A person with carpal tunnel syndrome may wake up feeling the need to "shake out" the hand or wrist. As symptoms worsen, people might feel tingling during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people are unable to tell between hot and cold by touch.


What are the causes of carpal tunnel syndrome?
Carpal tunnel syndrome is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. Most likely the disorder is due to a congenital predisposition - the carpal tunnel is simply smaller in some people than in others. Other contributing factors include trauma or injury to the wrist that cause swelling, such as sprain or fracture; overactivity of the pituitary gland; hypothyroidism; rheumatoid arthritis; mechanical problems in the wrist joint; work stress; repeated use of vibrating hand tools; fluid retention during pregnancy or menopause; or the development of a cyst or tumor in the canal. In some cases no cause can be identified.

There is little clinical data to prove whether repetitive and forceful movements of the hand and wrist during work or leisure activities can cause carpal tunnel syndrome. Repeated motions performed in the course of normal work or other daily activities can result in repetitive motion disorders such as bursitis and tendonitis. Writer's cramp - a condition in which a lack of fine motor skill coordination and ache and pressure in the fingers, wrist, or forearm is brought on by repetitive activity - is not a symptom of carpal tunnel syndrome.


Who is at risk of developing carpal tunnel syndrome?
Women are three times more likely than men to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself may be smaller in women than in men. The dominant hand is usually affected first and produces the most severe pain. Persons with diabetes or other metabolic disorders that directly affect the body's nerves and make them more susceptible to compression are also at high risk. Carpal tunnel syndrome usually occurs only in adults.

The risk of developing carpal tunnel syndrome is not confined to people in a single industry or job, but is especially common in those performing assembly line work - manufacturing, sewing, finishing, cleaning, and meat, poultry, or fish packing. In fact, carpal tunnel syndrome is three times more common among assemblers than among data-entry personnel. A 2001 study by the Mayo Clinic found heavy computer use (up to 7 hours a day) did not increase a person's risk of developing carpal tunnel syndrome.

During 1998, an estimated three of every 10,000 workers lost time from work because of carpal tunnel syndrome. Half of these workers missed more than 10 days of work. The average lifetime cost of carpal tunnel syndrome, including medical bills and lost time from work, is estimated to be about $30,000 for each injured worker.


How is carpal tunnel syndrome diagnosed?
Early diagnosis and treatment are important to avoid permanent damage to the median nerve. A physical examination of the hands, arms, shoulders, and neck can help determine if the patient's complaints are related to daily activities or to an underlying disorder, and can rule out other painful conditions that mimic carpal tunnel syndrome. The wrist is examined for tenderness, swelling, warmth, and discoloration. Each finger should be tested for sensation, and the muscles at the base of the hand should be examined for strength and signs of atrophy. Routine laboratory tests and X-rays can reveal diabetes, arthritis, and fractures.

Physicians can use specific tests to try to produce the symptoms of carpal tunnel syndrome. In the Tinel test, the doctor taps on or presses on the median nerve in the patient's wrist. The test is positive when tingling in the fingers or a resultant shock-like sensation occurs. The Phalen, or wrist-flexion, test involves having the patient hold his or her forearms upright by pointing the fingers down and pressing the backs of the hands together. The presence of carpal tunnel syndrome is suggested if one or more symptoms, such as tingling or increasing numbness, is felt in the fingers within 1 minute. Doctors may also ask patients to try to make a movement that brings on symptoms.

Often it is necessary to confirm the diagnosis by use of electrodiagnostic tests. In a nerve conduction study, electrodes are placed on the hand and wrist. Small electric shocks are applied and the speed with which nerves transmit impulses is measured. In electromyography, a fine needle is inserted into a muscle; electrical activity viewed on a screen can determine the severity of damage to the median nerve. Ultrasound imaging can show impaired movement of the median nerve. Magnetic resonance imaging (MRI) can show the anatomy of the wrist but to date has not been especially useful in diagnosing carpal tunnel syndrome.


How can carpal tunnel syndrome be treated?
Treatments for carpal tunnel syndrome should begin as early as possible, under a doctor's direction. Underlying causes such as diabetes or arthritis should be treated first. Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending. If there is inflammation, applying cool packs can help reduce swelling.

How can carpal tunnel syndrome be prevented?
Treatments for carpal tunnel syndrome should begin as early as possible, under a doctor's direction. Underlying causes such as diabetes or arthritis should be treated first. Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending. If there is inflammation, applying cool packs can help reduce swelling.


What research is being done?
At the workplace, workers can do on-the-job conditioning, perform stretching exercises, take frequent rest breaks, wear splints to keep wrists straight, and use correct posture and wrist position. Wearing fingerless gloves can help keep hands warm and flexible. Workstations, tools and tool handles, and tasks can be redesigned to enable the worker's wrist to maintain a natural position during work. Jobs can be rotated among workers. Employers can develop programs in ergonomics, the process of adapting workplace conditions and job demands to the capabilities of workers. However, research has not conclusively shown that these workplace changes prevent the occurrence of carpal tunnel syndrome.