Carpel Tunnel in Austin help!

[tojook]

Hey everyone,

So about a quarter of the way into our set last night, my right hand starts feeling like rubber. I managed to play through it but it was hard to keep my accuracy in check. I even dropped the pick at one point... (Funny thing is, a lot of the crowd said it was one of the "hardest and best" shows they had seen us play)

I was having pains in my wrist after, and today my hand still feels a bit "off". From my understanding, these are the hallmarks of carpel tunnel syndrome.

Anyone have any recommendations for a good doctor and/or anything else here in Austin, TX? A guitar player from one of the other bands that night recommended Acupuncture at the Natural Health Center of Austin, but I am a bit skeptical. I need this looked at ASAP as we have more shows than usual on the books in the coming months.

Thanks as always,

john

 

[sqadan]

I don't know any doctors in Austin...

But some recommendations (as I have mild carpal tunnel myself)...

Before you play, try holding out your arm straight out - and then while holding your hand with the palm down, gently pull back on each of your fingers until you can feel the nerves in your wrist moving... this will help free up the nerve bundle in the wrist, keeping it from getting numb.

You can also try dipping your wrist in alternating very hot and very cold water... this seems to help as well...

And ALWAYS stretch and warm up your hands / fingers before playing.

 

[Frankenstrat2]

Hi John
I have had successful carpal tunnel surgery in both wrists.
I'm sure you will get all kinds of suggestions for homeopathic remedies and exercises, but be cautioned-
Carpal Tunnel syndrome is a condition that effects the nerves that pass from your fingers through your wrist. As you age, the condition can become more severe. If not treated, the damage can become irreversible.
I think the first course of action is to consult your internist or family practitioner. He will need to refer you to a neurologist for testing. There is a test that will confirm if you have carpal tunnel syndrome, and if so, quantify the amount of restriction you have so far. Those numbers are what determine if surgery is recommended. If surgery is needed, you then have to go on the path of finding the best hand surgeon specialist in your area. Lots of orthopedists like to do carpal tunnel release. I would also caution that this is micro surgery of your wrist, and you are a guitar player. You don't want to give the job to a guy who sets broken legs. You want a hand surgeon who does this procedure all the time.
But mainly- don't put off getting a proper medical diagnosis.
You have plenty of time for acupuncture and other stuff later.

 

[The Scrutinizer]

Proper nutrition such as nutritional yeast to build up your tendons, daily stretching, massage, chiropractic, and acupuncture is the way to go

The modern medical model proposes doping you up with percocet, darvocet, or vicadin, and once that runs it's course . . . "we need to cut"

I overcame a bad tendonitis condition using all of the above non-drug/non-surgical procedures, no prob

http://carpaltunnelfix.com/

or the torrent

mopst hand problems start in the neck, that's why adjustments are the way to go

Alot of that stuff is not covered by insurance, but it is worth spending your money on something that will keep you away from dope & knives !

 

[teamdelfano]

take it from a guy who suffered from this for a year....i tried everything. the best doctors, nerve tests, accupuncture, chiropractor. i dont pretend to know about your particular situation...but

a lot of it has to do with your posture, and your lower back muscles. without proper posture, you begin to suffer from those sorts of symptoms that you currently exhibit. i stumbled upon this book one day, and tried the exercises in it...and noticed an immediate benefit. a few days later, my pain was gone. you just have to do these exercises every day that this author suggests, they're pretty simple and you dont need weights or anything.


http://www.amazon.com/Pain-Free-at-Your-PC/dp/0553380524

it sounds like BS, but if you at least read the premise behind it, it makes sense. this guy is an anatomical physiologist.

 

[Frankenstrat2]

From Wiki:Carpal tunnel syndrome (CTS), or median neuropathy at the wrist, is a medical condition in which the median nerve is compressed at the wrist, leading to paresthesias, numbness and muscle weakness in the hand. The diagnosis of CTS is often misapplied to patients who have activity-related arm pain.
Most cases of CTS are idiopathic (without known cause), genetic factors determine most of the risk, and the role of arm use and other environmental factors is disputed.
Night symptoms and waking at night--the hallmark of this illness--can be managed effectively with night-time wrist splinting in most patients. The role of medications, including corticosteroid injection into the carpal canal, is unclear. Surgery to cut the transverse carpal ligament is effective at relieving symptoms and preventing ongoing nerve damage, but established nerve dysfunction in the form of static (constant) numbness, atrophy, or weakness are usually permanent and do not respond predictably to surgery.


In laymans terms- CTS is often confused with tendonitis or other conditions, and mis-diagnosed. Surgery is a cure. If you wait to long, the nerve damage is irreversible. Get a diagnosos first, from a neurologist.
I'm not going to debate this with the naysayers, just trying to prevent you from the possibility of losing your ability to play entirely if you actually suffer from advanced CTS.
You can PM me if you wish to take this off-line.
barry

 

[townsend]

Frankinstrat2 has provided some good information in the wiki quote.

I'm not sure whether you have carpal tunnel syndrome (= CTS) or not. The hallmarks are paresthesias (= tingling) and numbness in the distribution of the median nerve. The median nerve provides sensation to the thumb, index, middle, and half of the ring finger. Yes, you can also get weakness, esp. so since the median nerve has a motor branch (you can test for weakness by testing "pinching" power between the pads of the thumb and index finger. And yes, you can get some pain as well.

A general practitioner, orthopedist, neurosurgeon, and neurologist, to name a few, can diagnose this condition with a high index of clinical suspicion on the basis of symptoms and a few physical exam signs (Tinel's sign; Phalen's sign). Definitive diagnosis can only be established by EMG/NCV (electromyelography/nerve conduction velocity study). Don't even think about surgery unless an EMG/NCV has been performed, and most of the time, even a positive study means surgery is an option, not mandatory (exception: if there is evidence of actual nerve damage, not just nerve irritation).

Summarized simply, treatment options are 1) wrist "cock-up" splits plus anti-inflammatories (start wearing splints all night every night); 2) steroid injection into carpal canal; and 3) surgery (carpal tunnel release).

The surgery takes at least 15 minutes (no kidding), but it is, of course, surgery, and you will need at least sedation + an anesthetic block to the arm. The surgery is highly successful but no surgery is 100% successful. Other treatments should be exhausted before contemplating surgery.

I've assisted in at least 50 of these surgeries when I worked with a hand orthopedist (in Plano, TX). I now work with a neurosurgeon, who also does carpal tunnel release, but I don't assist him because there is nothing for me to do! I'm not promoting surgery per se, and proper diagnosis and treatment awaits a knowledgeable healthcare provider. Best wishes to your recovery.

 

[Frankenstrat2]

Thanks Townsend
I couldn't remember the name of the test administered to diagnose CTS and quantify the damage. Its the EMG/NCV. That's the one usually administered by a Neurologist.
I don't want it to seem that I'm saying surgery is the best, or only option, I just wanted to stress that if someone has CTS and does not have it properly diagnosed, the result can be nerve damage.
Here's a great anecdote from my hand surgeon.
After surgery, he explained that you can think of the nerves that pass through the carpal tunnel sort of like a garden hose. As the tunnel constricts (from aging or hereditary reasons) its as if a car tire was sitting on the garden hose for as long time, constricting it. The surgical procedure cuts the tissue forming the tunnel, releasing the constriction. Its as if the car tire was now moved off the hose. The surgeon said he can actually see the nerve bundles regain their shape as soon as they are released, and the information can flow through the nerves. BUT if the garden hose has had the tire sitting on it too long, it can't spring back to its normal shape. It remains constricted permanently.
He also commented that men (as opposed to women) tend to be more stoic. They will put off diagnosis and treatment for too long, increasing the possibility of permanent, irreversible nerve damage.

 

[Strat]

as a occupational medicine and rehab Dr. with a large professional musician component in my practice I would suggest another diagnosis. It's more likely you have an overuse tendinitis - called a repetitive strain injury or RSI, and the swelling of the tendons and sheath is compromising the canal and it's structures. Stretching and helpful mysofascial release massotherapy will take care of it. No need for aexpensive testing unless it does not resolve in 6 weeks since that's how long it takes the test to become positive even in a CTS case. Oh - and if that's the case your techniques needs tweaking.