CARPAL TUNNEL SYNDROME/ ULNAR TUNNEL SYNDROME/ NUMBNESS HAND
Carpal tunnel is a fibro-osseous tunnel in the palm side of the wrist through which the median nerve passes; that provides the ability to feel on the fingers and impulse to the muscles on the thumb. Carpal tunnel syndrome is caused by the compression and excess pressure on the median nerve within the carpal tunnel in one or both of the hands. The condition causes pain, numbness, tingling and weakness in the hand and occasionally the entire upper limb.
Minimally invasive treatment methodUlnar Tunnel syndrome is similar to carpal tunnel condition caused due to the compression of the ulnar nerve in the Ulnar tunnel (Guyon’s canal of wrist) causing pain in the inner wrist and numbness of little finger, ring finger and half of middle finger. The condition is developed due to the repetitive pressure on the ulnar nerve fibers that runs from the neck to the hand.
Both these conditions are caused due to the compression of nerve and obstructed blood flow causing numbness and activity restriction. The doctor conducts a physical examination to test the feeling in the fingers and the strength of the muscles in the hand through clinical examination and may order an electromyogram or nerve conduction test.
Conventional treatment methods include nonsurgical therapy using Nonsteroidal anti-inflammatory drugs. Surgery treatment methods include endoscopic single or double portal surgery or an open surgery to release the pressure and to free the affected nerve followed by physical therapy, prescription pain medication or by wearing a wrist brace.
ALTERNATIVE TREATMENT OPTIONS AT BETH YEHUWDAH ARTHRITIS CENTRE, PULLAD AND DAYSTAR CLINIC, ALAPPUZHA
Neural (Juxtaneural) & Soft Tissue Infilteration Therapy (NESTIT)
Low Dose Steroid Infilteration/ Neural & Soft Tissue Infilteration Therapy (NESTIT): Steroid tablets and injections of the group Corticosteroids, (which are very different from Anabolic steroids misused by some athletes) have been repeatedly proven medically for the last 70 years in the successful treatment of inflammatory conditions due to its potent anti-inflammatory effect. Though corticosteroids are very effective in reducing inflammation, they carry numerous potential side effects, which are undesirable. To circumvent this problem, and in order to utilize the potent anti-inflammatory effects of steroid injections, at the same time taking appropriate measures to considerably lower its side-effects, Dr Tejaz Koshy John in 2010 while working as an Orthopaedician in his private clinic in Guyana, South America developed NESTIT. NESTIT stands for (Juxta) Neural and Soft Tissue Infilteration Therapy. It consists of injecting small amounts of diluted anti inflammatory steroid solution indirectly near (juxta) nerve CCPs- (chronic constricting points) in the lower back/ hip/ neck/ shoulder regions, in order to reduce juxtaneural and perineural inflammation, as well as in certain soft tissue sites including but not limited to trigger points (painful muscle “knots”)/ myofascial syndrome and/or enthesitis (inflammation of soft tissue-bone junctions) and/or sites of nerve inflammation (neuritis/ radiculitis) and/or bursitis (inflammation of fluid filled cushions called bursa) and/or additional sites causing pain referrals (referred pain) to distant sites; in order to obtain a reduction in inflammation and pain in the concerned joint/ region/ limb. It is preferably given for those patients who have Rheumatoid Arthritis, Inflammatory Arthritis, Synovitis, Inflammatory Low Back Pain, Spondyloarthropathy & Nerve and Nerve root irritation. It is not a substitute for DMARDS (Disease modifying anti rheumatoid drugs), however when given with low dose DMARDS, in Dr Tejaz John’s clinical experience it may result in significant reduction of local inflammation, pain and improvement of joint function in most cases, also indirectly reducing side effects of high dose DMARDS.
In Dr Tejaz John’s clinical experience, the patient benefits of Low Dose Steroid Infilteration/ Neural & Soft Tissue Infilteration Therapy (NESTIT) treatment are:
Almost painless injection technique using very thin needles under local anesthesia
At Beth Yehuwdah Arthritis Centre, Pullad and Daystar Clinic, Alappuzha we provide a variety of options for patients suffering from Carpal Tunnel/ Ulnar Tunnel/ Numbness. To know more about treatment plans and treatment cost, book an appointment now.
MBBS, MS Ortho (Christian Medical College, Ludhiana), Joint Replacement Fellowship (HOSMAT Hospital, Bangalore), Orthopaedic Trauma Fellowship (Hebrew University Hospital, Jerusalem, Israel)Read More