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A little more than two months ago, I was diagnosed with carpal tunnel syndrome (CTS), a painful affliction of a nerve in the wrist-a problem that turns out to be 15 times more common in people with diabetes than in the general population. Last issue, I wrote about my early prognosis and the healing methods I had already tried. I asked people to call the DIABETES HEALTH office and tell me about their experiences with CTS. To my amazement, I received calls from dozens of readers. I found all of your stories helpful. Many of you asked me to report back about what I've learned.
Don't Fear Surgery
Many told me not to fear corrective surgery. Ivy called to say that the surgery was the best thing she ever did for herself. She had tried a brace with no results. She watched during the surgery and actually saw a 'dent' in her carpal nerve where it had been pinched. She endured two weeks of discomfort following the surgery, but once her stitches came out, she improved.
Sandy said her surgery was "a piece of cake," and that the relief was so instant that, "The next day I was out digging holes in the garden. I went back the next week and they operated on the other hand."
Barbara called to say that she was given cortisone injections-in the beginning it was one shot per year, then two, and finally up to four injections per year. In the end, cortisone wasn't helping. Barbara had surgery on one hand, and planned to go in for the other, but to her amazement, the untouched hand "got better" on its own.
Bob C., like Barbara, takes cortisone injections and finds that they help for up to four months at a time. The only drawback is that it is sometimes as much as two weeks before the injections take effect.
There are two kinds of surgery for CTS, according to Marilyn. One involves a scope which is inserted into a half-inch incision in the wrist. She watched on a t.v. monitor as a little blade came out of the scope and cut at her tendon. The other method utilizes the traditional scalpel.
Trigger Finger Looms Ahead
Several people reported developing trigger finger after the surgery. Trigger finger is the involuntary contraction of one or more fingers. The fingers have to be pried away from the palm in order to extend the hand.
Gene, who has type 2 diabetes, told me that he has had "no problems since my surgery. I went right back to work and was able to write." Although he's glad he went ahead with the surgery, he did eventually develop six trigger fingers which had to be surgically corrected.
Sharon's doctor tried bathing her hands in hot paraffin wax on the theory that deep heat would help soothe her CTS. When that failed, she opted for surgery but developed trigger finger in all ten digits. The fingers had to be surgically released.
Bob D. had a similar experience. Since his CTS surgery 12 years ago, he has had five surgeries to repair other tendons in his wrist. Said Bob, "The annoying part for me was that I was a fairly good violinist before and never regained full strength or mobility."
Like Bob D., Theresa has endured multiple surgeries to correct her trigger finger. It has taken her two years of intensive therapy to heal after her four operations.
Surgery took about three minutes in Julie's case. Though she encouraged me not to wait too long and said that surgery was "great" for her, she now takes cortisone shots to ease trigger finger.
I heard stories of people who thought they were cured of their CTS after surgery only to "relapse" in a couple of years. Gordon said he was "not as good as new" after his surgery and two years later had a relapse of the CTS. I also listened to numerous accounts of people who had CTS in both hands, and after surgery was performed on one hand, the other healed on its own.
Even though many said "don't be afraid of the surgery," I'd like if possible. Some may think I'm dragging this out, but I'm a journalist after all, and it's my job to explore every angle for my readers.
Problem Not Just in the Wrist
Raised in this country, I do embrace Western medicine. But I also believe that it's important to try non-invasive and Eastern methods as well.
Several sources talked about CTS being the end result of poor posture, an ergonomically inefficient workspace, and not enough stretching. The way to cure CTS, according to these sources, is through exercise and pushing on knotted muscles, or pressure points. Since the muscles connected to these pressure points are shorter than normal muscle, they can pull the body into a bad posture, which in turn can lead to CTS-like symptoms.
By chance, there is a Chinese herbalist next door to the DIABETES HEALTH office, so I decided to go see him. At first, we tried acupuncture. The doctor stuck a needle into the center of the knotted tissue and attached wires to the needle in order to direct electrical current into the area. He said the treatment would work much faster that way, but I couldn't stand it. I made him take the needles out.
Now, he treats me by finding certain points in my shoulder, neck, arm and hands and applying pressure to them with just his hands. He rubs the spots with his finger and thumb, really digging into the muscle. It is somewhat painful, but I can actually feel the tension in my muscles giving way, and I experience relief for about three days after a treatment. I'm amazed that I have stress in my body that I don't even know exists until it's released.
Then I received a book published in 1995 called Conquering Carpal Tunnel by Sharon J. Butler. Butler discusses methods for stretching the muscles to relieve the tension that can cause CTS. An article from the December 1995 issue of Yoga Journal also focuses on releasing tension from knotted muscle tissue called "trigger points."
I've also taken some pretty straightforward steps toward easing the load on my wrists. For instance, I bought a headset for my telephone-holding the receiver was becoming excruciating. I wear a wrist brace at night. I also lowered the keyboard on my computer in an effort to make my working environment more ergonomically correct. Of course, there's nothing I can do about having two young [and heavy] children to carry around. They are one burden I'm happy to bear.
I tried magnet therapies, but I'm not sure if they have had any benefit. I have a wristband with magnets in it, and the theory is that the magnetic force stimulates circulation around the afflicted area. I've also slept on a magnetic mattress, which hasn't done much as far as I can tell. Magnet therapy has multi-level marketing and is quite expensive, but I am open to other variations on it.
Therapies I Haven't Tried
Dorothy called to tell me about a device from a company called Rehabilicare in St. Paul, Minn. that can be rented for about $220 per month with supplies. The appliance, called the SmartBrace, stimulates the wrist with electrical current. The SmartBrace received 510(k) approval from the FDA in 1994.
Another device is called the Carpal Lock, from CMO Inc. in Barberton, Ohio. The brace, which has its "spine" on top of the wrist rather than along the bottom, is worn 24-hours a day for 30 days and the company says that "Experience teaches that the syndrome may disappear entirely." The Carpal Lock costs less than $30 each and I have ordered two of them-I'll let you know if they help.
Bromelain, a derivative of pineapple that is used as both a meat tenderizer and for reducing inflammation injured soft tissues. Art told me that he took 1,000 IU of bromelain twice per day for two weeks and felt a marked improvement in his CTS.
Alan Marcus, MD, of the DIABETES HEALTH medical advisory board, said that people with diabetes and CTS should be checked for autoimmune thyroid disease.
Other people have said more exercise and stretching-perhaps in a gym-would be most helpful. I am trying to do as much of that as possible, but you know how it is trying to run a business, publish a newspaper and raise two children under age three! Sometimes it seems like my last priority is taking a half hour out of the day for myself.
I don't know if there is one therapy that will turn out to be the 'magic bullet' against CTS. Maybe a combination of therapies is the answer. As with any disorder, there are many different opinions about what is the proper treatment. I have moved from fear and anger about having to cope with one more health problem, to believing I can deal with CTS if I keep my mind and my eyes open.
Jun 29, 2007
Diabetes Health is the essential resource for people living with diabetes- both newly diagnosed and experienced as well as the professionals who care for them. We provide balanced expert news and information on living healthfully with diabetes. Each issue includes cutting-edge editorial coverage of new products, research, treatment options, and meaningful lifestyle issues.