KLaser for CTS
9 February 2015 - 5:16am
I have been reading about something called K Laser for CTS which is non invasive. Would you know whether its a viable alternative to surgery. I've been diagnosed with severe CTS and told I would need surgery. Reading your forum and other sites it would appear that surgery also can lead to further problems hence my query about K Laser.
Secondly, given the variation in surgical outcomes how can one find an experienced surgeon? The person doing the nerve condcution studies said when CTS is severe its important to ensure its not someone inexperienced dealing with the operation.
thank you.
There is no convincing evidence that any form of laser therapy has any effect on CTS - see the 'alternative treatments' page - but it's probably harmless (except possibly to your pocket). The only things that are definitely known to work are splints, steroids and surgery. If you delay having one of the established treatments in order to explore unproven alternatives there is always the possibility that your CTS will progress and become less treatable, that is why experiments such as our trial of ultrasound treatment are usually doen in milder cases. Knowing exactly how severe your CTS is would help in that sort of decision. Different EMG labs use English language terms like 'severe' in very different ways unfortunately so it's impossible to tell what they actually measured without seeing the results unless they use one of the published grading scales.
Finding a good surgeon for anything is a challenge. Even when surgical outcome statistics are available for individual surgeons they are a statistical nightmare to interpret because of variations in casemix. Personally I think the best the average patient can do is simply to ask two questions:
1) Will you personally be doing the operation?
2) How many of these have you done?
If the person doing the operation has lots of experience then they are probably quite good at it, as with most things. In the context of carpal tunnel surgery if you have done 500 you are probably going to be pretty good. I'm not sure that it matters whether your CTS is mild or severe - you want a decent surgeon - the operation is the same regardless of the severity of the nerve damage, and most surgeons seem to think that almost every CTS they operate on is 'severe' when they look at the nerve during surgery. Of course that poses an interesting problem - How does a surgeon become 'experienced'? At some point every surgeon has to do their first solo carpal tunnel decompression and there is no way to wholly avoid that using supervision and practice on models or cadavers. I have no answer to that. JB