Injections for surgery
So I have been researching a lot of studies with injections and surgery lately on the topic of carpal tunnel. I saw study I am still looking for it I will post it when I find it again, where it stated that surgery tends to have a better long-term benefit but however a side effect is that they lose their grip strength. With injections 1/3 of the patients tend to have an extremely long result and users tend to get their grip strength back more so with the shot. I also have a question on muscle wasting. Do you think muscle wasting happens with mild to moderate symptoms? Or only severe symptoms? And also do you think muscle wasting happens in all of the cases or can one have carpal tunnel syndrome without having any muscle wasting in the hands?
Well that’s kind of scary. Now I’m staring at my thumb
Muscles lol. So there’s no way of
Knowing how bad it is without tests
Can muscle wasting be reversed? I don’t notice any atrophy or strength loss. Yet..
You can tell how bad it is once the thumb muscles are visibly wasted... but then it's usually too late to do much about it. Before that stage it's impossible to know how bad it is physiologically without testing. In younger patients muscle atrophy can reverse to some extent but don't count on it - it's a rather haphazard process. JB
So that sucks. So my only option is really to get surgery to prevent that. Do all people with CTS get
Muscle wasting? Cause I definitely don’t wanna just wait around for that.
Not all by any means. There are surgeons out there who say that the disorder is always progressive and that if you don't do anything it will inevitably progress to atrophy and permanent sensory loss but I'm pretty sure they are wrong and that some cases of CTS resolve without any treatment at all. Just go and get it tested - there's no point operating on something you haven't got! JB
There are elements of truth in most of that but I don't think it's wholly accurate. I don't think there is much doubt that one operation is more likely to produce a long term benefit than one injection - but no-one has adequately studied the policy of repeated injection. Grip strength is not a problem with injection, but can be with surgery. Muscle wasting as a result of CTS is confined to the muscles at the base of the thumb and is considered a marker of very severe disease. It does not occur in neurophysiologically mild CTS so yes, patients can easily have CTS without muscle wasting. The subjective severity of symptoms is a completely different matter - how bad the disorder 'feels' to the patient is not well correlated with any other measure of how bad it is, and is a very poor guide to how it will respond to treatment. You meet patients who are woken ten times every night by severe pain and numbness yet have near normal NCS and ultrasound imaging. At the other extreme you meet patients with completely wasted thumb muscles and no measurable function in the nerve who swear that they have never noticed any tingling, pins and needles, numbness or pain. There is no useful correlation between the subective severity of symptoms and muscle wasting. JB