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Discussion Starter #1
Has anyone been diagnosed with carpal tunnel syndrome, and if so, what treatments have you pursued that did or did not work. Has anyone had surgery, or taken a cortisone shot? Are there exercises that help? Did you continue practicing, and did you alter your technique? I'm looking for as many experienced anecdotes as I can find.
 

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I inject them. Often works a treat and avoids surgery. Medications seldom work that well. Just make sure the guy holding the needle knows where to put it. I doubt that playing will make it much worse unless you play all day.
 

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As an industrial hygienist, I do ergonomic investigations quite often and I see a lot of carpal tunnel cases. Surgery is almost always the best cure. A good surgeon can have you playing the sax again in a couple of weeks. I'd recommend skipping the rest of the treatments and go right for the surgery. The rest will probably just cause you unneeded pain.
 

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Hopefully you have had a few tests to make sure that you do not have any associated medical problems - like thyroid problems or pregnancy.

If no reversible medical problem is found, then I would go for least intervention first, which is steroid injection. Some people get excellent long term relief from it - but many do need an operation for a cure.

In the mean time a physio or occupational therapist could fix you up with night splints while you decide what you want to do
 

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I have successfully managed my tendonitis/CP for years without surgery or cortisone injections. Sometimes with some pain, but I've been able to work and indulge all hobbies.

I've spoken with many people who had surgery and within months problems returns.
From my experience I feel strongly that the best way to handle it
is:

1) ice applied to wrists. 10-15 minutes. Get them nicely numb then rest them as they warm up. This is the absolute best way to stop the pain.
2) anti inflammatory drugs ( ibuprophen, aspirin)
3) rest if possible
4) careful stretching and strengthening when your hands are not inflammed
(if you want to know the ones I do send me a pm)
5) wrist braces worn while sleeping to keep wrists straight while sleeping. These do not need to be tight or binding, just keeps them straight of on ly slightly bent ( less then 45 degrees )
6) Get a Microsoft "natural" keyboard and a trackball you are comfortable with . use the track ball in you lap, or alternate hands. Do not reach out to use it as many people do with a mouse. A regular keyboard (crappy hand position inherently) and a mouse that you have to reach for are almost guaranteed to inflame my hands with in a couple of hours. With the other set up I can work all day.

Do not shake your hands thinking that you can get them to loosen or to get the pain to lessen. This will only further inflame them.
Cause of the problem is this:
Friction and over use in bad or fixed positions causes tendons inflame, inflammation causes swelling, swelling presses on the nerves and causes the pain.

Only solution is to reduce the inflammation and swelling with ice, drugs,

The friction on the tendons increases when the fingers are made to move when the wrists are in a bent position. When bent the carpal tunnel narrows.
Whenever possible keep your wrists in a straight position. That's why braces at night are important.

Personally I would avoid the injections, and would never ever get the surgery.
They cut a band of ligaments that go around the tendons in the wrist. This creats more room in the tunnel, but probably also some looseness. And, everyone I've ever spoken with that had it done had the problems return.

You absolutely can get your hands back into good shape but you need to change your habits and take counter measures to the inflammation you already have.
 

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Shandeleo,
If the carpal tunnel was diagnosed by a physician and confirmed by electromyography go for the treatments mentioned earlier; rest with a brace, steroid injection or surgery. If the diagnosis is not sure there might be other problems. Last year I had pain and twinklings in my left hand during playing.
I changed my neck strap for a BG Harness strap. This model reduces the strain on your neck muscles and divides the pressure more evenly on your shoulders.
The pain in my left hand disappeared since then. So your neck strap might cause troubles..
Stjontl.
 

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Good point from stjontl.
I may be wrong, but I think that nerves from the hands connect through the cervical 5-6 area.
Right where the neck strap sits for most.
Also, take notice of how you generally hold your hands when playing.
Wrists straight or bent?
 

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Drinking large amounts of non flouridated spring water and cutting out other kinds of liquids is reputed to bring considerable relief. Dehydration is surprisingly rampant among people who drink things other then water.
 

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Discussion Starter #10
Just to answer a few of these, My condition has been confirmed through Electromyography. I also have a compression of my left ulnar nerve, which actually may be the main problem. I use a strap that attaches to my belt in the back, instead of a traditional neckstrap, and the EMG found no neuropathy in the neck. I went through a whole thing about 10 years ago, with tendonitis, and totally overhauled my technique, and felt pretty confident that I was as relaxed as possible, so I'm a little more frustrated about finding the cause of the problem than anything else. Any cure is only going to be temporary, unless I stop doing whatever caused this. The water thing is very interesting, since I drink a lot of sodas, and generally have a beer or five after the gig at night.

Anyway, thanks for the advice. The more responses I get, the better, even if they're saying all the same thing, in order to better weigh my options.
Thanks,
Shannon.
 

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I've read that cell inflamation in general can be causes by acidic foods.
Unfortunately, coffee and wine are included in that list.
Ginger is a natural general anti-inflamatory.
Reducing inflamation sources in general may be worth researching, considering or trying.
 

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I'll add 2 things which I've found help.

If you are experiencing a flare up in one wrist, immobilize the other wrist as well. I've found that if one wrist is having a flare up I tend to rely heavily on the other wrist, which leads to both wrists in the same boat.

Another thing which helps is to not do any lifting or carrying if you are going to play soon. I can lift and carry things all day if I do not play an instrument. I can also play all day if I do not carry things in my hands. The combination of the fine (playing) and coarse (lifting and carrying) movement gives me a bad flare up in no time at all.

Ibuprofen does work, but it will destroy your stomach eventually, leading to prescription acid reducing pills.
 

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Well, shandeleo, you've had just about every treatment imaginable prescribed, apart from acupuncture, Hopi Ear Candle and witchcraft!
Take your pick and good luck!
 

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Carl H. said:
Ibuprofen does work, but it will destroy your stomach eventually, leading to prescription acid reducing pills.
Hmm... probably an exaggeration. NSAIDs can occasionally be pretty damaging, but most people get away with them which is why they're still available over-the-counter. Conversely I haven't had a serious complication in the last 1500 or so peri- and intra-articular injections I've done, so personally I'd choose that over taking Ibuprofen for long.

Additionally, I've not seen a single recurrence after carpal tunnel surgery - if I'd did, I'd think very carefully about whether something else was going on.

In any case, to echo the sentiments above, I hope whatever treatment you have sorts it out.
 

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I'm not exxagerating. I can't take advil like I used to to keep playing despite the pain. My stomach is a mess but the prescription acid reducers really do work.
 

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I recently had that electrowhatever test that was conclusive for carpal - i mainly have numbness in parts of the thumb and 2 fingers of my left hand. I use the splint at night and i symptoms have decreased a lot. The Doc suggested that if i did not get the surgery that the numbness could become permanent. I am reluctant to go the surgery route, but am not decided.
 

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Carl H. said:
I'm not exxagerating. I can't take advil like I used to to keep playing despite the pain. My stomach is a mess but the prescription acid reducers really do work.
Hard luck - you're right to stay off them and avoid major haemorrhages, etc. However, same isn't true for everyone - for example, I'm on acid reducing things for my Barrett's oesophagus, but Ibuprofen does wonders for my migraines. Horses for courses.
 

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Discussion Starter #18
I have numbness in fingers 3 4 and 5 in the left hand. I think this means that the compression my elbow is the real problem, meaning that carpal tunnel surgery isn't gonna do it. I hope it's not from playing, but rather from resting my elbow on hard surfaces, and sleeping in a bad position. Which fingers is CTS supposed to affect?
 

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shandeleo said:
I have numbness in fingers 3 4 and 5 in the left hand. I think this means that the compression my elbow is the real problem, meaning that carpal tunnel surgery isn't gonna do it. I hope it's not from playing, but rather from resting my elbow on hard surfaces, and sleeping in a bad position. Which fingers is CTS supposed to affect?
Median nerve, mainly 2nd, 3rd and half of 4th. Your symptoms might be from the elbow, but are more likely to be from the neck, or to be more precise the 1st thoracic level. Lie down and I'll manipulate it for you. Where do I collect my fee...chink. Thankyou.
 
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