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Carpal Tunnel & the Violin


nick60
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Sorry to hear of your Carpal Tunnel problems.

Some five years ago I had my left hand opened tp releave compression of the carpal nerve and for a short time it was ok but problems returned.

I then saw another Doctor who said the incision had not been long enough and I let him do it again. I watched him open my hand and I saw some four centemeters of the pearly white nerve exposed and I then believed I had a cure! NOT SO! My thumb frequently goes to sleep and I have difficulty in making a "fist". Pain often causes me to stop playing.

At the same time my right hand was giving trouble and I refused surgery on it. Hand excercises have returned it to normal and I now wish I had not had decompression on my left hand.

I think you would be best having Physiotherapy and resist having surgery.

Good Luck Busker.

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My wife is a sports medicine doc and here is an abstract from

meta-analysis.<script type="text/javascript" language="javascript">

From "/viewpublication/404_about">Cochrane Review Abstracts

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Surgical versus non &hyphen; surgical

treatment for carpal tunnel syndrome

Posted 10/01/2005

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RJ Verdugo 

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Introduction

Date of Most Recent Substantive Amendment: 2003 05 02

Background

Carpal tunnel syndrome results from entrapment of the median

nerve in the wrist. Common symptoms are tingling, numbness, and

pain in the hand that may radiate to the forearm or shoulder.

Surgical treatment is widely preferred to non – surgical or

conservative therapies for people who have overt symptoms, while

mild cases are usually not treated.

Objectives

The objective is to compare the efficacy of surgical treatment

of carpal tunnel syndrome with non – surgical treatment.

Search strategy

We searched the Cochrane Neuromuscular Disease Group trials

register and MEDLINE, EMBASE and LILACS (to October 2002). We

checked bibliographies in papers and contacted authors for

information about other published or unpublished studies.

Selection criteria

We included all randomised and quasi – randomised

controlled trials comparing any surgical and any non –

surgical therapies.

Data collection and analysis

Two reviewers independently assessed the eligibility of the

trials.

Main results

We found two randomised controlled trials involving 198

participants in total. The first trial included 22 participants, 11

allocated to surgery and 11 to splinting for one month. The trial

was not blinded nor was it clear if allocation was properly

concealed. In the second trial, 87 participants were allocated to

surgery and 89 to splinting for at least six weeks. The trial was

not blinded but allocation concealment was adequate. The second

trial considered our primary outcome measure, relevant clinical

improvement at three months. Sixty – two people out of 87

allocated to surgery (71%) qualified for treatment success. Forty

– six people out of 89 allocated to splinting (51.6%)

qualified for treatment success. The confidence interval favoured

the surgical group (relative risk 1.38 95% confidence interval 1.08

to 1.75). We were able to pool data from both trials for two

secondary outcomes. For clinical improvement at one year of follow

– up, the pooled estimate favoured surgery (relative risk

1.27, 95% confidence intervals 1.05 to 1.53). For need for surgery

during follow – up, the pooled estimate indicates that a

significant proportion of people treated medically will require

surgery while the risk of re – operation in surgically

treated people is low (relative risk 0.04 in favour of surgery, 95%

confidence intervals 0.01 to 0.17).

Authors' conclusions

Surgical treatment of carpal tunnel syndrome relieves symptoms

significantly better than splinting. Further research is needed to

discover whether this conclusion applies to people with mild

symptoms.

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Cochrane Rev Abstract.

 2005; ©2005 The Cochrane Collaboration

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