[Fran E]

Hi,

I haven't written here for quite a while. I went to see my neurologist last week to review last nerve conduction tests. ( I have idiopathic peripheral polyneuropathy). After three years of these tests and steady but slow decline, I now have had quite a leap to worse results - particularly in my hands/arms. I have conduction blocks and now carpal tunnel in both arms. She is recommending splints.
so here is my question - I am sure there must be therapy out there for carpal tunnel, is any such therapy of any use for polyneuropathy induced carpal tunnel? Acupunture, physio, etc etc??? Seeing as they can't figure out why my nerves aren't functioning would these therapies help?

thanks for listening!

[cyclelops]

I have the same issues going. My neuro told me that it wasn't of any use to fix the wrist, since the hand is so bad. Apparently the trauma of the surgery is bad for the small fiber stuff?? I dunno. It's a big pain, because I can't hold onto things and I have lost my pincher grasp too. Add arthritis and I am not sure what these digits are for anymore. Everything takes 10 times long than it used to.

[mrsD]

I had carpal tunnel with the foot PN severely with my low thyroid functions. Once that was fixed most of the carpal tunnel improved and so did my feet. I still have some, which is aggravated by some heavy working like gardening, so I splint my hands at night sometimes. I avoid surgery at all costs! My carpal tunnel got very bad during my pregnancy...that was frightening. But it resolved for the most part once my hormones returned to normal.

Fluid retention can also compress both the tarsal and carpal tunnel. So I suspect drugs like Neurontin and Lyrica could make this happen. Pre-diabetes also could be a culprit.
I think these compression issues, are mostly global in the body, so look for a metabolic trigger for yours.

[nide44]

I'm thinking that open wrist surgery for Carpa Tunnel could have negative post-operative consequences, but there is the laproscopic, less invasive type surgery to consider.
That's what I think I'll eventually have, when the cortisone shot- once every 10-12 mos, has no effect anymore.

[mrsD]

Yes, some people who have wrist trauma and/or surgery develop RSD... afterwards. A visit to our RSD forum is enough to put fear in your heart!

But there is one study showing Vit C treatment when wrist injury was treated, reduced this risk:

Lancet. 1999 Dec 11;354(9195):2025-8.
Effect of vitamin C on frequency of reflex sympathetic dystrophy in wrist fractures: a randomised trial.

Zollinger PE, Tuinebreijer WE, Kreis RW, Breederveld RS.

Department of Orthopaedics, Leyenburg Hospital, The Hague, The Netherlands.

Comment in:

* J Bone Joint Surg Am. 2007 Nov;89(11):2550-1; author reply 2551-2.

BACKGROUND: The pathogenesis of reflex sympathetic dystrophy (RSD) is not clear, nor is there a definitive treatment for this syndrome. The morbidity, costs in health care, and loss of work time justify the search for a means to prevent post-traumatic dystrophy. Although the role of toxic oxygen radicals has not yet been clarified, we investigated vitamin C (ascorbic acid) as a prophylactic antioxidant drug. METHODS: 123 adults with 127 conservatively treated wrist fractures were randomly allocated in a double-blind trial to take a capsule of 500 mg vitamin C or placebo daily for 50 days. Each participant's sex, age, side of fracture, dominance, fracture type, dislocation, reduction, and complaints with the plaster cast were recorded, and they were clinically scored for RSD. The follow-up lasted 1 year. FINDINGS: Eight patients were withdrawn after randomisation. 52 patients with 54 fractures (male 22%, female 78%; mean age 57 years) received vitamin C and 63 patients with 65 fractures (male 20%, female 80%; mean age 60 years) received placebo. RSD occurred in four (7%) wrists in the vitamin C group and 14 (22%) in the placebo group 15% (95% CI for differences 2-26). Other significant prognostic variables for the occurrence of RSD were complaints while wearing the cast (relative risk 0.17 [0.07-0.41]) and fracture type (0.37 [0.16-0.89]). INTERPRETATION: This prospective, double-blind study shows that vitamin C was associated with a lower risk of RSD after wrist fractures. Our hypothesis is that this beneficial effect of prophylaxis would be useful in other forms of trauma.

PMID: 10636366 [PubMed - indexed for MEDLINE]

500mg daily for 50 days!

[nide44]

I see the study was for fractures, not CTS, but they did hypothesize :
:.......Our hypothesis is that this beneficial effect of prophylaxis would be useful in other forms of trauma.".........

Couldn't hurt. Vit C has many other benefits, as well &
you cannot O.D. on it - excess is passed thru urine, I believe.
Could be useful for post operative CTS surgery recovery,
or maybe even help CTS symptoms without surgery?

[amit]

I read somewhere that one of the reasons for CTS - is hormones imbalance which can occur during menopause which influence the all body.

[cyclelops]

I broke my humerus in 2000, in 4 places, right near the wrist....(xc skiing down icy hill, back when I did stupid things). Anyway, I would not doubt that did NOT help matters. I did not need surgery or screws, I was lucky. I was by myself and had to ski out a mile by myself and drive myself to the ER. I just kept the wrist splinted very close to my body and nothing moved. Lord. I could not do those things these days!

Anyway, likely that break made matters worse, but it is still bad bilaterally.