For the most part, doctors believe that the Causes of Carpal Tunnel Syndrome are usually related to an 'impingement' of the median nerve that runs down the wrist. According to doctors, strain and repetitive motion causes inflammation of the connective tissue that surrounds this nerve running through your wrist into your hand; surgery is often indicated as a treatment to 'release' the impingement on this nerve. But Carpal Tunnel Syndrome is simply a collection of symptoms and not a disease itself. As with many 'Syndromes', there can be different causes of carpal tunnel syndrome and 'nerve impingement' is only ONE of the causes of carpal tunnel syndrome, making Conservative Non Surgical Treatment for Carpal Tunnel Syndrome imperative before surgery is attempted.
But other, more unlikely sounding Causes of Carpal syndrome are Thyroid Gland Problems. This may sound a bit crazy, but an under active thyroid gland, termed hypothyroid, can be one of the causes of of 'Carpal Tunnel Syndrome'. This was actually discovered by accident when patients with hypothyroidism suddenly found their carpal tunnel syndrome symptoms disappearing. While it SOUNDS easy to have a doctor simply check a person's thyroid levels before they consider surgery for carpal tunnel syndrome, it's not always that simple.
"Especially in the treatment of entrapment neuropathy
in hypothyroidism, the chance of medical treatment must
be given to patients before considering surgical treatment."
'Hormone replacement therapy in hypothyroidism
and nerve conduction study'
Unfortunately, hypothyroid isn't necessarily easy to diagnose. Even though the blood tests are readily available, doctors generally only look at ONE of the many different thyroid tests that are available. If this Thyroid Stimulating Hormone (TSH) is normal, then the doctor will determine that hypothyroidism is not present and will not check the many other thyroid hormones and antibodies that can be tested. But in the case of some study participants who had carpal tunnel syndrome, the majority who benefited from hypothyroid treatment actually had completely normal TSH levels. But these lucky carpal tunnel sufferers had ALL their levels analyzed and were diagnosed with 'Subclinical Hypothyroid', qualified for the more conservative medical treatment that eliminated their 'Carpal Tunnel Syndrome' and avoided unnecessary surgery.
Not only is Underactive thyroid one of the causes of Carpal Tunnel Syndrome, but Overactive thyroid can cause these Same symptoms. And just like with hypothyroid, treatment for hyperthyroid also prevented what would have been surgical cases. In the article 'Carpal tunnel syndrome and hyperthyroidism. A prospective study' the authors state, "CTS can be considered another peripheral neurological manifestation associated with hyperthyroidism." Yet instead of routinely screening patients for subtle health problems before surgery, doctors rarely check for these problems. In fact, one study that reviewed all of the literature available on metabolic causes of carpal tunnel syndrome concluded that "there is insufficient evidence for routine laboratory screening" in patients with carpal tunnel syndrome.
Certainly, for those who end up having an unnecessary and unsuccessful surgery, there is not 'insufficient evidence'. But until routine screenings with the simple and readily available blood tests are being done, it will be impossible to know how many people receive unnecessary carpal tunnel surgery every year. Given that there is always a percentage of people who don't improve with carpal tunnel surgery, it's evident that some of these surgical 'Non Responders' might have have something else as the causes of their carpal tunnel syndrome.
If you are EVER considering surgery for Carpal Tunnel Syndrome, INSIST upon your doctor checking ALL of your thyroid hormones: TSH, Free T3, Free T4, Thyroxine and your Thyroid autoantibodies. Your doctor will likely not agree to this and state that it is "Not Indicated", but when you are contemplating surgery, ruling out all possible causes of Carpal Tunnel Syndrome is VERY MUCH indicated if you are the one going under the knife!!
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