Samuel G Oltman, ND, RMSK
Over the weekend I had the honor and privilege of speaking at the 38th Annual AANP Conference, held at the Arizona Biltmore. I presented on "Ultrasound Diagnosis and Guided Injection Therapy for Carpal Tunnel Syndrome" (CTS). It was a 2-hour combination of lecture and hands-on demonstration where I taught what CTS is, how it occurs, what the conventional treatment options are, and what the better alternative is: perineural hydrodissection. Participants got a chance to scan the carpal tunnel with an ultrasound and get an appreciation for the complexity and intricacies of the anatomy.
Carpal Tunnel Syndrome Treatment
I finished with a live demonstration of a carpal tunnel syndrome treatment known as perineural hydrodissection. This is where fluid (D5W or PRP) is injected next to the nerve in a way that forms a fluid halo/cushion around the nerve. This decreases inflammation, improves nerve movement, and restores normal function. This is a very technically demanding procedure and requires a skilled hand, ultrasound expertise, and a lot of injection experience.
Carpal Tunnel Syndrome Scientific Evidence
The big takeaway for attendees and for anyone reading this is: the current conventional treatments for carpal tunnel syndrome are based on bad evidence. Surgery has a 40% failure rate at 5 years. Steroids are no better than placebo at 1 year (they help in the short term). NSAIDs do nothing. Icing does nothing (maybe is detrimental). Rest is not an option for most people.
Carpal Tunnel Syndrome Alternative
What has good evidence for long-term, durable treatment is perineural hydrodissection. It performs better than steroids in every head-to-head study. It can be done on someone who’s had surgery and relapsed. It provides relief and restoration of function with an average of less than 1 treatment per year. And this technique can be done on any nerve in the body that is inflammed, entrapped, or compressed.
Expertise Matters
For a treatment like this, you really want someone who is an expert. The technique is delicate and the anatomy is small. Don’t leave you carpal tunnel syndrome in the hands of someone who doesn’t have the experience or knowledge of the full array of options. Don't believe someone who tells you that surgery and steroids are your only options. Schedule at Cascade Regenerative Medicine today and see what it looks like when technical expertise meets person-centered care.
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