Medical Doctor Huntsville: Carpal Tunnel Syndrome

Carpal Tunnel Treatment in AlabamaTreating carpal tunnel in the elderly: early electrodiagnostic testing is key. Early diagnosis crucial.

Approximately 90% of mild-to-moderate cases of carpal tunnel syndrome respond to conservative management.

However, given that the condition is progressive, the earlier it is diagnosed the more likely it is to respond to conservative intervention.

Conservative management, of course, typically includes nighttime wrist splinting, use of nonsteroidal antiinflammatory drugs (with or without diuretics), oral or injectable steroids and physical or occupational therapy.

Naturally, though, before commencing conservative management of carpal tunnel syndrome, the patient’s complaint must be diagnosed as such. The “gold standard” of testing for carpal tunnel syndrome is an electrodiagnostic study performed by or under the direct supervision of a board-certified specialist adhering to testing standards and guidelines developed by the American Board of Electrodiagnostic Medicine.

The most relevant electrodiagnostic tests for diagnosing carpal tunnel syndrome are electromyography (EMG) and nerve conduction studies (NCS). In addition to identifying abnormalities associated with specific symptoms and signs of carpal tunnel syndrome, these two tests are capable of excluding other neurologic diagnoses.

Further, these tests can yield data of the sort necessary for accurately assessing the severity of nerve damage. Typically, testing that demonstrates nothing but sensory abnormalities will be found to have mild carpal tunnel syndrome, while sensory abnormalities accompanied by motor dysfunction are usually taken as evidence of moderate severity. The condition is considered truly severe when testing reveals decreased or absent sensory or motor responses distal to the carpal tunnel or neuropathic abnormalities.

These tests can be repeated at future dates to gauge the effectiveness of therapy and other interventions.

Conclusions

Carpal tunnel syndrome is a serious problem for the elderly.

It is treatable, but treatment is most effective when started while the condition is in an early stage. Carpal tunnel syndrome should be suspected when patients – old or young – present with symptoms even loosely characteristic of the condition. These patients should promptly undergo electrodiagnostic testing to establish or rule out carpal tunnel syndrome as the diagnosis.

However, a problem with electrodiagnostic testing is that often the interpretation of the raw data is reported in ambiguous terms. Worse, delivery of the unhelpfully vague report takes many long weeks, during which time the specialist who performs the interpretation is uncommunicative.

At the medical offices of Eric R. Beck, MD, PhD, FAAPMR, none of these shortcomings exists. We are very clear as to whether a study comes back normal or abnormal; if the latter, we then spell out the degree of severity so that you can confidently proceed with treatment planning. Further, we offer extremely rapid turnaround on our reports of findings:

Typically, we put a summary report in your hands within 24 hours and a full report a short time later.

We also see your patients quickly, usually seven days after we are contacted with a request to schedule an appointment.

Once your patient arrives here, he or she is treated with utmost courtesy. Moreover, we strive to make the examination as painless and stress-free as possible by offering ethyl chloride numbing of the skin prior to needle testing.

We welcome your referrals of patients suspected of carpal tunnel syndrome and other musculoskeletal-neurologic problems. We can perform comprehensive evaluations of your patients and, if you desire, initiate treatment and perform follow-up, keeping you apprised every step of the way. But no matter the way you choose to utilize us, know that your patients will be satisfied by the high-quality services and interactions delivered at each encounter and will return to you as willing as ever to continue entrusting you with their ongoing care.

For more information about carpal tunnel syndrome diagnosis and treatment, please call Valley Center for Nerve Studies in Huntsville, Fort Payne and Birmingham, Alabama at (256) 382-1603.

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