CARPAL TUNNEL TREATMENT TRIAL NOTES

Notes: The main supply of blood to the hand for an early stage fetus in the womb is the median artery which passes through the carpal tunnel. This is followed, in development, by the anterior interosseous, which is finally replaced by early childhood, with the ulnar and radial arteries as the principal blood supply of the hand in the majority of the population.

Some studies suggest that people suffering carpal tunnel syndrome may also have what is known as a persistent median artery.7 -8 The persistent median artery remains unusually large in some people and can be as large as 3 mm in diameter compared to the average found in one study of 1.1 mm. It is the belief of this investigator that a few millimeters of incremental space in and around the carpal tunnel, (where important nerves, vessels and tendons function in close proximity) can be the difference between chronic pain and restful relief leading to active vitality. The above study found that twenty three percent of the population studied had a persistent median artery. A persistent median artery may be a contributing factor in some people suffering from carpal tunnel syndrome.

References:

1. Gerritsen AA, de Krom MC, Struijs MA, Scholten RJ, de Vet HC, Bouter LM. Conservative treatment options for carpal tunnel syndrome: a systematic review of randomised controlled trials. J Neurol 2002;249:272-80.

2. Spooner GR, Desai HB, Angel JF, Reeder BA, Donat JR. Using pyridoxine to treat carpal tunnel syndrome. Randomized control trial. Can Fam Physician 1993;39:2122-7.

3. Chang MH, Chiang HT, Lee SS, Ger LP, Lo YK. Oral drug of choice in carpal tunnel syndrome. Neurology 1998;51:390-3.

4. Pal B, Mangion P, Hossain MA, Wallace AS, Diffey BL. Should diuretics be prescribed for idiopathic carpal tunnel syndrome? Results of a controlled trial. Clin Rehabil 1988;2:299-301.

5. Stransky M, Rubin A, Lava NS, Lazaro RP. Treatment of carpal tunnel syndrome with vitamin B6: a double-blind study. South Med J 1989;82:841-2.

6. Herskovitz S, Berger AR, Lipton RB. Low-dose, short-term oral prednisone in the treatment of carpal tunnel syndrome. Neurology 1995;45:1923-5.

7. Anthony J. Viera, Management of Carpal Tunnel Syndrome, American Academy of Family Physicians July 15, 2003.

8. Gassner EM, Schocke M, Peer S, Schwabegger A, Jaschke W, Bodner G. Persistent Median Artery In The Carpal Tunnel: Color Doppler Ultrasonographic Findings.

9. Fumiere E, Dugardeyn C, Roquet ME, Delcour C. US Demonstration of a Thrombosed Persistent Median Artery in Carpal Tunnel Syndrome.

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