Effective Carpal Tunnel Syndrome Treatment Options in Anchorage, AK: What Works and Where to Go

Introduction

Carpal Tunnel Syndrome (CTS) is a common condition affecting many people in Anchorage, Alaska and elsewhere. An entrapment neuropathy, it affects the median nerve at the wrist.

Symptoms include numbness,tingling, and weakness in the hand, especially in the thumb and fingers. Treatments vary with the severity of the condition which ranges from mild to moderate and even severe.

This brief guide breads down the scientifically backed treatment options and the appropriate providers for each. 

I. Conservative and Nonsurgical Interventions

A. Wrist Splinting (Nighttime Use)

One conservative, nonsurgical tactic used is wrist splinting – which is particularly useful at night. It is best used for mild to moderate CTS in the early stages of the condition. It works by keeping the wrist in a neutral position. This helps relieve pressure on the median nerve while the patient sleeps.

In terms of supporting evidence, a 2003 systematic review on the Cochrane Library found that wrist splints are effective for short-term use.¹ 

Patients seeking a wrist splint should seek out hand therapists, occupational therapists, and orthopedic clinics. The following clinics in Anchorage, AK offer such services:

• Orcaak
• Alaska Hand Rehabilitation
• Algone Anchorage Interventional Pain Clinic
• Alaska Orthopedic Specialists

B. Physical and Occupational Therapy

Another option for patients in Anchorage are physical and occupational therapy. These are excellent methods for treating mild to moderate CTS, especially for those cases that are related to work.

There are a number of science-backed therapies that PT and OT experts can provide like nerve gliding exercises, ergonomic training, and activity modification. A study on Elsevier on Science Direct found moderate evidence to support the effectiveness of several physical therapy modalities for treating CTS.²

The best places to seek out such care are at physical therapy and occupational therapy clinics – especially those that specialize in hand rehabilitation. In Anchorage, AK the following list should serve you well:

• Alaska Hand Rehabilitation
• Alaska Fracture & Orthopedic Clinic  – Physical Therapy
• Core Kinetics Orthopedic Therapy and Physical Rehabilitation
• Better Health Alaska

C. Chiropractic Care

Another effective conservative form of therapy for CTS is chiropractic care. It is best for mild to moderate conditions, especially when mechanical wrist or cervical involvement (an issue originating in the neck) is suspected.

Generally, chiropractic care for CTS, like that found at Better Health Alaska in Anchorage, will involve manual manipulation of the wrist, elbow, and cervical spine to reduce nerve compression and improve overall biomechanics.

A study on Europe PMC from 1998 found that chiropractic care was effective in treating some forms of carpal tunnel syndrome.³ 

For people suffering from CTS in Anchorage, AK, a great place to start is a chiropractic office like:

• Better Health Alaska

D. Corticosteroid Injections

Another treatment option for CTS is corticosteroid injections at the site of inflammation around the median nerve. This option is best for cases of moderate CTS or in situations where splinting has proven ineffective. The injection serves to reduce the aforementioned inflammation around the nerve, thereby bringing relief.

Patients seeking this treatment should go to a pain management specialist, an orthopedic surgeon, or a sports medicine physician. Clinics in Anchorage, AK that offer such include:

• Algone Anchorage Interventional Pain Clinic
• OPAlaska
• Alaska Orthopedic Specialists

II. Surgical Treatments

A. Open Carpal Tunnel Release Surgery

When conservative methods fail, or the condition is simply too severe, the patient may have to undergo surgery. One such option is open carpal tunnel release surgery which is best for cases of severe CTS, muscle atrophy, or, as noted, failed conservative therapy.

This procedure involves surgically cutting the transverse carpal ligament to relieve pressure on the median nerve. Caregivers who may perform this type of surgery include orthopedic hand surgeons, and plastic surgeons who specialize in nerve conditions.

A study by the NIH on PubMed Central found that “Standard open carpal tunnel release still provides efficacious symptomatic relief with a low risk of associated complications when performed by a general surgeon.”⁴

The following locations in Anchorage, AK provide this type of surgery:

• Orcaak
• Alaska Fracture & Ortho Clinic
• Orthopedic Surgeons Alaska

B. Endoscopic Carpal Tunnel Release

Another surgical option is endoscopic carpal tunnel release. This option is better for patients who want to recover more quickly and to experience less scar sensitivity. This is a minimally invasive procedure that uses a scope.

This type of procedure is available at specialized surgical centers or orthopedic surgery units offering endoscopic procedures. In Anchorage, AK, the following locations offer it:

• Orcaak
• Algone Anchorage Interventional Pain Clinic

III. Adjunct and Emerging Therapies

A. Ultrasound-Guided Hydrodissection

New technologies and techniques are emerging all the time. One of the more recent developments for CTS treatment is ultrasound-guided hydrodissection. It is a technique best used for cases of mild to moderate CTS – especially in those cases with recurrent symptoms.

The procedure works by injecting saline or an anesthetic into the wrist to separate the nerve from the surrounding tissue. This reduces compression and helps other treatments (i.e. nerve glide exercises, etc…) work more effectively.

This procedure may be available at some pain clinics, physical medicine and rehab (PM&R) specialists, and sports medicine clinics with ultrasound expertise.

B. Platelet-Rich Plasma (PRP) Injections

Another recent development in the fight to get rid of carpal tunnel syndrome is platelet-rich plasma (PRP) injections. This is best for mild to moderate cases of CTS. It is an alternative to corticosteroids and involves injecting platelet-rich plasma at the site of injury to speed healing. It can typically be found at regenerative medicine clinics and sports medicine centers.

The following clinics and offices offer PRP injections:

• Better Health Alaska
• Orcaak
• Arctic Medical Center
• Algone Anchorage Interventional Pain Clinic

IV. Where to Seek Comprehensive CTS Care

Taking care of carpal tunnel syndrome is a multi-step process that typically involves interaction between the patient and multiple types of caregivers. The foregoing information might be a little confusing with all the details of where and what to seek to help treat CTS. In light of that, we’ve constructed the following chartthat sums up what type of treatment each type of caregiver provides to the CTS patient:

Conclusion

All told, carpal tunnel syndrome has multiple effective, scientifically supported treatment options. Early diagnosis combined with choosing the correct treatment according to symptom severity is critical in constructing an effective care plan. Patients should seek care from certified specialists in neuromuscular and orthopedic fields.

Here at Better Health Alaska we combine multiple specialties under one roof. Our team of caregivers includes multiple chiropractors, physical therapists, massage therapists, and more. So, contact us today and schedule an appointment. We’ll get your CTS under control and on the road to healing.

Sources and Studies:

1. O’Connor, et al., “Non‐surgical treatment (other than steroid injection) for carpal tunnel syndrome,” Cochrane Database of Systematic Reviews, January 20, 2003, DOI: 10.1002/14651858.CD003219
2. Huisstede, B. M. PhD, et al., “Carpal Tunnel Syndrome: Effectiveness of Physical Therapy and Electrophysical Modalities. An Updated Systematic Review of Randomized Controlled Trials,” Archives of Physical Medicine and Rehabilitation, Vol. 99, Iss. 8, (Aug. 2018) Pages 1623-1634.e23, https://www.sciencedirect.com/science/article/abs/pii/S0003999317310948 
3. Davis, PT, et al., “Comparative efficacy of conservative medical and chiropractic treatments for carpal tunnel syndrome: a randomized clinical trail.” Journal of Manipulative and Physiological Therapeutics, 01 Jun 1998, 21(5):317-326
   PMID: 9627862, https://europepmc.org/article/med/9627862?utm_source=cowc_notset&utm_medium=cowc_notset&utm_campaign=cowc_notset&client=bot&client=bot  
4. Badger, S. A., et al., “Open Carpal Tunnel Release – still a safe and effective operation,” Ulster Medical Journal, 2008 Jan;77(1):22–24. https://pmc.ncbi.nlm.nih.gov/articles/PMC2397012/