there different kinds of pain?
Yes. Pain is classified as neuropathic (derived from diseased or compressed nerves or
nervous tissue structures) or inflammatory (caused by
inflammation of tissues). Examples of neuropathic pain include
peripheral neuropathies or nerve compressions caused by scars
or tumors. Inflammatory pain can be very diverse in its
specific cause such as inflammation associated with specific
disorders, trauma, surgery, burns or arthritis. Inflammatory
conditions can also cause tissue damage and nerve compressions
and the pain may be mixed in nature (both, inflammatory and
neuropathic). It is important that the physician identifies
correctly the neuropathic or inflammatory mechanisms
underlying a patientís pain because the medications and
strategies used to treat each of these are different.
Carpal Tunnel Treatment Without Surgery?
Carpal tunnel syndrome can
produce a spectrum of symptoms ranging from mild tingling
in the hand or fingers to numbness to severe hand pain,
wrist pain with or without associated arm pain. It is the
result of a compression of the median nerve at the carpal
ligament. Some patients are awakened by the pain. The hand
grip can get weak and patients may complain of dropping
objects. It is more frequently (but not necessarily)
associated with patients using their hands excessively
such as computer operators. It also shows a higher
prevalence in patients with diabetes and in pregnancy,
although there are many cases of carpal tunnel syndrome
that occur in isolation. Some rare cases of amyloidosis
(deposition of an abnormal substance due to several
conditions) can also show higher incidence of carpal
tunnel syndrome. One or both hands can be involved.
Our treatment is
based in the scientific medical literature and we obtained
more than 95% relief within 24 hours (see below). Studies
in the literature show that WITHOUT surgery, more that 75%
patients with carpal tunnel syndrome will not deteriorate.
In fact, the majority will improve with non surgical
therapy (2). There are many, many approaches in the
literature for non-surgical treatment of carpal tunnel
syndrome ranging from nutritional supplements to physical
therapy devises. Some of them work, some do not, contrary
to claims. Our therapy ONLY follows verifiable
evidence-based medicine guidelines (evidence supported by
high quality clinical trials).
1-Adv Ther. 2009 Jan;26(1):107-16. Epub 2009 Jan 22.
2-Clin Neurophysiol. 2008 Jun;119(6):1373-8. Epub 2008 Apr
THERE ARE MANY PEER REVIEWED SCIENTIFIC CLINICAL STUDIES
SUPPORTING OUR TREATMENT APPROACH. BELOW IS ONE OF SEVERAL
CLINICAL TRIALS CONDUCTED AT A UNIVERSITY HOSPITAL.
JOURNAL CITATION: Adv Ther. 2009 Jan;26(1):107-16. Epub
2009 Jan 22.
Evaluation of the clinical efficacy of conservative
treatment in the management of carpal tunnel syndrome.
INTRODUCTION: Carpal tunnel syndrome (CTS) is impingement
of the median nerve at the wrist. The aim of this study
was to compare the effectiveness of tendon and nerve
gliding exercises with standard conservative treatment (SCT),
which consists of splinting and local steroid injections,
in the treatment of CTS. METHODS: This study was a
prospective, randomized, single-blind trial. Patients were
randomized into three groups: treatment with SCT (Group
1); SCT and tendon and nerve gliding exercises (Group 2);
tendon and nerve gliding exercises only (Group 3). A
symptom total point score was obtained from five symptoms:
hand pain, tingling, numbness, nocturnal numbness, and
interrupted sleep. The functional status of the hand was
determined by assessing seven daily living activities:
writing, buttoning clothes, gripping a telephone receiver,
opening jars, doing housework, carrying grocery bags, and
bathing. Standard physical examinations (Tinel's test,
Phalen's test, reverse Phalen's test, and the compression
test) were also performed. RESULTS: A total of 111
patients who were diagnosed with intermediate-stage CTS
were included in the study. At the end of treatment,
significant improvements in symptoms and functionality
were detected in all groups. However, the recovery of
patients in Groups 1 (n=41) and 2 (n=35) were found to be
significantly greater than that of patients in Group 3
(n=35; P<0.001). Patient satisfaction was investigated a
mean of 11 months after treatment. Percentages of
asymptomatic patients in Group 1 and Group 2 were
significantly higher than in Group 3 (P=0.02 and P=0.04,
respectively). CONCLUSION: In the intermediate stage of
CTS, SCT was an effective treatment to improve symptoms
and functional status. Tendon and nerve gliding exercises
alone were inferior to either SCT alone or SCT in
combination with gliding exercises.