Carpal Tunnel Syndrome can be very painful, numbing in fact.
Women tend to get it twice as much as men. Pregnant women tend to get it. Those with diabetes are prone to it. And anyone who does a lot of keyboarding, may think they have it but studies show that carpel tunnel doesn't surface with excessive keyboarders.
Dr. Thomas Trumble, chief hand surgeon at University of Washington Medicine's School of Orthopaedics and Sports Medicine has been practicing since 1980 and has made significant inroads into care and treatment of those with carpal tunnel. He has helped grow the use of endoscopic surgery on carpal tunnel patients. Endoscopy is a non-invasive method of surgery that uses a device that looks something like a gun with a long white snout containing a blade assembly and fiber optics.
By making the tiniest incision in the hand or wrist area, Trumble can use the device to navigate inside the fascia of the hand, and find the median nerve in the carpal canal, the key nerve that supplies sensation to the hand. Before endoscopy, the hand was opened up.
The more invasive process added risk to damaging the sensitive and delicate nerves-damage that can't be undone.
"I feel pretty confident that we've developed a fairly dramatic improvement in carpal tunnel surgery," Trumble said. "We've made a lot of gains that we've always wanted to make, resolving the problems with very low chances of them coming back."
Trumble recently returned from Chicago where he attended the annual conference of the American Society for Surgery of the Hand.
Among the many papers presented, one looked into a new, chemical treatment of Dupuytren's Disease, which is an abnormal thickening of the tissue just beneath the skin of the palm.
It starts with lumps in the palm and develops into firm cords that stretch from the palm and into the fingers, pulling the fingers into a curl, making the hand useless.
People of Scandinavian descent are particularly susceptible to the hereditary disease, which means a lot of folks in Seattle are susceptible. The presentation in Chicago talked about an enzyme that is used to dissolve the cords of Dupuytren's Disease.
"The company called Auxilium, they make a drug, which is some distant cousin of what's in meat tenderizer," Trumble said. "We've done some trials with an earlier version of it and set up our own trials." If and when the injectable drug gets Federal Drug Administration approval, many people in this area can get some relief.
That kind of chemical solution may be on the horizon for sufferers of Carpel Tunnel Syndrome, even as Trumble continues to shepherd non-invasive endoscopy.
"The major option is being able to do surgery even with less invasive techniques and know how much it needs to be corrected," Trumble said. He likened Auxilium's drug solution for Dupuytren's Disease to what could be done for carpal tunnel.
The transverse carpal ligament, he believes, is the culprit to most carpal tunnel cases. When that ligament thickens over time, it presses down on the median nerve essentially shutting it down and causing numbness in the hand.
If a drug could be developed to reduce the thickening of the transverse carpal ligament, then "that would be something very interesting," he said. "With the advances to deliver medication so exactly...I think it's a possibility."
But currently, Trumble knows of no pharmaceutical company working on any drug for that. "Until you can make sure it can work in one setting, it's probably not quite worth the risk of venture," he said.
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