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Home / ‘Proof’ about Carpal Tunnel Syndrome

‘Proof’ about Carpal Tunnel Syndrome

Posted on August 10, 2007 by Badia Hand to Shoulder Center

'Proof' about Carpal Tunnel Syndrome

Letter: ‘Proof’ about Carpal Tunnel Syndrome Published on Saturday, August 18, 2007 Dear Sir, I would like to respond to Ms Christina Dumal’s letter of August 2, 2007 in which she asked for “proof” of my statement that repetitive activities, such as using a computer keyboard, are not the cause of carpal tunnel syndrome. Her concern allows me to elaborate on certain points which were not addressed in the series, The Truth About Carpal Tunnel Syndrome (CTS) which recently appeared in your newspaper. No, we don’t yet know what causes carpal tunnel syndrome. We don’t know exactly what causes the diffuse tendon sheath thickening in the carpal canal that then compromises the median nerve. However, we do understand the pathophysiology and know that certain medical conditions predispose patients to developing CTS: rheumatoid arthritis, diabetes, thyroid conditions, even menopause. It is entirely possible that future research will determine that in certain patients, obesity, genetics (inherited traits such as the structure of the carpal tunnel canal) and even today’s often poor, high fat diet, or excessive alcohol and caffeine consumption may be contributing factors that produce metabolic changes leading to CTS. We already suspect a strong metabolic connection. I’d like to make the analogous comparison to our knowledge of cancer. We understand the histology, cell types and progression of the disease, but we don’t really know the cause—likely aberrant genes, perhaps triggered by undiscovered viruses or prions—and certainly not some simple activity. Ms. Dumal asked for proof that carpal tunnel syndrome is not “work related” and by that I assume she means caused by jobs that require repetitive motion activities. That proof can be found in findings of numerous scientific studies conducted during the past 15 years, many of which have been published in leading medical journals, including the Journal of the American Medical Association (JAMA). One of the leaders in CTS research is Dr. Peter Nathan of the Portland Hand Surgery and Rehabilitation Center in Portland, Oregon. His landmark 11- year study, involving of hundreds of subjects representing a very diverse range of ages, was one of the first definitive studies that found no relationship between repetitive activity and the compression of the median nerve within the carpal canal. That compression of the nerve is what causes the symptoms of CTS. Another often cited study conducted by Oregon State University’ medical department reinforced this finding, as Dr. Richard Kinston, working with Dr. Nathan confirmed: “In fact, the job studied requiring the most intense repetitive motions, keyboard data entry, actually had a significantly reduced risk for CTS in over 2600 subjects studied. Ongoing studies conducted at the Mayo Clinic in Rochester, MN continue to provide the proof Ms. Dumal seeks. Many of these published findings can be accessed online through university and public library systems, often at no charge. These and other epidemiological studies have demonstrated that so called” repetitive stress injury” has no relationship to compression neuropathies. There are other well-known researchers whose studies have shown that people with repetitive motion jobs don’t experience any more aches or pains in their hands than the population at large. Despite published scientific data that repetitive activity is not the cause of CTS, this mythical link seems impossible to correct. The media, and even members of the medical community, choose to ignore the evidence refuting this fallacy. If in fact, repetitive activities “caused CTS” then every computer user, video game player and typist would develop CTS. Much of the world’s professional work force would be disabled due to such widespread computer use. Not only is this obviously not the case, but many CTS sufferers I have treated have never used a computer or keyboard of any kind, or performed any repetitive activities whatsoever. Ms. Dumal asks why “recurrence is so high (for CTS) when one returns to the same job that involves what many researchers believe contributes to this syndrome, such as repetitive motion…” This is simply not true. Resuming prolonged repetitive activities can aggravate the symptoms of CTS once a patient experiences the onset of those symptoms—this is not a “recurrence of CTS.” Logically, how could you expect to do the same thing and have different results? An important component of conservative treatment advises the patient to change his work habits if the job requires such activities; take breaks from those activities frequently, rest, and stretch. With proper evaluation by a hand specialist and early treatment, the majority of patients experience relief from CTS symptoms. If a patient fails to respond to conservative treatment, then a simple surgical procedure called endoscopic carpal tunnel release, discussed at length in the series, has proved extremely effective in relieving CTS symptoms and those symptoms have a very, very low recurrence rate. I hope that if Ms. Dumall herself is suffering from CTS symptoms she will overcome her suspicion and fear and be evaluated by a hand specialist. I welcome any readers with concerns or questions to contact me through my website, https://www.drbadia.com/. It’s important to understand the medical facts about CTS and know that treatment is not only available to you, but also quite simple. Dr. Alejandro Badia Miami, FL


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I am really satisfy with my hand surgery that was done by Dr. Alejandro Badia, and I want to thanks all the... professional personal and staff that always are very kind. I highly recommended!read more
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Dr. Badia is an outstanding Dr and surgeon. I first sought his expertise, in late 2013, after a misdiagnosis and a... botched surgery by another Dr that left me with unbearable pain and unable to move my right hand for months. After doing some research online, looking for some excellent hand surgeons, a lot of articles came up praising Dr. Badia's expertise and competence. I sent him an email explaining what happened, how the pain started and asked for his opinion. To my surprise, I received a thorough response the same day with detailed information. I right then decided to drive 4hours to go see him; I must say it was the best decision I made. From the 1st visit, Dr. Badia performed surgery to fix the initial issue and later did another surgery to correct the botched one; I couldn't be happier with the results. Earlier this year, I slipped and injured my left wrist. I made another trip to Miami and once again Dr. Badia came to the rescue. He did surgery on my left wrist after the conservative treatment didn't fully help and at the same time did a cubital nerve release on my right elbow that instantly stopped the pain I've been having. I HIGHLY recommend Dr. Badia; he's a true expert and an outstanding surgeon. His staff is very kind, professional, friendly and truly cares.read more
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I first contacted Dr. Badia's clinic after I injured my hamate bone. I needed a surgery and someone in my family that... knew Dr. Badia convinced me that he was one of the best if not the best hand surgeon in the world. I am a high level Baseball player so I needed treatments in order to get back on the field as soon as possible. I have been able to book an appointment the next week which was great. I'm Canadian which made it tougher with my insurance company, but Dr. Badia's team has been really helpful with that, they sent numerous emails and even made some calls with the company to make sure I would not have any fees related to the consultation and surgery. The surgery went really well, without any complication and I don't think it would have been as quick and easy with anyone else than Dr. Badia and his team. I would definitively recomand Badia Hand to Shoulder Center to anyone in the need of treatments.read more
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The Dr and staff are professional and friendly. I’m happy I came here and I received the attention and answers I... needed. I had injured my hand and I left the office feeling better. Thank you all for everything!!!read more
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Staff displayed professionalism and caring. Dr. Badia was as enthusiastic as I was about this surgery to improve the... function of my hand. The surgical day process was smooth; I was kept informed every step of the way. I felt comfortable and safe.read more
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From the first call I made to Dr. Badia‘s office I was impressed by the professionalism of the person who answered... the phone. When I arrived at the office for my appointment I was once again greeted in a professional manner. This professionalism radiated through all of the team. I hadn’t seen Dr. Badia for over 10 years and he greeted me as if we’ve been in contact with each other for years.read more
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From my first visit the staff as well as the Dr. Badia have been exceptionally professional and caring. I had an injury... to my pinky finger, the required a placement of a rod in order to align. The surgery went well and was scheduled right away. The office staff has been amazing with scheduling and confirming appointments. Overall I am very happy with the care i received as well as the results. My finger healed and my range of motion has also gotten much better. Thank you Dr. Badiaread more
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