Thanks for your comments. If you come up with anything else let me know. This is just a little of my theories. I think another factor involved is fascia but thats another long discussion. Thats why I am not a fan of the idea of surgery like decompression. Although decompression cuts the fascia, it is also creating scar tissue in there. Its kind of a catch 22. Many carpal tunnel surgeries fail years down the road as that scar tissue develops and causes problems. I have seen the medical journal articles that show recurrence after surgery. Ulnar decompression is fairly new and there is not a lot of data out yet in what the long term is. Blah, Im babbling....

With regard to the scar tissue, I think it depends on how masterful one's surgeon is. From what I've read, the recurrence rate for decompression surgery is about 5%, and it's not because the surgery itself failed but rather there were other sites of compression that were not addressed during the procedure. However, the recurrence rate jumps up to 20% for those who have thoracic outlet syndrome or are diabetic. For carpal tunnel, the rate of recurrence is even lower at 1%.

While simple decompression is just now becoming widely used in the U.S., Europe has been doing it longer. In fact, it doesn't seem that transposition is even performed over there unless there is a clear deformation of the elbow.

Gettingonmynerves,

I wanted to quickly respond to your post. I haven't been on in a while so sorry for the delay. Anytime you have surgery there is scar tissue. I have seen it every time I am in the OR and we are operating on an area where there has been a previous surgery. I have personally seen many patients have to have repeats of CTS surgeries to CUT AWAY SCAR TISSUE that has impinged the nerve. Most of the data I have read on uptodate.com which is one of the best medical resources that physicians use today, shows that decompression is a fairly new procedure and the studies done so far are few and are poor design models. There are no comparison groups or double blinds studies. Its all retro-analysis. That is why I am not yet convinced about surgery in my circumstance. I could be completely wrong though in my doubts.

Spongeracer,

I had no idea you were actually assisting/observing/performing surgeries, so I bow to you. I'd be interested in knowing what percentage of cts patients eventually undergo surgery to remove scar tissue. It's just that I've read on several hospital/ortho sites that recurrence after cts is on the order of 1 - 5%. Is it perhaps the case that while you have seen several 2nd procedures with cts, there are far more that are successful long-term since it's such a common condition? My ortho said the same with regard to unknown long-term effects of simple decompression, but he said that was more an issue of the nerve's tension as it bends around the epicondyle, which as you know, is decreased by transposition.

I had simple decompression performed on my left elbow, and hopefully scar tissue won't be an issue down the road.

i have to agree with you. actually i can tell you exactly how mine started. i go outside to smoke adn chat on the phone. i was sitting in a folding camping chair with a soft arm. my husband upgraded me to a fancy new chair with a hard plastic arm. being that im right handed i would prop my elbow right on the spot where my ulnar nerve was pinched. after a few months i noticed the numbness and tingling coming and going adn then it was permanent. also happened at night when i slept on my arm under the pillow. it got to the point where i couldnt open doors, jars, ect. i had the transposition surgery and almost think i was better off before. im almost 1 yr. post op and im finally feeling better. still have mild numbness and tingling. oh well i tried! still have not recovered my strength. its is still very sensitive and my whole forearm is completely numb. i went to 1 therapy they didnt do much other than nerve glides and sensitivy things. i actually started playing darts adn that was the best part of therapy! not only that i am really good at it now. i like to think i have a super arm when it comes to aim. something i never had before! i swear it helped tons!

Dear Jace,

I note from this post that you are a 3rd year medical student in Michigan. I have a favor to ask.

I live in Midland, seem to have CuTS, but am suffering from a lack of local expertise. Can you recommend a few places/doctors in Michigan (or nearby states) where I could contact to seek expert diagnosis and treatment for my condition?

I'm willing to drive a ways, and would be willing to use facilities which are relatively costly in hopes of getting the diagnosis (key part of fixing any illness) right.

Thanks so much! Hope you're still reading your replies, even though I know this post isn't quite on topic.

Dick