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Understanding Carpal Tunnel Release Surgery: Everything You Need to Know

Understanding Carpal Tunnel Release Surgery: Everything You Need to Know

Carpal tunnel syndrome is a prevalent condition that affects millions worldwide, causing pain, numbness, and tingling in the hand and wrist. If you or someone you know is struggling with this condition, carpal tunnel release surgery may be a viable solution. This article provides a comprehensive guide to understanding carpal tunnel syndrome, the necessity and procedure of carpal tunnel release surgery, and how to treat carpal tunnel syndrome effectively. By reading this, you’ll gain valuable insights into the condition and the surgical intervention, helping you make informed decisions about your health.

Outline

  1. What is Carpal Tunnel Syndrome?
  2. What Causes Carpal Tunnel Syndrome?
  3. What are the Symptoms of Carpal Tunnel Syndrome?
  4. How is Carpal Tunnel Syndrome Diagnosed?
  5. Non-Surgical Treatments for Carpal Tunnel Syndrome
  6. When Do You Need A Carpal Tunnel Release Procedure?
  7. Types of Carpal Tunnel Release
  8. What to Expect During Carpal Tunnel Surgery
  9. Post-Surgery Recovery: What to Expect
  10. Hand Therapy After Carpal Tunnel Surgery
  11. FAQs About Carpal Tunnel Release Surgery

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a condition caused by pressure on the median nerve at the wrist. This nerve runs from the forearm into the palm and controls sensations to the palm side of the thumb and fingers (except the little finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move. The “carpal tunnel” is a narrow, rigid passageway of ligaments and bones at the base of the hand that houses the median nerve and tendons.

What Causes Carpal Tunnel Syndrome?

Carpal tunnel syndrome can be caused by several factors that increase pressure on your median nerve and tendons in the carpal tunnel. This increased pressure may be due to repetitive motions of the hand and wrist, such as typing or assembly line work, which can cause swelling and inflammation in the affected hand. Other contributing factors include wrist injuries, certain medical conditions like diabetes or rheumatoid arthritis, and fluid retention during pregnancy or menopause.

What are the Symptoms of Carpal Tunnel Syndrome?

The symptoms of carpal tunnel syndrome usually start gradually and include frequent burning, tingling, or itching, numbness and pain in the palm of the hand and fingers. The symptoms often first appear in one or both hands during the night. As symptoms worsen, people might experience numbness during the day, particularly when holding objects like a phone or a book. In severe cases, the muscles at the base of the thumb may weaken, making it difficult to grip objects.

How is Carpal Tunnel Syndrome Diagnosed?

The diagnosis of carpal tunnel syndrome begins with a detailed patient history and physical examination. Your therapist will check for signs of numbness and tingling in the fingers and hand and test the strength of the muscles in the hand. Diagnostic tests such as nerve conduction studies or electromyography (EMG) may be used to measure how well the median nerve is functioning and to rule out other conditions that might cause similar symptoms.

The pressure on a nerve creates a predictable pattern of tingling in your hand. When you bend your wrist or the therapist taps your wrist over the path of the nerve (Tinel’s Sign), you will often experience tingling or “pins and needles” in your thumb, index finger, middle finger and half of the ring finger. Another test is Phalen’s Test (see picture below). This position will often reproduce your symptoms.

Non-Surgical Treatments for Carpal Tunnel Syndrome

Before considering surgery, doctors often recommend trying nonsurgical treatments first. These treatments include:

  • Wrist Splints: Wearing a wrist splint at night can help relieve symptoms by keeping the wrist in a neutral position and reducing pressure on the median nerve.
  • Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce pain and inflammation.
  • Lifestyle Changes: Modifying activities that exacerbate symptoms, such as reducing repetitive hand movements or taking frequent breaks.
  • Steroid Injections: Corticosteroids can be injected into the carpal tunnel to reduce inflammation and alleviate symptoms temporarily.

When Do You Need Carpal Tunnel Release Procedure?

You may need carpal tunnel release if nonsurgical treatments fail to relieve your symptoms, or if you have severe symptoms like constant numbness or weakness in your hand or your symptoms are progressively getting worse. Surgery may be necessary to prevent permanent nerve damage and restore function to your hand and wrist.

Types of Carpal Tunnel Release

There are two main types of carpal tunnel release:

  1. Open Carpal Tunnel Release: The surgeon makes an incision in the palm of the hand over the carpal tunnel and cuts through the transverse carpal ligament to release the pressure on the nerve.
  2. Endoscopic Carpal Tunnel Release: This involves one or two smaller incisions and the use of a tiny camera (endoscope) to guide the surgeon as they cut the ligament. Compared to open release, endoscopic surgery usually results in less postoperative pain and a quicker recovery.

What to Expect During Carpal Tunnel Surgery

During carpal tunnel surgery of the hand, the patient is usually given local anaesthesia to numb the hand and wrist. Although in some instances general anaesthesia may be given.  The surgeon then makes an incision in the palm or wrist to access the carpal tunnel. The transverse carpal ligament is located and the surgeon cuts through the ligament to relieve the increased pressure on the median nerve. The procedure typically lasts about 15–30 minutes, and most patients can go home the same day. 

Post-Surgery Recovery: What to Expect

After surgery, the wrist will be bandaged, and you may need to wear a wrist splint to keep the wrist in a neutral position. Pain and swelling are common in the first two to three days but can be managed with medications like ibuprofen. Initially, it is common to still feel numbness, and you may still feel pain in your hand. This is quite normal and will usually subside with treatment.

It’s important to keep the surgical scar clean and dry and to follow your surgeon’s instructions for care. Recovery time varies, but many people can stop taking any painkillers after 1–2 weeks and can return to work within a few weeks, although full recovery may take several months.

Hand Therapy After Carpal Tunnel Surgery

Hand therapy is an essential part of the recovery process after carpal tunnel release. A hand therapist will guide you through exercises to improve strength and flexibility in your hand and wrist. These exercises help reduce stiffness and prevent scar tissue from limiting your range of motion. It’s crucial to follow your therapist’s instructions to ensure you are able to move your fingers, wrist and hand as normal. 

FAQs About Carpal Tunnel Release Surgery

Q: How do I know if I need carpal tunnel release surgery?

A: You may need surgery if nonsurgical treatments haven’t worked, or if you have severe symptoms like constant numbness or weakness in your hand. Your doctor will let you know if surgery is the best option.

Q: What are the risks associated with carpal tunnel release surgery?

A: Like any surgical procedure, carpal tunnel release surgery carries some risks, including infection, nerve damage, and persistent symptoms. However, it is generally considered safe, and most patients experience significant relief from their symptoms.

Q: How long does it take to recover from carpal tunnel release surgery?

A: Recovery time varies, but many people can go back to work within a few weeks. Full recovery, including regaining strength and flexibility in your hand and wrist, may take several months.

Summary

  • Carpal tunnel syndrome is caused by pressure on the median nerve at the wrist.
  • Symptoms include numbness, tingling, and weakness in the hand.
  • Non-surgical treatments include wrist splints, medications, lifestyle changes, and steroid injections.
  • Carpal tunnel release surgery may be necessary if nonsurgical treatments fail or symptoms are severe.
  • There are two types of surgery: open and endoscopic.
  • Post-surgery recovery involves pain management, keeping the surgical area clean, and hand therapy.
  • Most patients can return to work within a few weeks, but full recovery may take several months.

Our team of Advanced Specialist Hand Therapists are here to guide you through your recovery. You can book to see one of them by contacting our Reception team on 02074046343 or [email protected].

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