Why Might I Need Carpal Tunnel Surgery
A diagnosis of carpal tunnel syndrome is about the only reason to have a carpal tunnel surgery. And even then, your doctor will likely want you to try nonsurgical treatments first. These may include over-the-counter pain medicines, physical therapy, changes to the equipment you use at work, wrist splints, or shots of steroids in the wrist to help relieve swelling and pain.
The reasons that a doctor would recommend a carpal tunnel release surgery may include:
- The nonsurgical interventions for carpal tunnel syndrome don’t relieve the pain.
- The doctor performs an electromyography test of the median nerve and determines that you have carpal tunnel syndrome.
- The muscles of the hands or wrists are weak and actually getting smaller because of the severe pinching of the median nerve.
- The symptoms of carpal tunnel syndrome have lasted 6 months or longer with no relief.
What Is The Difference Between Endoscopic And Open Surgery For Cts
Endoscopic carpal tunnel release is a means of dividing the ligament that is placing too much pressure on the median nerve from the inside out. It involves a smaller incision and a slightly faster recovery, but usually requires general anesthesia or intravenous sedation. Open carpal tunnel surgery involves a longer incision, but can be performed under local anesthesia. This may be a better option for patients who are at higher risk for complications during general anesthesia. In the long run, both approaches yield similar results. Rarely, a patient scheduled to undergo endoscopic carpal tunnel surgery ends up being converted to an open approach. The most common reason for this is the inability to get a clear view of the ligament through the camera at the time of surgery, usually because of swollen tissue or unusual anatomy. Both are outpatient procedures.
How Long Does It Take To Recover From Endoscopic Carpal Tunnel Surgery
Grip and pinch strength usually return by about 2 months after surgery. You may have some soreness and weakness in the hand for up to 6 months after surgery. If you still have pain or weakness after 2 months, your doctor may recommend that you work with a hand therapist. Complete recovery may take up to a year.
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Carpal Tunnel Surgery Painful
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Pillar Pain After Carpal Tunnel Release
Carpal tunnel release surgery is one of the most common procedures performed in the United States. Over 90% of patients are pleased with the results, and they would recommend the surgery to a loved one. Most patients have decreased hand numbness, no night-time hand tingling, and less pins and needles hand pain. Many of my patients tell me that after surgery they were able to sleep well for the first time in months.
However, surgical site pain can be a temporary problem for some patients. Pillar pain is a frequent symptom following carpal tunnel release. The pain is located at the base of the hand in the palm, within the muscles at the thumb base and the muscles at the base of the small finger . The palm is tender when pressed in these areas . This condition can occur with either open carpal tunnel release or endoscopic carpal tunnel release, but is more common in open surgery.
Most patients can return to office work within a week and heavy manual labor within 3-4 weeks following carpal tunnel release. Pillar pain can make recovery from carpal tunnel release surgery take longer than expected. Putting pressure on the palm, such as trying to do a push-up or gripping a golf club, can increase the soreness.
Pillar pain does not last forever. The symptoms go away within 3 months in most patients. Occasionally pillar pain can last 6 months. The vast majority of patients no longer have this type of pain 12 months after surgery.
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Why Is Carpal Tunnel Painful
Did you ever lean on your funny bone ? As a result you get tingling or pain in your hand. In fact, the funny bone is theulnar nerveinside the elbow. So if you press on the ulnar nerve at the elbow your hand and fingers feel tingly.
Its about the same thing with carpal tunnel syndrome. Squeezing or compressing the median nerve at the wrist joint causes numbness in the hand and fingers. But that squeezing is not from leaning on the wrist. It comes fromswelling & fluid buildupdeep inside the wrist joint.
The median nerve gets compressed as fluid builds up around the tendons right next to it. Exactly why the tendons swell is still debatable.
To visualize what happens, think of a blood pressure cuff on your arm. The cuff represents the tendons getting swollen due to fluid buildup. Your arm is the median nerve. Therefore, with more compression, the median nerve reacts by producing abnormal sensations. Thats why this condition causes pain, tingling and numbness in your hand and fingers.
Carpal Tunnel Syndrome Surgery
If your CTS is getting worse and other treatments have not worked, the GP might refer you to a specialist to discuss surgery.
Surgery usually cures CTS. You and your specialist will decide together if its the right treatment for you.
An injection numbs your wrist so you do not feel pain and a small cut is made in your hand. The carpal tunnel inside your wrist is cut so it no longer puts pressure on the nerve.
The operation takes around 20 minutes and you do not have to stay in hospital overnight.
It can take a month after the operation to get back to normal activities.
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How Can I Tell If My Shoulder Pain Is Median Nerve Pain
Nerve pain especially that associated with carpal tunnel syndrome affects each person in a distinct manner. It often starts with numbness and sensitivity in the fingers and hand.
Then, there are some that start to feel burning sensations or tingling sensations. Many may feel the impact of median nerve pain from their fingertips all the way back into the back.
The truth of the matter is, median nerve pain is felt in many ways and it is not the same for two people.
Each form of compression is unique and is based on a number of factors. These include age, risk factors, general level of health, and the manner in which the median nerve is compressed.
Two Basic Types Of Carpal Tunnel Surgery
Carpal tunnel release surgery can either beopenorendoscopic. Both aim to cut the ligament holding the wrist bones together.
Open carpal tunnel release surgerymeans the surgeon creates a 2-3 inch slit on the palm. The surgeon cuts the ligament, and then sutures the skin closed. This results in a significantly long scar on the palm.
- Theadvantageof this technique is that the surgeon can clearly see all of the structures in the hand. That means theres less chance to accidentally lacerate an important structure like a nerve or blood vessel.
- Thedisadvantageof the open technique is that theres much more hand trauma. This means more postsurgical pain and longerrecovery and aftercare.
Endoscopic carpal tunnel release surgeryis a little different. It means a surgeon uses an endoscope to see inside the carpal tunnel space rather than opening the skin over the palm. The surgery uses a thin, flexible tube containing a camera guided through a small incision in the wrist.
Sometimes the surgeon makes two small holes one in the wrist and one in the palm. This is calleddouble portal endoscopic carpal tunnel release surgery.
- Theadvantageof endoscopic surgery is that the surgeon cuts the ligament without having to make a large incision. This means less trauma. And less trauma means less postsurgical pain and faster recovery.
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How Carpal Tunnel Syndrome Can Lead To Shoulder Pain
The carpal tunnel is a narrow region in the wrist that is located on the side of the palm. It protects the tendons that are responsible for bending the fingers, as well as the median nerve. When there is too much pressure in this area, a person can experience weakness, numbness, or tingling in the fingers and hand.
Over time, the entire functionality of a persons arm can be affected. Shoulder pain can be intense and constant, or it can occur with specific motions such as reaching overhead or behind the back. This can make it difficult to handle everyday tasks as simple as brushing your hair or putting away your groceries after a shopping trip.
What Happens After Surgery
Pain after surgery is minimized with oral or intravenous analgesics. Elevation and an ice pack for the bandaged hand can help reduce bleeding and swelling. You will be monitored for a short time. When the doctor believes you are stable, you can leave the surgery center. Be sure to bring someone to drive you home. If you have any complications, you may be required to stay longer.
Mild pain, discomfort, and swelling are common after surgery. Your doctor may recommend icing, elevation of the hand, over-the-counter pain medications or a splint to be worn at night or during various activities. Your doctor also may limit the amount of weight you can lift.
Stitches are removed 7â10 days after surgery in the doctors office.
Follow the surgeonâs home care instructions for 2 weeks after surgery or until your follow-up appointment. In general, you can expect:
- Keep the arm elevated above your heart for 48 hours.
- Avoid pushing down on your palm . Donât lift anything heavier than 5 pounds on the involved arm for one month after surgery.
- No strenuous activity including yard work, housework, and sex.
- You may drive 2 days after surgery if the pain and swelling in your arm is controlled.
- Donât drink alcohol. It thins the blood and increases the risk of bleeding. Also, donât mix alcohol with pain medicines.
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Active Hands For Life It Is A Wonderful Concept
I had a lot of hand pain that was waking me up throughout the night due to Carpal Tunnel Syndrome. I purchased the Carpal Solution, followed the directions and after the fourth night my pain was completely eliminated.
Since I use the computer daily as part of my job, I am going to purchase some additional Carpal Solution Therapy Pacs to have on hand when symptoms flare up. It is great to have a reliable therapy available, which I can depend upon.
Patti Mortgage Broker Texas.
Fantastic product! I now have feeling in my thumb and forefinger . I had been told by several doctors over the years that my only recourse was to have an operation which I would not give in to.
No doubt, I made the correct decision over the years. I am telling everyone I know and come in contact with about the Carpal Solution.
Billy, 3M Factory Worker. Wisconsin
Fourteen nights in a row with sound sleep. It required a little more time with my left hand, but over a three week period both hands were feeling better. I am so pleased with this product.
I wore the Carpal Solution for fourteen nights. My left hand is now fine, it is remarkable, but my right hand may still require surgery, I will keep doing the six week protocol and then make a decision
Linda, Cashier Indianapolis, Indiana
Pain In Your Hand & Upper Arm Is It Carpal Tunnel Syndrome
February 6, 2009 by Kathryn Merrow
Pain from trigger points runs in typical patterns.
If you have pain in your upper arm and hand that meets the following pattern, there is a fairly easy fix.
Sometimes the muscles that are causing symptoms are deep inside the body, hidden under bones or other muscles. But, the cause of this pain pattern is on the outside of your shoulder blade, so that makes treating it easy.
When I give directions for locating pain on your arm or body, like outside or front, that means you are standing or seated with your thumbs rotated outward or away from your body. Your thumbs are pointed away from you, sideways. Your palms are facing forward. Then outside or front always means the same thing, because we are all in the same position.
Heres the pain pattern:
The most painful area is usually on the outside of your upper arm and on the front side of your upper arm, through your bicep muscle. A lesser amount of pain runs down your arm as far as the fingers That pain is usually felt on both the back side and the palm side of the hand and arm.
You might also have quite a bit of pain on the spine side of your shoulder blade. You might also have head or neck pain at the base of your skull on the same side as the painful arm. Pain in both of these areas is caused by trigger points in the muscle on your shoulder blade and it will go away when the trigger point is resolved
Whats a trigger point?
A trigger point is a hyper-irritable place
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The Effect Of An Open Carpal Tunnel Release On Thumb Cmc Biomechanics
Thomas W. Wright
1Department of Orthopaedics and Rehabilitation, Orthopaedics and Sports Medicine Institute, University of Florida, Gainesville, FL 32608, USA
Purpose. We have observed worsening thumb pain following carpal tunnel release in some patients. Our purpose was to determine the effect of open CTR on thumb carpometacarpal biomechanics. Methods. Five fresh-frozen cadaver arms with intact soft tissues were used. Each specimen was secured to a jig which fixed the forearm at 45° supination, and the wrist at 20° dorsiflexion, with thumb pointing up. The thumb was axially loaded with a force of 130N. We measured 3D translation and rotation of the trapezium, radius, and first metacarpal, before and after open CTR. Motion between radius and first metacarpal, radius and trapezium, and first metacarpal and trapezium during loading was calculated using rigid body mechanics. Overall stiffness of each specimen was determined. Results. Total construct stiffness following CTR was reduced in all specimens but not significantly. No significant changes were found in adduction, pronation, or dorsiflexion of the trapezium with respect to radius after open CTR. Motion between radius and first metacarpal, between radius and trapezium, or between first metacarpal and trapezium after open CTR was not decreased significantly. . From this data, we cannot determine if releasing the transverse carpal ligament alters kinematics of the CMC joint.
What Are The Symptoms Of Carpal Tunnel Syndrome
Symptoms usually begin slowly and can occur at any time. Early symptoms include:
- Numbness at night.
- Tingling and/or pain in the fingers .
In fact, because some people sleep with their wrists curled, nighttime symptoms are common and can wake people from sleep. These nighttime symptoms are often the first reported symptoms. Shaking the hands helps relieve symptoms in the early stage of the condition.
Common daytime symptoms can include:
- Tingling in the fingers.
As carpal tunnel syndrome worsens, symptoms become more constant. These symptoms can include:
- Weakness in the hand.
- Inability to perform tasks that require delicate motions .
- Dropping objects.
In the most severe condition, the muscles at the base of the thumb visibly shrink in size .
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How Do I Get Ready For Carpal Tunnel Surgery
- Tell your doctor about all medicines you are currently taking, including over-the-counter drugs, vitamins, herbs, and supplements. You will probably need to stop taking any medicines that make it harder for the blood to clot, such as ibuprofen, aspirin, or naproxen.
- If you’re a smoker, try to quit before to the surgery. Smoking can delay healing.
- You may need to get blood tests or an electrocardiogram before surgery.
- You will usually be asked not to eat or drink anything for 6 to 12 hours before the surgery.
Based on your medical condition, your doctor may request other specific preparations.
Who Is At Risk Of Developing Carpal Tunnel Syndrome
Women are three times more likely than men to develop carpal tunnel syndrome. People with diabetes or other metabolic disorders that directly affect the bodys nerves and make them more susceptible to compression are also at high risk. CTS usually occurs only in adults.
Workplace factors may contribute to existing pressure on or damage to the median nerve. The risk of developing CTS is not confined to people in a single industry or job, but may be more reported in those performing assembly line worksuch as manufacturing, sewing, finishing, cleaning, and meatpackingthan it is among data-entry personnel.
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The Carpal Solution Alternative To Surgery Is Self
The Carpal Solution is a Better First Line of Defense for CTS. What people love about the Carpal Solution is that it is so simple and convenient. It allows them to control their Carpal Tunnel Symptoms conveniently and cost effectively relying on their bodys natural healing process, in the comfort of their own home. The Carpal Solution gently stretches simultaneously at three key points on the palm surrounding the carpal tunnel during sleep. Consistent gentle pulling action applied for 6 to 8 hours while the hand is relaxed, gently stretches and reshapes the soft fascia tissue around the carpal tunnel relieving pressure on the Median Nerve.
There is an old adage that gentle pressure consistently applied is the key to solving most problems in life. This describes the power behind Carpal Solution Therapy. Over the Six Week Protocol The Carpal Solution puts Carpal Tunnel Syndrome into remission naturally and non-invasively without the risky outcomes and long rehabs associated with surgery, the complications of oral pain medication or the downside of steroid injections or the risk of muscle atrophy so common with conventional rigid hand braces and restrictive splints.
The Carpal Solution has been shown to enhance blood circulationto the hand. Dr. Morgan suggests that increased nutrient and oxygen rich blood circulation reinvigorates the hand naturally and helps contribute to rapid recovery through metabolic processes at the cellular level.