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Is Carpal Tunnel Surgery Successful

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Hand and Wrist Procedures: How successful is carpal tunnel surgery?

This question is not as easy to answer as it appears to be the private medical insurance system in Australia is ridiculously and needlessly complicated. The MBS rebate for the surgical fee is roughly $220-290. There will be a known gap for surgeon and anaesthetic fees. Most patients also have an excess for hospital fees. Here is an online calculator your insurance fund may offer something similar.

My staff will help you with a written quote before surgery, which is usually accurate. I do not have patients complaining about “unpleasant surprises”.

Although Conservative And Surgical Modalities Work In Specific Patients Complications Can Vary

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The optimal treatment for carpal tunnel syndrome remains a hot-button issue among surgeons. Some of the most common regimens include open carpal tunnel release, limited release, endoscopic release and conservative treatments.

While passionate proponents back each modality, many agree that the indications for conservative treatment are limited, and that results from the different surgical options are similar.

You should ask the question, Is there any difference in the results of a carpal tunnel release whether you do it mini open, conventional open, or endoscopically? Barry P. Simmons, MD, the chief of hand and upper extremity service at Brigham & Womens Hospital in Boston, told Orthopedics Today. Nothing has proven that theres any difference in the long-term results . So in fact, the efficacy of the procedure seems to be the same whichever one you do. Its the morbidity and complications that differ.

Open release

Traditional open carpal tunnel release gives surgeons full visualization of the hand structures, which may decrease the risk for nerve damage. The trade-off: increased sensitivity.

Because the incision crosses the wrist, patients may experience tenderness for up to six months, American Society for Surgery of the Hand past president Jim Strickland, MD, told Orthopedics Today.

Endoscopic release

James C.Y. Chow

Unnecessary risks?

Will I Need Occupational Therapy

If you do, your doctor will suggest it once your bandage comes off. Youâll learn exercises to improve your hand and wrist movement, which can also speed up healing.

Some people find that their wrists arenât as strong after surgery as they were before. If this happens to you, occupational therapy can help increase your strength.

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Watch Linda Tell Her Carpal Tunnel Journey

Consider the experience of Linda, a Retail Merchandiser who is constantly scanning bar codes and working on a computer. She also loves to Garden and is an avid Knitter. All of these activities result in a high incidence of CTS. Linda was diagnosed with severe Carpal Tunnel in both hands. The Surgeon rushed her into surgery and post-surgery her symptoms got worse in both hands.

The Surgeon tried everything to try to help her with steroid injections, evaluating and treating her neck and back, etc. Finally, he threw up his hands and gave up saying he could not help her.

A second Surgeon, believed he could help her by doing a second Carpal Tunnel Surgery. Linda was desperate and was ready to try anything to get her life back.

However, her husband was concerned about doing another surgery. He went online and found the Carpal Solution Treatment and ordered it for Linda.

Within Six Weeks she was delighted her left has was completely better and her right has was 80% better.

She continued with this natural Carpal Tunnel Treatment and now Linda is completely cured even after a failed Carpal Tunnel Surgery.

So, you see there is hope even after a failed Carpal Tunnel Surgical Procedure.

If you are suffering with Carpal Tunnel and are unsure where to turn. We can help you. Ninety Seven percent of people can put their worries and their Carpal Tunnel Symptoms behind them in just a few weeks.

Why Might I Need Carpal Tunnel Surgery

Discover a safer alternative to Carpal Tunnel Surgery that ...

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.

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How Is Carpal Tunnel Syndrome Diagnosed

First, your doctor will discuss your symptoms, medical history and examine you. Next, tests are performed, which may include:

  • Tinels sign: In this test, the physician taps over the median nerve at the wrist to see if it produces a tingling sensation in the fingers.
  • Wrist flexion test : In this test, the patient rests his or her elbows on a table and allows the wrist to fall forward freely. Individuals with carpal tunnel syndrome will experience numbness and tingling in the fingers within 60 seconds. The more quickly symptoms appear, the more severe the carpal tunnel syndrome.
  • X-rays: X-rays of the wrist may be ordered if there is limited wrist motion, or evidence of arthritis or trauma.
  • Electromyography and nerve conduction studies: These studies determine how well the median nerve itself is working and how well it controls muscle movement.

What Are My Surgery Options

There are two main types of carpal tunnel release surgery: open and endoscopic. In both cases, your doctor cuts the ligament around the carpal tunnel to take pressure off the median nerve and relieve your symptoms. After the surgery, the ligament comes back together, but with more room for the median nerve to pass through.

  • Open surgery involves a larger cut, or incision — up to 2 inches from your wrist to your palm.
  • In endoscopic surgery, your surgeon makes one opening in your wrist. They may also make one in your arm. These cuts are smaller, about a half-inch each. They then place a tiny camera in one of the openings to guide them as they cut the ligament.

Because the openings are smaller with endoscopic surgery, you may heal faster and have less pain. Ask your doctor which operation is best for you.

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Pros And Cons Of Carpal Tunnel Surgery

Carpal tunnel syndrome is a physiological condition that is caused by the compression of the median nerve. The compression occurs in the carpal tunnel through to the wrist. Carpal tunnel syndrome is characterized by pain and numbness. The numbness is typically felt in the thumb, index and middle finger but the whole forearm may also have tingling sensations. Depending on the severity of carpal tunnel syndrome, one may not be able to do much work with the affected hand.

Lifting weights may be difficult. Normal tasks such as cooking, typing or writing, washing and attending to daily chores can also become quite a challenge. Some severe cases of the condition can cause immense pain to render the hand unusable but it is very rare for carpal tunnel syndrome to get this worse.

What To Expect After Surgery

How successful is carpal tunnel release?

While most people who have carpal tunnel release surgery get immediate symptom relief and their symptoms dont return, others may still have sensations of numbness, tingling, or pain from time to time. There are also associated risks to the surgery that your doctor will explain to you. Complete healing takes time. You can expect some pain, swelling, and stiffness after your surgery, but prescribed medication can relieve these symptoms.

Youll need to undergo physical or occupational therapy to get full movement, strength, function, and feeling back in your hand and wrist after successful carpal tunnel release surgery. Slowly, youll be ready to do your normal activities, like driving, writing, pulling, gripping, pinching objects, and more. Your orthopedic surgeon will discuss when you can go back to work and what limitations you will have while you heal.

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Carpal Tunnel Surgery: What To Expect

During carpal tunnel release surgery the transverse carpal ligament is cut to relieve pressure on the median nerve. Read:All About Carpal Tunnel Release Surgery

The carpal tunnel is a narrow opening in the wrist through which the median nerve and several tendons pass through. When these tendons become inflamed, pressure on the median nerve can cause pain, numbness, and tingling sensations to radiate into the hand.

See What Is Carpal Tunnel Syndrome?

If youre considering carpal tunnel release surgery, here are some pointers to help you be prepared and understand what to expect:

  • The surgery is fairly simple and successful, but there are some risks.The goal of a carpal tunnel release is to create more space in the carpal tunnel by cutting the transverse carpal ligament, which runs across the top of the carpal tunnel. Its easy to find and access, so the procedure is pretty straightforward. Studies suggest it has a clinical success rate of 75 to 90%.

    See Surgery for Carpal Tunnel Syndrome

    But like any surgery, there are some risks and potential complications. The most likely complication is an infection at the surgical sight, which can cause symptoms such as redness or oozing from the surgical site, swollen lymph nodes, or a fever. The most serious potential complication, which is rare, is permanent damage to the median nerve.

  • Keeping your hand elevated.
  • Icing the surgical site for 10 to 15 minutes a few times a day.
  • Treating Carpal Tunnel Syndrome

    For mild cases of carpal tunnel syndrome, resting your hand and wearing a splint at night might be all it takes to relieve symptoms. Symptoms of carpal tunnel syndrome often occur at night, causing people to wake up and shake or move their hand around until the numbness resolves and it feels better, says Dr. Rozental. Medications, such as aspirin and ibuprofen aren’t a cure, but can help relieve pain. Your doctor may also want to try giving you steroid injections to help relieve symptoms.

    If these carpal tunnel treatments aren’t effective, however, it may be time to consider surgery to release the ligament that is placing pressure on the median nerve.

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    Carpal Tunnel Surgery Complications

    In an attempt to release pressure from the median nerve and relieve symptoms, surgery is often done. There are two types of carpal tunnel surgeries: open surgery and endoscopic surgery. Both types of carpal tunnel surgeries present issues.

    Open carpal tunnel surgery involves a large incision up to two inches from your wrist to your palm. Open surgery commonly results in scar sensitivity and pillar pain, which is pain on the sides of the incision in the thicker parts of the palm and can take several months to resolve.

    Endoscopic carpal tunnel surgery involves a small incision in your wrist and sometimes another in your arm. A tiny camera is then used to guide your surgeon as they cut the ligament. Endoscopic surgery can cause nerve injury, either to the median nerve or nearby branches, such as the one that controls the muscles of the thumb or sensation to the palm of the hand.

    After their carpal tunnel surgery, patients in Jonesboro often experience the same or worsened symptoms and undergo yet another surgical procedure called revision carpal tunnel surgery. It should not come as a surprise that the results of a second surgery tend to be not as favorable as the results of initial surgery, meaning people are undergoing two expensive, invasive, and unnecessary surgeries with no relief.

    Traditional Open Carpal Tunnel Release Surgery

    What Carpal Tunnel Syndrome Feels Like

    Traditional Carpal Tunnel Release Surgery requires a long incision across the pressure bearing area of the palm

    During Open Surgery, an incision is made from the crease of the wrist toward the center of the palm, through layers of skin, fat and connective tissue. Once the transverse ligament is exposed, the surgeon cuts the ligament with a blade to release the pressure on the nerve. The surgeon the closes the incision with sutures and dresses the hand.

    The procedure is effective but it may not be the best option for some patients because it leaves a scar from the wrist to the center of the palm and recovery and rehabilitation can take several weeks due to post operative pain, the deep cutting of the hand and a longer incision.

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    What To Do Carpal Tunnel Symptoms Return After Surgery

    If you notice a return of painful and bothersome symptoms following your carpal tunnel release surgery, or if your symptoms simply fail to improve with surgery, it is important to see your doctor again. It is possible that carpal tunnel syndrome was the wrong diagnosis, and that there is in fact something else going on.

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    Carpal Tunnel Syndrome 101

    The pain, tingling, and numbness of carpal tunnel syndrome can be the result of genetics, injury, or overuse. If you have diabetes, thyroid disease, or rheumatoid arthritis, you are more prone to carpal tunnel syndrome.

    Regardless of the reason for your carpal tunnel syndrome, you know that the pain can limit your life.

    If left untreated, carpal tunnel syndrome can weaken your fingers and reduce coordination, making everyday tasks difficult. With carpal tunnel syndrome, your wrist swells, putting pressure on the median nerve. Symptoms often start small and get worse over time.

    If you suffer from carpal tunnel syndrome, there are a few non-surgical treatments to try before having surgery. These treatments include:

    • Wrist splinting
    • Nonsteroidal anti-inflammatory drugs like ibuprofen
    • Cortisone shots

    At Coastal Empire Orthopedics, our orthopedic surgeon, Jonathan Shults, MD, and his team diagnose your carpal tunnel syndrome and propose treatment methods based on the severity of your condition. If youve tried non-surgical carpal tunnel treatments without success, we can help you find relief with carpal tunnel surgery.

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    How Long Will Recovery Take

    Recovery can last from days to months, depending on the nerve damage. The longer the carpal tunnel syndrome stayed, the longer it takes for the wrist to return to normal. Further treatments and therapies can speed up this process.

    You should avoid straining your wounds. Instead, you should use your hands lightly. Treat them well as you recover.

    Generally, you can gradually return to normal activities within two weeks. Remember to ask your surgeon regularly if you can perform specific tasks.

    For example, you can drive a week after the surgery. You can write with that hand after a week. But it may take more than a month to do it with ease. Fully gaining the strength on that hand may take a minimum of three months.

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    Myth: Getting Carpal Tunnel Surgery Means Missing Work For A Long Time

    Carpal Tunnel Surgery? Try Carpal Solution First 97% Success

    Many people are hesitant to consider carpal tunnel release because they fear losing use of their hand for weeks or even months, or they dont feel they can take enough time off work. But the recovery period for carpal tunnel release can be relatively quicklight non-repetitive use of the hand is permitted after about a week, when the bandage is removed.

    In fact, those who have jobs with minimal involvement of the affected hand may return to work in a week or two. This may be particularly true for those who receive the endoscopic approach. A splint may still be needed occasionally to support the wrist, especially at night.

    See Surgery for Carpal Tunnel Syndrome

    Patients who had the procedure in their dominant hand or who perform repetitive labor, such as an assembly line worker, may need to wait six to eight weeks before returning to work. After two or three months, most patients will experience the return of grip and pinch strength and can resume heavy use of the hand.

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    Myth: Endoscopic Approach Is Riskier Than Open Approach

    In the past, many patients were concerned or advised against the endoscopic approach for fear of higher risk for complications such as nerve damage.

    However, current research shows that theres no statistically significant added risk of complications from the endoscopic approach. A large systemic review of 28 studies that compared open and endoscopic approach for carpal tunnel release found that:3

    • Both approaches were equally effective in relieving symptoms and improving function and had similarly low rates of major complications
    • The endoscopic approach was better in restoring grip strength, allowed patients to return to work faster , and was safer in terms of minor complications

    Individuals who suspect they may have carpal tunnel syndromeor have been diagnosed but have questions about their treatmentshould see their physician to formulate a successful treatment plan.

    See Diagnosing Carpal Tunnel Syndrome

    How Can Complications And Poor Outcomes Be Predicted And/or Avoided

    Bad diagnosis can obviously be reduced by meticulous attention to detail by an experienced clinician aided as necessary by diagnostic tests and I believe that this factor is a significant one in the achievement of the very high success rates reported by some surgeons. If one further limits surgery to only cases in which one is very certain of the diagnosis, and does not operate on people with equivocal clinical features, then it is possible to select a patient population for surgery in whom bad diagnosis, as a cause for surgical failure, is almost non-existent. There are people however in whom the diagnosis is somewhat uncertain, even after exhaustive investigation, and if one operates on these cases one has to accept that the success rate will be lower, even though some will be dramatically improved.

    Bad luck – something which all of this group have in common is that they are unpredictable. No amount of pre-surgical information gathering is going to be able predict that Mrs X is going to fall and fracture the wrist badly 2 days after surgery, nor that Mr Y will develop complex regional pain syndrome

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