What Is Carpal Tunnel Release Surgery
Carpal tunnel release is a surgery used to treat and potentially heal the painful condition known as carpal tunnel syndrome. Doctors used to think that carpal tunnel syndrome was caused by an overuse injury or a repetitive motion performed by the wrist or hand, often at work. They now know that it’s most likely a congenital predisposition some people simply have smaller carpal tunnels than others. Carpal tunnel syndrome can also be caused by injury, such as a sprain or fracture, or repetitive use of a vibrating tool. It’s also been linked to pregnancy, diabetes, thyroid disease, and rheumatoid arthritis.
The median nerve and tendons that allow your fingers to move pass through a narrow passageway in the wrist called the carpal tunnel. The carpal tunnel is formed by the wrist bones on the bottom and the transverse carpal ligament across the top of the wrist. When this part of the body is injured or tight, swelling of the tissues within the tunnel can press on the median nerve. This causes numbness and tingling of the hand, pain, and loss of function if not treated. Symptoms usually start slowly, and may get worse over time. They tend to be worse on the thumb side of the hand.
During a carpal tunnel release, a surgeon cuts through the ligament that is pressing down on the carpal tunnel. This makes more room for the median nerve and tendons passing through the tunnel, and usually improves pain and function.
Diseases Of The Thyroid
People with improperly-managed thyroid conditions may retain excess fluid in their connective tissues. This contributes to inflammation within the wrist, which can cause CTS, especially if left untreated. Hypothyroidism is particularly linked to CTS, but people with hyperthyroidism are also more likely to develop CTS than the general population.
What Is The Carpal Tunnel
The carpal tunnel is a narrow canal or tube in the wrist. Similarly to a tunnel you could travel through by car, this part of the wrist allows the median nerve and tendons to connect the hand and forearm. The parts of this tunnel include:
- Carpal bones: These bones make up the bottom and sides of the tunnel. They are formed in a semi-circle.
- Ligament: The top of the tunnel, the ligament is a strong tissue that holds the tunnel together.
Inside the tunnel are the median nerve and tendons.
- Median nerve: This nerve provides feeling to most of the fingers in the hand . It also adds strength to the base of the thumb and index finger.
- Tendons: Rope-like structures, tendons connect muscles in the forearm to the bones in the hand. They allow the fingers and thumb to bend.
Recommended Reading: What Does Arthritis In Leg Feel Like
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.
There Is A Natural Treatment For Carpal Tunnel Syndrome Developed By Doctors That Works For 97% Of People
Doctors have developed a natural stretching treatment for Carpal Tunnel that works for 97% of people in the comfort and convenience of home. It is called the Carpal Solution Nighttime Stretching Treatment and it requires no downtime and involves none of the risks associated with Carpal Tunnel Surgery.
Read Also: Is It Painful To Cut Your Wrist
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.
What Is A Workers Compensation Settlement
A settlement is an agreement on the benefits available to the injured worker. The agreement is between the injured laborer and the applicable workers compensation insurance company.
If a claimant was a federal employee, then he/she will file a claim with the U.S. Department of Labors Office of Workers Compensation.1
If a claimant was employed by a private company or a state or local government agency, then the laborer will file a claim with his or her states workers compensation board.
Recommended Reading: Uses Of Lidocaine
When Should You Call Your Doctor
911 or go to an emergency room immediately if you notice sudden loss of feeling in your arm.
- Have tingling, numbness, weakness, or pain in your fingers or hand that keeps coming back or that has not gone away after 2 weeks of home treatment.
- Have gradually developed little or no feeling in your fingers or hand.
- Cannot do simple hand movements, or you drop things.
- Cannot pinch your thumb and index finger together, or your pinch is weak.
- Cannot use your thumb normally .
- Have problems with daily activities because of pain in your fingers or hand.
Other Conditions Which May Be Misdiagnosed As Cts
Carpal tunnel syndrome is frequently misdiagnosed due to the fact that it shares symptoms with several other conditions, including arthritis, wrist tendonitis, repetitive strain injury and thoracic outlet syndrome. Symptoms which CTS shares with other conditions include:
- Hot-and-cold sensations
- Difficulty grasping or using oneÃ¢â¬â¢s hand
It is important to be aware of the key differences between CTS and some other conditions which share its symptoms, in order to avoid a misdiagnosis. Other conditions which are commonly misdiagnosed as CTS include:
Arthritis can affect all the fingers in the hand, whereas CTS cannot affect the little finger. Whereas CTS is worse at night, arthritis is not affected by the time of day. The symptoms of CTS can be absent and then suddenly become triggered by a particular activity, whereas the pain associated with arthritis is usually constantly present but alters in intensity during activities which put strain on the hands and wrists.
Nerve compression due to conditions affecting the spine
Conditions such as spinal disc herniation and cervical stenosis can cause nerve compression that may result in similar sensations to those of CTS.
Thoracic outlet syndrome
Repetitive strain injury
Don’t Miss: What Happens When You Cut Your Wrist
Causes Of Carpal Tunnel Syndrome
- Arthritis various types of arthritis, especially rheumatoid arthritis, can cause inflammation and swelling
- Pregnancy the hormones associated with pregnancy cause general fluid retention, which can compress the nerve. Carpal tunnel syndrome triggered by pregnancy usually goes away soon after birth
- Wrist fractures bone fragments can irritate the tenosynovium or reduce the amount of space in the carpal tunnel
- Congenital factors some people have a smaller carpal tunnel than others
- Overuse injury the tendons in the carpal tunnel can become irritated and inflamed by awkward postures or repetitive hand movements.
Living With Carpal Tunnel Syndrome
You may decide against having surgery for your carpal tunnel syndrome. If so, here are some things that may help relieve your symptoms.
- Prop up your arm with pillows when you lie down.
- Avoid overusing the affected hand.
- Find a new way to use your hand by using a different tool.
- Try to use the unaffected hand more often.
- Avoid holding your wrists in a downward bent position for long periods of time.
Read Also: Is Heat Good For Sciatic Pain
Carpal Tunnel Syndrome Vs Cervical Radiculopathy
Hand pain, numbness and tingling is a common symptom of both carpal tunnel syndrome and cervical spine issues. It can be hard to tell the difference between the two problems. Sometimes a careful exam and assessment is required by a hand and/or spine specialist. This article will discuss the cause, symptoms and treatment of each diagnosis. It will also review some ways to tell the difference between them.
CARPAL TUNNEL SYNDROME
Carpal tunnel syndrome occurs when the median nerve is compressed. The median nerve travels through the wrist. It controls feeling and sensation in the thumb, index finger, middle finger and part of the ring finger. Compression of this nerve can cause numbness, tingling, pain and sometimes weakness in these areas . The pinky and remaining part of the ring finger are usually spared. Pain can occasionally occur in the forearm and even up into the shoulder. Some patients may complain of clumsiness. Symptoms of carpal tunnel syndrome are usually worse at night or with repetitive activity with that hand and wrist.
If you are experiencing any of the above symptoms, call Three Rivers Orthopedics at 412-782-3990. Our team of orthopedic surgeons would be happy to help you alleviate your pain.
What Does Surgery Do
Cutting this ligament lets the wrist bones spread apart. This gives the median nerve more room in an already crowded passageway. The result is that the nerve is decompressed.
The symptoms related to the compressed nerve disappear. Over 59% of those patients had symptoms in both hands . Of those patients, 73% had symptomsso severethey needed surgery on the other hand as well.
Recommended Reading: Pineapple And Stomach Ache
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.
Carpal Tunnel Release Surgery
The goal ofcarpal tunnel surgeryis to de-compress the median nerve. All hand surgeons will advise you that the more advanced or intense your carpal tunnel, the less likelihood surgery will relieve symptoms. In other words,surgery has a higher failure rate with more severe symptoms.
Carpal tunnel release surgery can be performed using theendoscopic surgerymethod or theopen releasemethod. Each method has itspros and cons,and your doctor will choose which to use. Usually the doctor will specialize in one or the other method.
Whichever surgical method is used, the success rate of carpal tunnel release surgery is proportional to how severe your symptoms are at the time of surgery.
Unfortunately, there are no good statistics to show the association between symptoms severity and surgical success rates. Therefore, ask your surgeon what his/her success rate is relative to having mild, moderate or severe symptoms.
Also make sure you ask the doctor for an answer that defines success aspatient satisfaction 3 years after surgery. Why? When combining all levels of severity, the publishedsuccess rate of surgery is 50% patient satisfaction at year 3.
What Is Carpal Tunnel Syndrome Bilateral Upper Limbs
Besides, what does bilateral carpal tunnel syndrome mean?
Carpal tunnel syndrome is a common condition that causes pain, numbness, and tingling in the hand and arm. The condition occurs when one of the major nerves to the hand the median nerve is squeezed or compressed as it travels through the wrist.
Additionally, how common is bilateral carpal tunnel syndrome? Bilateral CTS is common, although the dominant hand is usually affected first and more severely than the other hand. Complaints should be localized to the palmar aspect of the first to the fourth fingers and the distal palm .
Just so, can carpal tunnel syndrome affect other parts of the body?
The most common cause of CTS is swelling or inflammation around the tendons and nerve, which increases the pressure within the carpal tunnel. These diseases cause pain and swelling in joints and other parts of the body. They can cause swelling of tissues in the carpal tunnel, resulting in pressure on the median nerve.
How does a doctor diagnose carpal tunnel syndrome?
Doctors can diagnose carpal tunnel syndrome using a combination of your history, a physical examination, and tests called nerve conduction studies. A physical examination includes a detailed evaluation of your hand, wrist, shoulder, and neck to check for any other causes of nerve pressure.
What Is Advanced Severe Carpal Tunnel Syndrome
Just when you thought carpal tunnel couldn’t get any worse, it does. Doctors call thisadvanced severecarpal tunnel syndrome. Some doctors more ominously call itend-stagecarpal tunnel syndrome. This means, because there was no intervention, the condition progressed to its final, natural, inevitable, and incurable conclusion.
Up until this point , patients had the opportunityto do somethingin order to halt carpal tunnel’s progression. It was even possible toreversemost of carpal tunnel’s symptoms and restore their hand. That’s because some parts of the median nerve were still alive and active during the severe stage.
But once patients reach the advanced severe stage, the problem is usually not salvageable, much less reversible.Carpal tunnel doctorsusually will not perform surgery at this point due to the high failure rate.
Surgeons also call this thehypo-atrophystage, and for good reason. That’s because there’s significantmuscle wastingat the base of the patient’s thumb. It means there’s no saving the thumb’s muscle now.
That muscle is normally the thick bump between the wrist and thumb. When it wastes away, you can actually see the muscle has flattened out and became wrinkly. It signifies that most of the median nerve has died. As a result, the muscle it connects to no longer gets motor commands. As a result, the muscle degenerates and dies as well.
Also Check: Can Neck Pain Cause Nausea
Surgeons Often Face Conflicts Of Interest
It is difficult to think of any medical advantage to the patient in doing the surgical procedure on both hands other than saving downtime.
While most surgeons are quite altruistic, some are insensitive to the patients plight post-carpal tunnel surgery.
From a Surgeons point of view, it saves time and increases revenue generated per operation by doing both hands at the same time. It seems more efficient to the Surgeon.
Generally, surgeons are altruistic and follow the Hippocratic Oath closely. Most surgeons endeavor to do the best for the patient despite potential conflicts of interest.
However, it is also true that a lot of patients never come back to have surgery on the second hand, once they know what they went through with surgery on the first hand.
So, the Surgeon can make sure that he has the opportunity to perform the procedure on both hands by doing them both at the same time. Again, advantage Surgeon not patient.
Surgeons often have conflicts of interest where what is in the patients best interest is not necessarily in the Surgeons best interest. Again, we have found surgeons usually error on the side of what is in the patients best interest when confronted with such situations.
Carpal Tunnel Syndrome Faqs
Q: Does typing cause CTS?A: Typing is associated with an increased likelihood of developing repetitive strain injury . If RSI affects the tendons or ligaments in the carpal tunnel, this can cause compression on the median nerve and the development of CTS. However, research has shown that there is at most a very small direct link between computer work and CTS. Activities which involve using the hands and wrists with a greater intensity, such as using vibrating tools, are significantly more likely to cause CTS than typing. The use of ergonomic computer keyboards is, however, sometimes recommended as a preventative measure against developing CTS.
Q: Can children be affected by CTS?A: CTS in children is rare. When it develops, it is most commonly related to having a genetically inherited condition associated with inflammation, such as lysosomal storage disease, which can cause swelling in the joints and pressure to build up in the carpal tunnel. The symptoms of CTS and its treatment options are the same for children as for adults. If you are concerned that your child, or a child that you know, may be affected by CTS, you can get a free symptom assessment by downloading the Ada app.
Ã¢â¬ÅCarpal tunnel syndrome fact sheet.Ã¢â¬ï¿½ National Institute of Neurological Disorders and Stroke. 10 May 2017. Accessed: 29 January 2018.
Ã¢â¬ÅNonoccupational risk factors for carpal tunnel syndrome].Ã¢â¬ï¿½ Journal of General Internal Medicine. May 1999. Accessed: 29 January 2018.
Also Check: Lidocaine Patch Neck Pain
Where Can I Get More Information
For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network at:
Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.