Tuesday, May 24, 2022

What Doctor Performs Carpal Tunnel Surgery

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Carpal Tunnel Thread Release

Carpal Tunnel Surgery performed in Doctor’s Office under local anesthesia

In this procedure, the surgeon doesnt use a scalpel to sever the ligament. Instead, they insert a needle into the hand using ultrasound technology as a guide. The needle is used to loop a thread around the ligament that then gently severs it. This method is thought to result in minimal scarring. However, this newer procedure is riskier and not yet widely practiced, since doctors arent able to see what theyre doing quite as well. Dr. Hay questions if the benefits are worth the risk, given the imprecise nature of the procedure. Theres a lot going on in the carpal tunnel, so any of these blind procedures where youre doing it through a needle and ultrasound theres just a risk of a problem, he says, noting that theres no reason to change a procedure that is already safe and has high patient satisfaction.

In nearly all cases, surgeons perform either open carpal tunnel release or endoscopic carpal tunnel release. Once the surgery is completed, your surgeon will suture the wound closed and dress your wrist with a bandage or a splint.

» Curious about different methods for carpal tunnel release?Ask a doctor on our forum for more information.

Is It Worth Having Carpal Tunnel Surgery

Most people with carpal tunnel syndrome only consider having surgery if other treatments dont provide enough relief. Surgery can help relieve symptoms or make them go away for good, but it is not without risks. In carpal tunnel syndrome the median nerve, which runs through the carpal tunnel in your wrist, is squashed.

Some Doctors Wrongly Advise Surgery

Another alarming statistic comes from theNational Institutes of Healthand other medical resources. They estimate more than50 percent of patientswho undergo carpal tunnel release surgery to treat their symptoms dont have carpal tunnel syndrome to begin with!

  • Thats 50% unnecessary surgeries!

Carpal tunnel release surgery is thesecond most common surgeryin the USA today. So this statistic comes as no surprise given the wild over-diagnosis of carpal tunnel syndrome in recent years.

Therefore, be very skeptical if any doctor rushes to advise hand surgery without being absolutely sure this is the treatment you need.

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Carpal Tunnel Care At Geisinger

Carpal tunnel syndrome affects as many as three percent of all working-age Americans nearly 8 million people. If youre suffering from hand or wrist pain, our team of skilled hand surgeons performs outpatient surgery that can have you home the same day. Geisingers orthopaedic hand surgeons are fellowship trained, which means they hold additional training than whats required and theyre the only fellowship trained hand surgeons in our region.

Finding The Best Carpal Tunnel Doctor

CARPAL TUNNEL RELEASE Surgery Performed by Toronto Surgeon ...

Finding the best carpal tunnel doctor to take care of your symptoms is a big step. You need to make the right choice because your hand’s health depends on it.

There’s no greater satisfaction than finding therightdoctor for your surgery. And there’s simply no substitute for anexperienced and knowledgeabledoctor.

Choosing a great carpal tunnel doctor is thefirst and most important stepin diagnosing your condition. A doctor who knows this disorder inside and out is invaluable. But its unfortunate that some doctors dont understand the fundamentals of carpal tunnel syndrome. For instance, many primary doctors can’ttell the differencebetween carpal tunnel syndrome andwrist tendonitis.

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Actually, theAmerican Academy of Orthopedic Surgeonsestimates that doctors who practice general medicine misdiagnoseanother hand problem as carpal tunnel syndrome83% of the time.

  • In other words, a patient diagnosed with carpal tunnel does NOT have it MOST of the time!

The usual confusion doctors have is between carpal tunnel syndrome, arthritis and tendonitis. Thesymptomsof each condition are nearly identical. But most importantly, they’re treated differently.

Therefore, the most experienced carpal tunnel doctor will know how to tell the difference by using the proper diagnostic methods.

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What Is Carpal Tunnel Decompression

Carpal tunnel decompression is a procedure performed on the wrist to relieve the pain and weakness caused by pinching of the median nerve as it passes through a narrow portion of the wrist . In this procedure, the roof of the carpal tunnel is loosened which decreases pressure on the nerve, allowing it to heal.

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.

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Diagnosis Of Carpal Tunnel

When you come to Hoag Orthopedic Institute for a physical exam, your hand doctor will consider many factors before diagnosing carpal tunnel, including how your symptoms developed.

During your physical exam, your orthopedic doctor will use a variety of diagnostic tests to pinpoint what exactly is causing your hand and arm pain, including:

  • Observation for thenar atrophy
  • Sensory testing
  • Provocative testing via media nerve compression
  • Electrodiagnostic studies
  • Phalens test of wrist flexion
  • Tinels test
  • Compression test
  • Nerve test directly records from the muscles and measures severity of nerve dysfunction

Significant Benefits Of The Sx

What to expect: Carpal tunnel surgery in the clinic
  • Performed in a procedure room or office setting
  • Can be performed using local anesthesia
  • Small wrist incision is typically closed without sutures
  • Reduces or eliminates the need for opioids
  • Postoperative therapy is typically not requiredsaving you time and money
  • Immediate motion in the hand for rapid recovery
  • Return to normal activity in a few days, not months

After the procedure at ATX Orthopedics, youll be able to resume activities as toleratedmost patients can return to work and the activities they love within 3-6 days.

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Common Conditions Requiring Treatment

Carpal tunnel syndrome is the condition that carpal tunnel release surgery treats. It starts gradually and gets worse over time. You may feel tingling and numbness in your fingers or palm. Your hands might also become weak, and you may have trouble holding onto things. This condition can also cause sensations that feel like small electric shocks going up your arm.When your doctor diagnoses you with carpal tunnel syndrome, they first might want you to try a few different treatments that don’t involve surgery. These treatments include:

  • Icing your wrist a few times a day
  • Taking medications that lower inflammation in your body
  • Wearing a brace to stabilize your wrist and keep it straight
  • Getting cortisone injections to reduce swelling around the carpal tunnel

If these treatments don’t relieve symptoms, your doctor may decide that surgery is the best option.

Ways To Ease Carpal Tunnel Syndrome Without Surgery

If youve ever experienced pain, numbness, or tingling in your hands youre not alone. Carpal tunnel syndrome is the most common cause of loss of function and pain in peripheral nerves due to chronic compression, otherwise known as entrapment neuropathy. Luckily, there are several ways to ease the uncomfortable symptoms of carpal tunnel syndrome so you can get back to living your life on your terms.

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Carpal Tunnel Surgery In Sarasota Fl

Our orthopedic surgeons here at Intercoastal Medical Group are experts at treating patients who are suffering from the pain and weakness of carpal tunnel syndrome. If you have wrist pain or unusual sensations in your hand, have an evaluation by one of our experienced orthopedists so you can find out what your best options are.

We perform carpal tunnel release surgery at our Ambulatory Surgery Center in Sarasota at our Cattleridge Medical Building, 3333 Cattlemen Road, Sarasota, FL. We have performed numerous carpal tunnel release surgeries using the open release and endoscopic release techniques, and we will explain what might work best in your case.

If you have any questions or would like to make an appointment with one of our world-class orthopedic surgeons, contact our friendly staff today by calling our location nearest you: either the Beneva Professional Center at 955-6748 or our Lakewood Ranch I office at 362-8662. If you prefer, you can also fill out our easy-to-use appointment request form online now. We look forward to helping you find relief from your wrist pain!

Interventional Specialists Provide Surgery Alternatives

Carpal Tunnel Surgery High Resolution Stock Photography ...

For the reasons above, we recommend an evaluation with an interventional specialist before you have carpal tunnel surgery. An interventional specialist provides you with the full range of carpal tunnel treatment options.

Our Interventional Specialists provide an extensive evaluation, treatment, and procedures to allow patients to avoid surgery for carpal tunnel syndrome. We utilize the latest diagnostics, electrodiagnostic studies, therapy, and image-guided treatments enabling the majority of our patients to avoid surgery. Only those patients that fail conservative treatment options should require the pain, risk, expense, and extended recovery time of carpal tunnel surgery.

your complete carpal tunnel syndrome evaluation and learn about your surgery alternatives.

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What Will Your Results Be 2 Years From Now

After you and your doctor carefully discuss the risks and benefits of hand surgery, ask what the plan is in 1-2 years. If your hand is fine, then youre golden and hopefully symptoms wont return. But what if the pain, numbness or tingling comes back then or soon after?

Surveys show that over50% of all surgical patientsare not satisfied with their results 2 years later. So plan ahead in the event you dont see good improvement. What does your doctor see as a next step at that point?

Endoscopic Carpal Tunnel Release Procedure

Endoscopic carpal tunnel surgery is performed after administering local anesthetic into the wrist and palm of your hand. You will be awake and may feel pressure, but will not feel any pain during the procedure.

  • A single incision is made in the wrist. Sometimes, your surgeon may make two incisions one on the wrist and the other on the palm.
  • A tube with a slot on the side called a cannula is inserted through the incision and placed next to the median nerve, just under the offending transverse ligament.
  • An endoscope, a thin, flexible tube with a camera attached is passed through the cannula to look at the carpal ligament from below. The images from the endoscope are visible to the surgeon on the video monitor in the operating room. Your surgeon ensures that the nerves and arteries are not in the way while cutting the ligament.
  • A special cutting tool with a hook is inserted into the cannula.
  • As the tool is pulled back out of the cannula, it cuts the carpal ligament and releases the pressure over the median nerve.
  • The cut ends of the ligament eventually fill in with scar tissue.
  • The skin incision is closed with dissolvable stitches and a dressing is placed.
  • The arm may be put in a sling to provide extra support and reduce swelling.
  • The procedure usually takes about 20 minutes to complete.

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What Is Carpal Tunnel Syndrome

The carpal tunnel is a narrow passageway in your wrist formed by bones at the bottom and the transverse carpal ligament on the top. Your median nerve and tendons that grant movement to your fingers run through this passageway.

Carpal tunnel syndrome happens when the tissues within the tunnel become swollen and put pressure on the median nerve. This leads to symptoms such as:

  • Numbness, tingling, or a burning sensation in the thumb, index, middle, and ring fingers
  • Pain or tingling that may radiate up our arm toward the shoulder
  • Weakness in the hand and tendency to drop things
  • Painful shocklike sensations in the hand

Most of the time, carpal tunnel syndrome symptoms develop slowly and grow progressively worse. Without treatment, this condition can lead to permanent nerve damage.

Early diagnosis and treatment at Texas Orthopaedic Associates, greatly improves your chances of avoiding carpal tunnel syndrome surgery. Schedule an appointment right away if you experience symptoms of carpal tunnel syndrome.

How Is Carpal Tunnel Syndrome Diagnosed

Office-based carpal tunnel surgery

Youll need a confirmed diagnosis of carpal tunnel syndrome before surgery. There are a number of ways to test for the condition. These are the three most common:

  • Compression Test Your wrist is squeezed to further compress the median nerve. If this causes symptoms to flare up, then you have carpal tunnel syndrome.
  • Phalens Test This test, which involves hyperflexing the wrist for about a minute, is also intended to trigger symptoms.
  • Tinels Test In this test your doctor will tap on the inside of your wrist above the carpal tunnel. If you feel something like an electric shock, then you have carpal tunnel syndrome.

Sometimes, the above tests arent conclusive enough. In these cases, surgeons may run more advanced tests, including electromyography or electroneurography , both of which read the electroactivity of the median nerve to determine if its actually being compressed.

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What Is Cold Laser Therapy And Does It Work To Treat Carpal Tunnel

Low-level lasers, also known as cold lasers or non-thermal lasers, are used as a repetitive therapy for pain and soft tissue injuries. It refers to the use of a red-beam that is similar to infrared lasers with a wavelength between 600 and 1000 nanometers and powered by wattage ranging from 5 to 500 milli-watts.

To give a rough idea of the relative power being used in low level laser therapy. The power behind a laser used in surgical procedures is typically around 300 Watts or at least 600 times more powerful than the low-level or cold laser therapy.

When applied to the skin, the low-level lasers produce no sensation of any kind and do not burn the skin or surrounding tissue, because of the low absorption by human skin and surface tissue and the low level power being applied broadly to the area of injury or pain.

It is hypothesized by supporters of Low-Level Laser Therapy that the laser light can penetrate deeply into the tissues where it has a photo-bio-stimulative effect. The exact mechanism of its effect on carpal tunnel and other pain syndromes is not well understood by the medical community. Supporters suggest that its works by improving cellular repair through stimulation of the immune, lymphatic, and vascular systems. This seems plausible, but is difficult to prove and can only be judged based on the results. As such this Cold Laser Therapy could be complimentary to Carpal Solution Therapy, but is much more expensive and time consuming.

Carpal Tunnel Syndrome Treatments

We usually begin carpal tunnel treatment with the most conservative options, such as wrist splinting or medications. If your condition does not improve, our highly-skilled specialists may recommend carpal tunnel surgery. The course of action your doctor recommends depends on your diagnostic tests and other factors. Carpal tunnel treatment options at The University of Vermont Medical Center include:

Carpal Tunnel Surgery

For persistent or severe carpal tunnel syndrome, surgery may be the best option. Our surgical treatments include:

Nonsurgical Therapy for Carpal Tunnel

This is a conservative approach and a good starting point for most carpal tunnel treatment. Our nonsurgical options include:

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Ask Your Insurance Company

Your insurance companys online website is another good resource since you will ensure that your carpal tunnel surgery will be performed by a carpal tunnel surgeon that takes your insurance plan. If you are unsure, call your insurance to find an in-network provider that specializes in carpal tunnel surgery.

Limited Open Carpal Tunnel Release

Carpal Tunnel Surgery: Preparation, Recovery, Long

Limited-incision carpal tunnel release techniques similar to endoscopic surgery were developed to decrease palmar discomfort and hasten the return to activities. It allows for adequate exposure to avoid complications and keeps the incision out of the painful portion of the palm. The surgical approach involves a small skin incision in the palm followed by release of the distal end of the TCL under direct visualization. Patients experience reduced post-operative pain as this techniques leaves the palmar fascia intact over the proximal TCL.

Carpal tunnel release through mini-transverse approach

Sayed Issa’s approach is a carpal tunnel release through a small approach on the distal wrist crease it is about 1.5 cm the benefits of this technique are less surgical traumatic and more tender, it takes less time for rehabilitation, so the patient can work next day of operation, and it has very cosmetic and gentle scar in results and outcome. A skin incision is made and the surgeon will dissect through fat and the superficial palmar fascia. Once the superficial palmar fascia has been released the transverse carpal ligament will be exposed. The transverse carpal ligament will be cut longitudinally to release it.

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Neurosurgeon Offers Carpal Tunnel Surgery

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Carpal tunnel syndrome numbness, tingling, weakness, and other problems in one or both hands is caused by pressure on the median nerve in your wrist. This nerve, and several tendons, run from the forearm into the hand through a small opening in the wrist called the carpal tunnel.

The median nerve controls movement and feeling in the thumb and first three fingers. Symptoms most often occur in the thumb, index finger, middle finger, and half of the ring finger.

Patients often experience symptoms at night, which may be relieved by shaking the hand. Most people with carpal tunnel syndrome can be treated without surgery. Surgery is considered only when:

  • Symptoms haven’t improved after several months of nonsurgical treatment.
  • Severe symptoms restrict normal daily activities.
  • There is damage to the median nerve or a risk of damage to the nerve.

A nerve conduction test and EMG can be ordered by your physician to determine if there has been damage.

Surgery choices

Carpal tunnel release involves cutting the transverse carpal ligament to relieve pressure on the median nerve. This surgery may be performed as an openprocedure or endoscopically. Many patients prefer the minimally invasive approach because recovery is quicker, scars are smaller, and there is less discomfort following surgery. However, there may be a slightly increased risk of need for a future surgery.

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