Physical Therapy To Determine The Root Of Pain Post
Post-operatively, some carpal tunnel release patients could still feel pain and numbness in their hands three months following the operation. While it may be a fairly common side effect of the operation, the root of the problem may actually be determined through physical therapy.
Working together with our orthopedic surgeon, our physical therapist will help in determining if there’s a surgical injury, neurogenic pain, and other associated conditions. Working with a therapist may also help the patient manage these uncomfortable moments during the recovery period.
This process is more than just a physical examination as it can also be for patient education. By doing a thorough exam, such as measuring the strength of the fingers and hands, our physical therapist can advise the patient on how to do correct movements and exercises that will make them feel more comfortable.
Mayo Clinic Q And A: Recovery After Surgery For Carpal Tunnel Syndrome Whats Normal And Whats Not
DEAR MAYO CLINIC: Three months ago, I had surgery on my left wrist to treat carpal tunnel syndrome. Since then, I am in much more pain than before surgery, and two of my fingers are completely numb. I cannot even button a button, and tying my shoes is a chore. What would cause the pain to worsen after surgery? Could another surgery remedy the problem, or is this my new normal?
ANSWER: Your condition as it stands now shouldnt be considered a new normal. Its possible your symptoms are part of the recovery from surgery, and they may improve with time. It would be a good idea, however, to meet with your surgeon now, so he or she can reassess your condition and decide if you need additional tests or treatment.
Carpal tunnel syndrome is caused by compression of the median nerve within the carpal tunnel a narrow passageway on the palm side of your wrist. The median nerve runs from your forearm through the carpal tunnel and into your hand. It controls the sensations you feel on the palm side of your thumb and fingers, except the little finger. Carpal tunnel syndrome often causes numbness and tingling in the hand and arm. Surgery to treat it involves relieving pressure on the median nerve by cutting the ligament that crosses over it.
Its helpful to note, too, that nerves typically improve after surgery at a rate of about 1 inch per month. When sensation returns, it happens gradually. In general, full recovery after carpal tunnel syndrome may take up to a year.
Steps You Might Follow After The Surgery
Recovery period may vary considering the individual difference. The condition of the median nerve plays an important role in case of carpal tunnel treatment surgery and recovery period can vastly be affected by this. Age, health and mental condition of an individual can also affect the recovery period.
What To Expect After The Operation
Not everyone needs to see a physiotherapist after surgery unless there is a problem with scar pain or stiffness. Some general rules that are useful for everyone are:
- Hand elevation is important to prevent swelling and stiffness of the fingers.
- Remember not to walk with your hand dangling, or to sit with your hand held in your lap.
- It is fine, however, to lower your hand for light use and you should get back to normal light activities as soon as possible as guided by common sense.
- It is safe to use the fingers for day-today activities such as eating, dressing, brushing your hair. These activities all help to prevent stiffness and swelling.
The pain and tingling you experienced at night before the operation should settle immediately. If you have established numbness, dryness, lost dexterity or wasting of the muscle at the base of the thumb, then recovery of these problems is uncertain, especially as you get older. Ideally, surgery should be performed before these problems develop.
Your stitches will be removed at about 10 to 14 days after the operation.
You will find that your grip is weaker than before the operation and slightly uncomfortable. This can be a bit frustrating but you should be back to full power by 6 to 12 weeks as healing occurs. Exercises such as squeezing balls will not speed up the process, and if overdone this can actually delay your recovery.
Choosing The Right Surgeon
You should avoid surgery if you can, but if you feel that you have exhausted all clinically documented treatments, and need to resort to surgery on your hand, you should pick a good surgeon with a strong track record and schedule sufficient downtime for full recovery.
It would also be wise to line up someone who can lend you a hand when needed during recovery. Handicapped people or caregivers taking care of a loved one, find it particularly difficult to line up the support.
How long does carpal tunnel surgery last?
What Is The Success Rate For Carpal Tunnel Syndrome Surgery
Surgery for carpal tunnel syndrome has a very high success rate of over 90%. Many symptoms are relieved quickly after treatment, including tingling sensation in the hands and waking up at night. Numbness may take longer to be relieved, even up to three months. Surgery wont help if carpal tunnel syndrome is the wrong diagnosis.
When the carpal tunnel syndrome has become severe, relief may not be complete. There may be some pain in the palm around the incisions that can last up to a few months. Other after-surgery pain may not be related to carpal tunnel syndrome. Patients who complain of pain or whose symptoms remain unchanged after surgery either had severe carpal tunnel syndrome, had a nerve that was not completely released during surgery, or did not really have carpal tunnel syndrome. Only a small percentage of patients do not gain substantial relief from symptoms.
Last reviewed by a Cleveland Clinic medical professional on 10/22/2019.
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.
How Effective Is Surgery
Surgery is usually only considered if symptoms return regularly and problems associated with the painful sensations increase despite trying other treatments such as splints or corticosteroid injections. In those cases surgery can provide better relief than repeat injections or splint treatments.
Acute carpal tunnel syndrome with sudden and severe pain is quite rare. It most often occurs after an injury, infection or bleeding in the wrist. Having surgery quickly is then often the only way to get effective relief.
Most peoples symptoms disappear after surgery: If you don’t experience any lasting abnormal sensations or loss of strength in the wrist, the symptoms usually improve rapidly. One of the things that determines how fast you recover is how badly the nerve was damaged. It can take several weeks or months for more severe symptoms to go away completely. The pain usually improves pretty fast, but the abnormal sensations may need more time to disappear. So it might be preferable to not wait too long to have surgery.
If the surgical procedure doesn’t have the desired outcome, there are a number of possible explanations:
- The condition might already be at such an advanced stage that surgery can no longer make the symptoms go away completely.
- The may have been wrong, so surgery was performed even though the symptoms were being caused by something else.
- Symptoms may persist or worsen if there is a surgical error or the flexor retinaculum is not cut through completely.
When Is Surgery Required For Carpal Tunnel
Going under the knife is always a scary and last resort for most people. With carpal tunnel syndrome, some non-surgery options can be tried before a doctor wants to perform surgery. Over-the-counter medication, wrist splints, physical therapy, steroid shots, or changing equipment at work are things that your doctor may have you try first. Surgery might be recommended within 2 months depending on the severity if these options are not successful and the patient continues to suffer from the pain.The doctor may also perform an electromyography test to determine that carpal tunnel syndrome is present. If the pinching of the median nerve is severe enough that it is causing the muscles to weaken in the hands or wrists, a doctor will want to perform surgery.
Typical Carpal Tunnel Operation Recovery Time Scenarios
Am I at risk for a longer recovery time?
What About You Should Care
Open carpal tunnel surgery cuts open the base of the palm and may need a longer recovery duration than endoscopic surgery. Short-term nerve problems may be less likely with open surgery. However agonizing scar tissue might be most likely to establish after open surgery than after endoscopic surgery.
Both endoscopic and open carpal tunnel release have benefits and threats. Studies do disappoint that procedure is much better than the other.2 Talk to your doctor about your choices.
Make Your Carpal Tunnel Surgery Recovery Fast And Complete
An effective plan forCarpal Tunnel Surgery Recoveryis necessary if you want the best possible outcome from healing from surgery.
If you’re lucky, before or after Carpal Tunnel surgery your doctor will give you post-surgery self care advice that consists of something more and other than “Take some Ibuprofen and take it easy for a couple days.”
Carpal Tunnel surgery is not a quick fix. It comes with it’s own set of problems since it is cutting into your flesh and causing damage that the body needs to adjust to and heal from.
If you expect to get the surgery and then be as good as new the next week, you are likely to end up very disappointed.
If you have already had the release surgery on your wrist, you are probably wondering how and when you are finally going to heal and be pain free again.
It’s never to late to help heal your wrists from Carpal Tunnel symptoms. Even if you’ve had surgery. Surgery just makes it that much more complicated and adds time and effort to what you will need to do.
If someone were to ask ‘What does Carpal Tunnel Surgery Recovery actually mean?” I would tell them that it means -actually- recovering after Carpal Tunnel surgery back to a 100% state of health.
Of course, nobody every asks this. We all just assume that we will heal back to as good as new after a surgical operation.
But we don’t.
I really don’t know why we assume that we’ll heal back to ‘normal’, but we consistently do think that it will happen.
The body just doesn’t work that way.
What Is The Recovery Timeline For Carpal Tunnel Release Surgery
Exact recovery time can vary widely for those who have a carpal tunnel release surgery depending upon the speed of their recovery. In addition, various factors can impact the recovery time such as patient age and other health factors, severity of carpal tunnel syndrome prior to the surgery, and the ability of the patient to follow up the post-operative guidelines and recommendations.
Usually, you can expect the following stages during your recovery period after the carpal tunnel release surgery:
Physical Therapy And Exercise After Carpal Tunnel Surgery
Your doctor may refer you to a physical therapist to teach you special exercises for wrist and hand rehabilitation. These exercises help in decreasing the pain and improving the movement of your hand. It also decreases the risk of function loss.
There is a series of exercises you do after your surgery. This helps you in gaining back your wrists and hand’s strength, grip range of motion. These exercises are particularly helpful in wrist pain after carpal tunnel surgery and thumb pain after carpal tunnel surgery.
To get maximum benefit from these exercises, you should follow the instruction of your physiotherapist and doctor correctly. Read more about post-carpal tunnel surgery exercises.
Post Recovery Period Of Carpal Tunnel Surgery
Carpal Tunnel Surgery is used to treat a painful condition of hand and fingers caused by compression of a major nerve. Post recovery period of carpal tunnel treatment surgery is subjected to change. Certain individual conditions affect the recovery period. Carpal tunnel surgery in both hands may take up to a little more time to recover. In this case, you may follow certain steps in order to get relief from the pain.
Do Not Have Surgery Performed On Both Hands At The Same Time
If you do decide to go forward with surgery, definitely do not do both hands at the same time unless you have a close to fulltime caregiver that you have an intimate personal connection with and that you trust with personal hygiene and intimate daily care for several weeks. Life can be complicated without the use of either hand.
Using a hand that has been operated on for Carpal Tunnel Release Surgery before it has completely healed can result in serious potential complications and generation of scar tissue. The formation of scar tissue can actually make Carpal Tunnel worse after surgery than it was before the surgical procedure at the base of the hand. Soft tissue healing takes six weeks minimum and can take up to 8 weeks or even 12 weeks if there are complications with bacterial infection.
The temptation to use your hand for some essential task when a caregiver is not immediately available is too high for most people to resist. The probability that you will be put in a situation where you must use your hand for a task that puts too much force on the injured tissue before the healing is complete is high, even if you think you will have the full-time attention of a caregiver. This is why we strongly recommend that you do not have a surgical procedure for Carpal Tunnel Release performed on both hands at the same time.
Some people are excited about the idea that you can minimize downtime by having both hands done at the same time.
What Is Endoscopic Carpal Tunnel Release
Carpal tunnel release is surgery to treat carpal tunnel syndrome, a condition that causes pain, weakness, tingling, and numbing in the thumb and fingers. Carpal tunnel syndrome is caused by activities or motions that put pressure on the median nerve in the wrist.
The median nerve and the tendons that bend and flex your fingers pass through the narrow area of the wrist called the carpal tunnel. In carpal tunnel release surgery, the surgeon cuts the transverse carpal ligament, a band of tissue on the palm side of the carpal tunnel. This takes pressure off the median nerve and relieves symptoms. You will still be able to use your wrist and hand, and eventually scar tissue will form where the ligament was cut.
Your doctor may recommend carpal tunnel surgery if:
- You have tried nonsurgical treatments for several weeks or months and your symptoms have not improved.
- Your symptoms are severe and interfere with your daily activities.
- Your median nerve is damaged.
- Other tissue, such as a tumor, is putting pressure on the median nerve.
There are two different types of carpal tunnel release surgery open, when the surgeon makes an incision in your palm, and endoscopic , when the surgeon does surgery through a small tube placed into your wrist.
The Role Of Physical Therapy After Carpal Tunnel Release
Carpal tunnel release is a surgical procedure involving cutting through the ligament that’s putting pressure on the median nerve. This is a necessary procedure after nonsurgical treatments have been exhausted without significant improvements to the function of the hand.
Following carpal tunnel release, the patient will have to wear a splint or bandage on the wrist for a period of two weeks. Our usually asks patients to undergo physical therapy as soon as the stitches from the surgery are removed.
Does Carpal Tunnel Syndrome Have A Long Recovery
Surgery to repair carpal tunnel syndrome does not have a particularly long recovery. The bandage that covers the stitches after surgery can be removed in a few days. The hand can then be used for light activities. Making a fist is encouraged. Full range of finger motion and early symptom relief is usually seen within two weeks after the stitches have been removed. You can usually return to most activities by six weeks. Your return to work depends on factors such as type of work, how much control you have over your work and workplace equipment.
The Limitations Of Carpal Tunnel Surgery
What is the cost of surgery?
Ulnar Nerve Surgery Recovery
Your doctor may recommend that you keep your arm elevated above your heart for 24 to 48 hours after surgery to prevent swelling. It may be necessary to wear a splint on your elbow for a few weeks to help the area heal, and moving your fingers or applying an ice pack can help prevent swelling and stiffness.
Patients can resume most everyday activities soon after surgery. Your physician will tell you which movements or activities to avoid and may recommend physical therapy exercises to build strength and mobility. Depending on the physical demands of your job, you may be able to return to work one or two weeks after surgery, though at first you may need to limit your work to less physical tasks.
How To Recover After Carpal Tunnel Release Surgery
This article was medically reviewed by Eric Christensen, DPT. Eric Christensen is a Physical Therapist based in Chandler, Arizona. With over a decade of experience, Eric works in both orthopedic and neurological fields and specializes in custom orthotic prescription and casting, vestibular reprogramming, and manual therapy. He holds a Bachelors degree in Exercise Science with a focus in Sports Medicine from Colorado State University and a Doctor of Physical Therapy from Regis University. In practice, Eric takes a developmental approach to rehabilitation utilizing the Selective Functional Movement Assessment. He uses functional movement patterning and manual therapy to return patients to prior levels of function. This article has been viewed 26,963 times.
Carpal tunnel release surgery is done as a last-resort treatment for carpal tunnel syndrome that has failed to improve via more conservative methods. Surgery can lead to great improvement or a cure of the condition. However, there are also risks associated and a lengthy recovery time. Recovery usually takes several weeks to several months; it requires dedication to a physiotherapy program to help strengthen and heal your wrist and hand following surgery.XTrustworthy SourceJohns Hopkins MedicineOfficial resource database of the world-leading Johns Hopkins HospitalGo to source
Recovery Times After Carpal Tunnel Surgery
EVERYTHING YOU NEED TO KNOW
People often hear that Carpal Tunnel Surgery is quick and easy to perform, implying that it is no big deal. From a surgeons perspective, that is true.
A Carpal Tunnel Release Surgical Procedure generally takes less than 30 minutes and the incision does not need to penetrate deep into the body to sever the Transverse Carpal Ligament.
For a Surgeon, it is one of the simplest procedures to perform. It can be done as an out-patient procedure, so you do not have to spend the night in the hospital. From that perspective, it is relatively simple.
However, from a patients perspective, you might say not so fast.
What are the recovery times after Carpal Tunnel Surgery?
What Are The Symptoms Of Cts
Symptoms of CTS include pain, numbness, and tingling of the fingertips. Often there is radiating pain into the forearm. In mild to moderate cases, the symptoms come and go, and are often more pronounced at night, or while performing sustained eye level activity such as talking on the phone, driving, or holding a book, tablet, or newspaper.
Advanced cases of CTS are characterized by constant numbness, as well as loss of strength and dexterity. The presence of constant numbness usually indicates that some degree of irreversible nerve damage has occurred. When this is the case, the goals of surgery shift away from complete cure of symptoms towards halting any further progression.
Other conditions can be confused for CTS. These include but are not limited to diabetes and neck arthritis . It is possible to have a combination of conditions.
Answers By Doctors At First Hand Medical
Surgery for Carpal Tunnel is considered a last resort for treating Carpal Tunnel Syndrome.
It is generally accepted in Medical Schools and by Medical Experts, that invasive treatments that bear multiple risks should be avoided, unless all clinically documented less invasive treatments guided by Doctors have been tried and failed.
It is a medical fact that some people actually get worse after Carpal Tunnel Surgery About 7% to 10%.
Surgeons Claim a 90% success rate. While patients report a 50% to 60% success rate.